India delays release of WHO estimates on global deaths, report says

The World Health Organization is facing resistance from countries including India to release a report on its estimates of global excess mortality from the coronavirus disease, reported Devex.

Excess mortality is the discrepancy between all-cause deaths reported during pandemic years and normal years. The figures are an indicator of the undercount of deaths caused by the coronavirus disease.

Quoting a member of the WHO Technical Advisory Group, the report in Devexreleased on March 30, said the Indian government disagreed with the estimates, which are four times higher than the official figure of around 5.2 lakh.

The WHO estimates were due to be released in early April, but the report has yet to be released.

The Saturday, The New York Times also reported that India was delaying the release of WHO estimates. Citing people familiar with the estimates, the article also estimated that the toll in India was much higher – 40 lakh – than that reported by Devex.

Although India said it had no objections to the estimates, it questioned the methodology used by the global health body to arrive at the figure.

The WHO estimate is based on the country’s data on reported deaths, information from household surveys and the statistical model to include deaths that have not been counted.

“WHO calculations include those deaths directly from Covid-19, deaths of people from conditions complicated by Covid-19, and deaths of those who did not have Covid-19 but needed medical care. ‘treatment they weren’t able to get because of the pandemic,’ the report said.

He added: “The calculations also take into account expected deaths that did not occur due to Covid-19 restrictions, such as those from traffic accidents.”

The New York Times The report said some countries have tracked mortality data and submitted it to the WHO, but India has not done so for the past two years. He also said mortality data was uncertain in India and some other countries.

In order to create mortality estimates for countries that have only partial or no death records, WHO experts used statistical models and made predictions based on the containment measures of a country, historical disease rates, temperature and demographics.

The estimates were projected through a collaboration between the United Nations Department of Economic and Social Affairs and the Technical Advisory Group set up for this task. They started their work in February 2021.

The global health body had invited all member states to nominate someone to engage with the WHO, submit any data they deemed important for the project and nominate national experts to the advisory group.

A team member said Devex that India wanted the estimates released 10 years later.

A spokesperson for the global health body had told the media organization that it was actively engaging with Indian officials to answer their questions.

“While WHO is doing everything to address concerns, this must be balanced against WHO’s obligation to publish health statistics,” the spokesperson said. “Therefore, the estimates will be released, but taking into account India’s reservations.”

Later, WHO spokeswoman Amna Smailbegovic said The New York Times that the report will be published in April.

Dr Samira Asma, WHO’s deputy director-general for data, analysis and delivery for impact, said the release of the estimates had been “slightly delayed”, but added that it was because the health organization wanted to make sure everyone was consulted.

Given the delay, members of the advisory group had warned the WHO that if the estimates were not published, the experts would publish the report themselves, three unidentified officials said. The New York Times.

An estimated 1.50 crore people have died worldwide from Covid-19. The official global toll currently stands at 61.97 lakh, according to data from Johns Hopkins University.

India questions WHO methodology

In a statement, the Union Health Ministry said on Saturday that the WHO used mortality data submitted by Tier 1 countries for their estimates, but applied a mathematical modeling process for projections from Tier 1 countries. 2, which includes India.

He asked how the statistical model used to project estimates for a country that has the geographic size and population of India fits in with other places that have a smaller population.

“Such a unique approach and models that are true for smaller countries like Tunisia might not be applicable to India with a population of 1.3 billion,” the health ministry said. ‘Union.

The Ministry of Health said the WHO model gave different sets of excess death estimates when using data from Tier 1 countries and “unverified data” from 18 Indian states. He said such large variation raises concerns about the validity and accuracy of the model.

The Department of Health said that if the model was reliable, it should be used for Tier I countries, including the United States, Germany and France.

The statement says India’s test positivity rate has not been uniform across the country at any given time, but the model did not account for variation in rates for the estimates.

“Additionally, India has undertaken Covid-19 testing at a much faster pace than the WHO has advised,” he said. “India has maintained molecular testing as the preferred testing methods and has only used Rapid Antigen for screening purposes. Whether these factors were used in the model for India remains unanswered.

The ministry also said the model assumed there was an inverse relationship between temperature and deaths. This means that the lower temperature resulted in a higher toll and vice versa.

The press release indicates that this hypothesis has no scientific basis.

“India is a country of continental proportions, climatic and seasonal conditions vary greatly from state to state and even within a state and as a result all states have widely varying seasonal patterns,” did he declare.

On estimates using containment measures to create death estimates, the ministry said the approach was questionable. He said the lockdown was a “subjective approach” to quantifying and the measures varied by state and district across the country.

The statement also said it was surprising that The New York Times was able to obtain the Covid-19 excess mortality figures for India but was “unable to know the estimates for other countries”.

He added: “While India has remained open to collaboration with WHO as datasets like these will be useful from a policy-making perspective, India believes that a Thorough clarity about the methodology and clear evidence of its validity are essential for policy makers to feel confident about any use of these data.

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Highest toll in India

Several reports pointed out that guidelines were not followed in cases of deaths due to post-Covid complications in India and that crematoriums did not keep proper death records.

In March, medical journal The Lancet had stated in a study that India had the highest number of excess deaths in the world at 40.7 lakh between January 1, 2020 and December 31, 2021.

In June, an article published in The Economist on research by Christopher Leffler of Virginia Commonwealth University suggested that India’s actual toll could be over 20 lakh. India’s official tally at that time was 3,67,081.

A month before that, The New York Times had reported that India’s balance sheet could reach 6 lakh according to conservative estimates, and up to 42 lakh in the worst case. At the time of the report’s release, India’s official balance sheet was 3.15 lakh.

The Center rejected all of these reports.

Jacob L. Thornton