The World Health Organization has estimated the global death toll associated with Covid at 14.9 million, more than double the reported number, between January 2020 and December 2021. And India, with an estimated 4.7 million deaths in this period, featured among the top 20 countries accounting for 80 per cent of the excess mortality, said the WHO report.

The estimated global and India death toll were way higher than the numbers reported to the WHO at 5.4 million and 4,81,000 for the period.

India, though, had pushed back on the data and methodology of the WHO in estimating the overall toll. Even as WHO representatives briefed the media on the latest statistics, the Union Health Ministry issued its rebuttal against the use of mathematical models to arrive at the final estimate. “WHO has released the excess mortality estimates without adequately addressing India’s concerns. India had also informed WHO that in view of the availability of authentic data published through Civil Registration System (CRS) by Registrar General of India (RGI), mathematical models should not be used for projecting excess mortality numbers for India,” said the Ministry.

In past consultations with the WHO, India had questioned the reliance on Global Health Estimates (2019) to arrive at India’s final toll and the classification of the country under Tier II, indicating countries where mathematical modelling estimates were used due to the absence of consistent data. WHO has not responded to India’s contention, said the Ministry.

Responding to multiple queries on the India toll, Samira Asma, Assistant Director-General for Data, Analytics and Delivery at WHO, said they had consulted with representatives in India and would continue to do so.She explained that the report relied on expert opinions from a technical advisory team set up early in the pandemic, comprising representatives from multiple countries.

Somnath Chatterji, Senior Advisor, Department of Data and Analytics, said mathematical models were put in place because high-quality data was absent from some countries or only partly available in others. Stephen MacFeely, Director, Department of Data and Analytics, pointed out that even prior to the pandemic, 6 out of 10 deaths were unregistered, a shocking statistic that underscored the need for countries to invest in their civil registry and vital statistics and health information systems.

Health data was important, they pointed out, not just to understand the pandemic and be prepared for other health emergencies, but also to plan targeted interventions.

Excess mortality

The WHO explained that excess mortality was calculated as the difference between the number of deaths that have occurred and the number that would be expected in the absence of the pandemic based on data from earlier years. It includeddeaths directly or indirectly linked to Covid.

Most of the excess deaths (84 per cent) were concentrated in South-East Asia, Europe and the Americas. Some 68 per cent of excess deaths were from just 10 countries globally. Middle-income countries account for 81 per cent of the 14.9 million excess deaths over the 24-month period, with high-income and low-income countries each accounting for 15 percent and 4 percent, respectively.

The impact of the pandemic has been over several waves with each characterised by unique regional distributions, mortality levels and drivers, the WHO said. “Twenty countries, representing approximately 50 percent of the global population, account for over 80 percent of the estimated global excess mortality for the January 2020 to December 2021 period. These countries are Brazil, Colombia, Egypt, Germany, India, Indonesia, the Islamic Republic of Iran, Italy, Mexico, Nigeria, Pakistan, Peru, the Philippines, Poland, the Russian Federation, South Africa, the United Kingdom of Great Britain and Northern Ireland, Turkey, Ukraine, and the United States of America.”

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