A report in the New York Times has suggested that India’s actual toll from Covid could be about double the official count in an optimistic case scenario and up to nearly 14 times the recorded numbers in a worstcase scenario. That would imply at least 6 lakh deaths and at worst 42 lakh deaths.
The NYT put together these estimates by talking to “more than a dozen experts” including Dan Weinberger of the Yale School of Public Health. The estimates, the report says, are based on extrapolations from sero surveys for the true number of infected people and assumptions about the infection fatality rate, a measure of the number of people who die for every 100 infected.
The report points out that while official figures miss deaths all over the world, “the undercount of cases and deaths in India is most likely even more pronounced, for technical, cultural and logistical reasons”. With hospitals overwhelmed, many Covid deaths occur at home, especially in rural areas, and are omitted from the official count, it quoted Kayoko Shioda, an epidemiologist at Emory University, as saying. It also said that even in the best of times, four out of five deaths in India are not medically investigated.
The best-case scenario assumes that actual infections are about 15 times the number of cases detected, that is about 40.4 crore. It assumes an IFR of 0.15% which gives 6 lakh deaths. A second scenario, which the report describes as “a more likely scenario” takes the actual infections at 20 times what’s been detected by tests, or 53.9 crore. It assumes the IFR is 0.30%, “in line with what has been estimated in the US at the end of 2020”. That gives a figure of 16 lakh deaths or over five times the official count of 3 lakh.
The most alarming scenario assumes there are 26 actual infections for every detected case — based on the last national sero prevalence study that ended in January — which puts the number of infected at just over 70 crore. It also assumes an IFR of 0.6% “to take into account the tremendous stress that India’s health system has been under during the current wave”. Those assumptions yield a toll of 42 lakh or 13.7 times what the official numbers suggest.