Bihar recorded 251k excess deaths since Covid-19 pandemic: Data
There were at least 251,000 excess deaths registered under the Civil Registration System (CRS) in Bihar since the start of the Covid-19 outbreak (from March 2020 to May 2021), which is 48.6 times the official number of confirmed coronavirus deaths (5,163) in the state in the same time period, data accessed by HT shows.
The figures from Bihar, based on deaths registered in the state’s Civil Registration System between January 2015 and May 2021, present one of the largest deviations in excess mortality seen in such calculations of any state in the country so far.
“Excess death” or mortality is a generalised term that refers to the total number of deaths occurring due to all causes during a crisis that is above and beyond what would have been expected under regular conditions. To be sure, not all such excess deaths may be due to Covid-19, but during a pandemic such major deviations in fatalities is likely to be either directly or indirectly caused by the outbreak and the stress it had caused on a region’s healthcare system.
For the analysis here, the CRS data from the pre-pandemic period (January 2015 to February 2020) has been averaged to establish an all-cause mortality baseline, which has then been compared to the deaths registered from March 2020 onwards, resulting in the number of “excess deaths”.
Internationally and domestically, such data has provided vital information on the true toll of the pandemic on human life.
For Bihar, data shows that there were 251,053 “excess deaths” since the start of the outbreak compared to the corresponding four-year period before the pandemic (2015-2019). The state’s official Covid-19 death toll till the end of May was 5,163. This means CRS data showed that the official Covid-19 death toll had an undercount factor of 48.6 times.
Of these, over 126,000 such excess deaths were reported in the first five months of 2021 against 3,766 reported Covid-19 deaths in the same period – resulting in an undercount factor of 33.7 this year.
During the Covid-19 outbreak, such data, calculated from CRS – a national system of recording all births and deaths, under the Office of the Registrar General of India and implemented on the ground by state governments – is being used to count the number of deaths that would not have occurred had the pandemic never happened.
Similar analysis conducted by several news organisations such as The Hindu, Scroll, The News Minute, Article 14, among others, have estimated the undercount factor for different states, cities and districts in the country. Such estimates have been arrived at for Andhra Pradesh, Assam, Gujarat, Himachal Pradesh, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Punjab, Tamil Nadu, Uttar Pradesh and West Bengal, and have shown a wide range of undercount factors — as little as 0.42 times in Kerala to 43 times in UP (based on data from 24 of the state’s 75 districts).
The findings from Bihar, however, appear to show the highest undercount factor in the country so far. This is not surprising as the state ranks the second lowest in the country (after UP) in Niti Aayog’s Health Index, 2020, and despite being home to 9% of the country’s population, has seen 9,649 confirmed deaths due to Covid, accounting for just 2.2% of the total 432,138 fatalities in the country till August 19, according to HT’s Covid dashboard.
Globally, the World Health Organization (WHO) has estimated that Covid-19 deaths may be as much as two-three times the officially reported numbers.
To be sure, as pointed out by Shamika Ravi in a July 14 article in HT, such an analysis suffers from certain shortcomings: historically, not all deaths in India are registered under CRS, which is why the Sample Registration System (SRS) – an annual survey conducted by the Office of the Registrar General in India – is considered the primary source of annual estimates of deaths. Furthermore, she writes that registered deaths are not necessarily domiciliary, while deaths, if registered at all, may not be reported promptly. She added that the level of registration from CRS to the estimated deaths from SRS is not uniform across the country and over time.
Another factor in the increase in CRS numbers may be the improvement in registration of deaths in the country. According to the CRS’ 2019 annual report on “vital statistics”, while only 20.7% deaths in the country were medically certified, registration of deaths in India has improved to more than 90%.
Thus, it is possible that the period since March 2020 has seen a sharp improvement in registration of deaths, resulting in the spike seen, with very little or none of the increase being on account of Covid-19.
Indeed, despite the apparent improvement in registration of deaths, the CRS data from Bihar shows fluctuations – there were 204,093 registered deaths in 2015, but it dropped to 177,021 in 2016, then spiked to 261,425 in 2017, before dropping again in 2019 (213,989).
Still, the magnitude of the difference since last March (a quarter of a million) is staggering.
Bihar health minister Mangal Pandey said that he cannot comment on CRS data, but all the Covid-19 related deaths have been verified by district magistrates and civil surgeons.
“That is why we were able to give a revised death figures in June. Yet we have from time-to-time requested to all if there has been death in their family where the cause in death certificate is mentioned as Covid 19, they can get their entry recorded and claim the compensation announced by the state government,” said the health minister.