For months, India has been struggling to control the coronavirus pandemic with limited success.
The country of 1.3 billion people has the second-highest number of cases globally (more than 4.4 million), and the third highest number of deaths (over 75,000), according to Johns Hopkins University – and the outbreak shows no sign of abating.
But India’s reported mortality rate – calculated by the number of deaths per 100 confirmed cases – is surprisingly low compared to other countries with high infection rates.
India’s Covid-19 mortality rate stands at 1.7%. For context, the same rate is about 3% in the US, 11.7% in the UK, and 12.6% in Italy, according to Johns Hopkins University.
The Indian government claims India’s lower death rate is a sign of its success in handling the crisis, and has used the figure to support its decision to lift some coronavirus restrictions.
“The average fatality rate in the country is … continuously going down,” said Prime Minister Narendra Modi in a press release in August. “The target of bringing down the fatality rate below 1% can be achieved soon.”
But some scientists in India warn that the numbers are incomplete and misleading – and that relying on them to reopen the country could make matters worse.
How bad is Covid-19 in India?
Though the number of reported cases had been steadily increasing since March, India’s epidemic intensified in June, when transmission began increasing at an exponential rate.
It took almost six months for India to record 1 million cases on July 17. Then, it took another three weeks to hit 2 million, 16 days to reach 3 million, and only 12 days to pass 4 million in early September.
New Delhi and Mumbai, the country’s two most-populous cities, are among the worst hit. In those cities, the crisis is exacerbated by slums where millions live in cramped conditions with little running water or sanitation.
The country was placed under a complete lockdown in March, forcing millions to remain indoors. The move devastated the economy, leaving millions of migrant workers without income and further marginalizing India’s poorest people.
Under pressure, the government began rolling back restrictions in May despite soaring infections. In July, Delhi Chief Minister Arvind Kejriwal said India needed to turn its attention to the economy: “We now have to focus on the next stage. During Covid people lost their jobs, factories were closed, people faced losses, it became difficult for people to face themselves … Let us now focus on reviving India’s economy.”
Earlier this month, India’s subway reopened for the first time in five months, and from September 21 gatherings of up to 100 people will be permitted at sports, entertainment, cultural, religious and political events outside hotspots.
Are the statistics on death accurate?
The number of coronavirus cases in India may be rising, but the mortality rate is dropping. According to the Health Ministry, deaths per 100 cases went from 4% in April to 2.15% in August, and is now under 2%.
But some experts warn that the data is full of gaps. India has a weak, underfunded public health infrastructure, and for years it has failed to accurately record the deaths of its own citizens.
Even when India isn’t facing a pandemic, only 86% of deaths nationwide are even registered in government systems. And only 22% of all registered deaths get an official cause of death, certified by a doctor, said community medicine specialist Dr Hemant Shewade.
There are a few reasons behind this. The majority of people in India die at home or other places, not in a hospital, so doctors usually aren’t present to assign a cause of death.