India recorded 11.9 lakh excess mortality in 2020, the first pandemic year: Study

New Delhi: India has recorded an estimated 11.9 lakh (1.19 million) excess Covid-19 deaths in 2020, eight times more than the official figure, according to a new study, which suggests a very high death toll in the first year of pandemic itself, with marginalised populations like Adivasis, Dalits, and Muslims bearing the brunt and women suffering more than men.

The research, led by Indian-origin scholars--a sociologist at the University of Oxford, and an economist at the City University, New York--for the first time probed the pandemic’s impact on age, gender and social disparity using official data, and found that females and deprived sections of the society experienced a greater decline in life expectancy.

Their analysis of pandemic-linked loss of life-expectancy at birth across different social groups revealed that Muslims were the worst sufferers as their life expectancy came down by 5.4 years followed by the Scheduled Tribe (4.1 years) and Scheduled Caste (2.7 years) population. In comparison, higher caste Hindus, and OBCs (Other Backward Classes) lost 1.3 years.

The loss of life expectancy was 3.1 years for females and 2.1 years for males. Combining both, the overall loss in life expectancy in India was 2.6 years, according to the study that used data from the National Family Health Survey-5 conducted during 2019-21.

Such a large female disadvantage in the pandemic's impact, as observed in India, has not been documented in any other country. Moreover, the mortality was 17 per cent higher in 2020.

“What makes our study novel is that we are able to look at differences in mortality by age, sex, and social group, and show that there were very unequal impacts of the pandemic in India,” Sangita Vyas, an economist at the City University, New York and one of the corresponding authors of the study told DH.

“Life expectancy declines in India were larger and had a younger age profile than in high-income countries. In contrast to global patterns, females in India experienced a life expectancy decline that was one year larger than losses for males. Also, marginalised social groups experienced greater declines than the most privileged social group,” she said.

Such loss of life expectancy is similar or greater than declines experienced by the Blacks, Hispanics and Native Americans in the USA, says the study published in Science Advances on Friday.

Reacting to the study, NITI Ayog Member (Health) Vinod Paul told DH, “There are serious methodological flaws in the study because of which the researchers arrive at wrong conclusions.”

Quoting India’s civil registration system (CRS) that registered over 99 per cent of all deaths, Paul said, “Compared to 2019, there were 4.74 lakh extra or excess deaths in 2020. The estimate of 11.9 lakh excess deaths concluded in the study is untenable and unacceptable.”

“India reported 1.49 lakh Covid deaths in 2020 which were surely a part of the CRS excess number. But all excess deaths in CRS are not attributable to the pandemic. Excess number is also due to an increasing trend of death registration in CRS (it was 92 per cent in 2019) and a larger population base in the succeeding year,” he added.

The new research comes nearly two years after the World Health Organisation released a global report on excess Covid-19 deaths, missed by the country’s own surveillance system. Going by the WHO report, there were 4.74 million excess deaths in India in 2020 and 2021.

Vyas pointed out that her team’s estimate was 1.5 times the WHO estimate of 8,00,000 and eight times more than the official figure of about 1,50,000 Covid deaths by 2020.

The WHO report, they say, is based on an incomplete dataset from 17 states and union territories whereas the team led by Vyas and Oxford sociologist Aashish Gupta use a set of NFHS data collected in 2021 to study the mortality in 2020. The data collection for NFHS-5 took place between 2019 and 2021.

The mortality in 2020 did not receive as much attention as in 2021 when there was a steep surge due to an unprecedented strike by the Delta variant of the virus. “The pandemic exacerbated the long-standing inequalities in population health,” the study says.

Paul, a former professor at the All India Institute of Medical Sciences and the government’s principal advisor on Covid-19 said he did not concur with the study’s conclusion of more women dying from Covid-19 than men. “Excess death distribution in the CRS data and analysis of Covid deaths clearly show male predominance” he said.

“The researchers used data from a small sample of a part of the geography of only 14 states/UTs, and extrapolated it to the entire country. We don’t agree with their conclusions."

Asked about the Indian government’s previous rejection of similar studies, Vyas said, “Very little has been known about the social gradient of the pandemic in India. Regardless of how the study is received, it is important to document these facts for researchers, civil society, and the broader public. This might be helpful for routine mortality surveillance and future mortality crises.”

Other researchers in the team are from the University of California, Berkeley; University of Texas, Austin; Emory University; Paris School of Economics and Heidelberg Institute of Global Health.