In a report released on Thursday, the WHO estimated that nearly 15 million people were killed either by the coronavirus or by its impact on overwhelmed health systems in the past two years, more than double the official death toll of 6 million
According to the WHO report, there were 4.7 million Covid deaths in India — 10 times the official figures and almost a third of Covid deaths globally
NEW DELHI:
India on Thursday strongly objected to the use of mathematical models by the World Health Organization (WHO) for projecting excess mortality estimates linked to the coronavirus pandemic in view of the availability of authentic data, saying validity and robustness of the models used and methodology of data collection are questionable.
In a report released on Thursday, the WHO estimated that nearly 15 million people were killed either by the coronavirus or by its impact on overwhelmed health systems in the past two years, more than double the official death toll of 6 million.
Most of the fatalities were in Southeast Asia, Europe and the Americas.
In a press briefing on Thursday organised by World Health Organisation (WHO) said that India had 4.7 million “excess” COVID deaths, 10 times more than the official figure.
The technical officer at the department of data and analytics William Msemburi said, “The reported Covid-19 number is 481,000 and the estimated excess is 4.74 million. So 481,000 reported COVID-19 numbers and then an excess mean of 4.7 million.
The uncertainty around that is 3.3 million to 6.5 million. So, those are the estimated numbers for India.
According to the report, there were 4.7 million Covid deaths in India — 10 times the official figures and almost a third of Covid deaths globally.
India likely to raise the issue at the World Health Assembly and required multilateral forums, sources said.
India has been consistently objecting to the methodology adopted by the WHO to project excess mortality estimates based on mathematical models, the Union Health Ministry said in a statement.
“Despite India’s objection to the process, methodology and outcome of this modelling exercise, WHO has released the excess mortality estimates without adequately addressing India’s concerns,” the statement said.
India had also informed the WHO that in view of the availability of authentic data published through Civil Registration System (CRS) by the Registrar General of India (RGI), mathematical models should not be used for projecting excess mortality numbers for India.
Registration of births and deaths in India is extremely robust and is governed by decades old statutory legal framework, i.e.
Dr VK Paul, Member-Health, NITI Aayog, speaking to ANI said, “Unfortunately, in spite of our emphatic writing, rational communication at the ministerial level, they have chosen to use the number that is based on modelling assumptions– one size fits all kind of assumptions.
Dr Paul said that India has been telling WHO that the country does not agree with the methodology followed by India. “We understand that this report has covered what they label as excess mortality, in the year spanning COVID19. India has been telling WHO via diplomatic channels with data that we don’t agree with the methodology followed for us,” he added.
However, Director-General of the Indian Council of Medical Research (ICMR) Dr Balram Bhargava said, “Once we have this systematic data, we do not need to rely on modelling, extrapolations and taking press reports and utilising them for putting into a modelling exercise.”
All India Institute of Medical Sciences in New Delhi Director Randeep Guleria objected to the WHO’s approach and gave three reasons for it.
“I have objections and I will give three reasons for that. India has a very robust system of birth and death registration which has been going on for decades. We know it works very well and that data is available,” said Guleria.
AIIMS Director further said that data should be used to see the number of excess deaths that happened during this time and excess deaths that could be attributable to COVID and WHO didn’t use that data.
“Secondly– data that WHO used is more on hearsay evidence– what’s there in media or unconfirmed sources. That data is questionable. Modelling on that data isn’t the correct and scientifically right thing to do, especially, when you have data that is more robust,” he said. Giving the last reason Dr Guleria said India has been very liberal in offering compensation for people who died of COVID, that is, there is a very open manner.
“So, even if there were excessive deaths that were COVID related, they would have been recorded because people would have come forward, and their relatives would have come forward for compensation. This has not been the case as far as the numbers that WHO is predicting,” said AIIMS Director. Further speaking on WHO’s claim on COVID deaths in India, he said that India needs to present the data which is scientific and more on an evidence basis.
“So, the prediction seems to be way beyond what actual numbers are and is based on data that is not substantiated. That is why I think that this is something which we, as a country, should object to and we need to present our data which is scientific and more on evidence basis,” he added.
“Births & Deaths Registration Act, 1969”.
The civil registration data as well as sample registration data released annually by the RGI has been used by a large number of researchers, policy makers and scientists both domestically and globally, the ministry said.
The RGI is over a century old statutory organisation and is assisted by chief registrars of states and union territories and about three lakh registrars and sub-registrars across the country.
Based on reports submitted by states and UTs, national reports are published annually by the RGI.
The national report for the year 2019 was published in June 2021 and for the year 2020 on May 3, 2022.
These reports are in public domain.
“India firmly believes that such robust and accurate data generated through Legal Framework of a Member State must be respected, accepted and used by WHO rather than relying on less than accurate mathematical projection based on non-official sources of data,” the statement stated.
India had pointed out the inconsistencies in the criteria and assumption used by the WHO to classify countries into Tier I and II as well as questioned the very basis for placing India into Tier II countries, for which a mathematical modelling estimate is used.
India had also underlined the fact that given the accuracy of the mortality data collected through an effective and robust statutory system, India doesn’t deserve to be placed in Tier II countries, the statement said.
“WHO till date has not responded to India’s contention. India has consistently questioned WHO’s own admission that data in respect of seventeen Indian states was obtained from some websites and media reports and was used in their mathematical model. This reflects a statistically unsound and scientifically questionable methodology of data collection for making excess mortality projections in case of India,” the statement said.
Throughout the process of dialogue, engagement and communication with WHO, it has projected different excess mortality figures for India citing multiple models, which itself raises questions on the validity and robustness of the models used.
India objected to the use of Global Health Estimates (GHE) 2019 in one of the models used by WHO for calculating excess mortality estimates for India.
GHE itself is an estimate.
“Therefore, a modeling approach which provides mortality estimates on the basis of another estimate, while totally disregarding the actual data available within the country, exhibits lack of academic rigour,” the statement said.
The test positivity rate — another key variable used by the WHO — for COVID-19 in India was never uniform throughout the country at any point of time.
Such a modeling approach fails to take into account the variability in Covid positivity rate both in terms of space and time within the country.
The model also fails to take into account the rate of testing and impact of different diagnostic methods (RAT/RT-PCR) used in different geographies, the statement stated.
Owing to its large area, diversity and a population of 1.3 billion which witnessed variable severity of the pandemic both across space and time, India consistently objected to the use of “one size fits all” approach and model, which may be applicable to smaller countries but cannot be applicable to India, it said.
In spite of these differences, India continued to collaborate and coordinate with WHO on this exercise and multiple formal communications — 10 times from November 2021 to May 2022 — as well as numerous virtual interactions were held with the global body.
“Despite communicating this data to WHO for supporting their publication, WHO for reasons best known to them conveniently chose to ignore the available data submitted by India and published the excess mortality estimates for which the methodology, source of data, and the outcomes has been consistently questioned by India,” the statement said.