Decline in patient arrivals from other states due to lockdown may explain under-count factor falling below one in 2020
The number of “additional deaths” registered by the Civil Registration System (CRS) in Delhi since the COVID-19 pandemic (from April 2020 to June 2021) was an estimated 55,239, which is 2.2 times the officially reported figure of 24,977 COVID-19 cases. -19 death for the same period.
If the period from January to June 2021 is considered, the undercount factor increased to 3.4, which is increasing due to the increase in mortality during the second wave in May and June 2021.
The data on deaths recorded in Delhi from January 2020 to June 2021 was obtained by Hindu Through multiple Right to Information (RTI) queries filed with five urban local bodies. The data for the previous years were drawn from the Annual Report on Registration of Births and Deaths in Delhi.
The additional deaths were calculated as the difference between the total number of deaths registered month-wise during the pandemic period and the average of the deaths recorded for the same months during the pre-pandemic period (2018 and 2019).
If 2020 is considered only, the additional deaths are significantly less than the deaths from COVID-19. Thus, the undercount factor was below one. This could be due to the sudden drop in the number of patients from outside Delhi due to stringent lockdown and border closure during the first wave. The CRS also includes deaths in the migrant population, whereas the death estimates made by the sample registration system only consider deaths among the domicile population. In 2001, the number of registered CRS deaths in Delhi was only 1.1 times the estimated SRS deaths. As of 2018 registered CRS deaths were more than twice (2.25 times) the estimated SRS deaths. This reflects a significant increase in patients from outside Delhi who come to the city’s hospitals to make use of its better healthcare facilities.
Commenting on the under-count factor falling below one in 2020, the Head of the Department of Community Medicine at Safdarjung Hospital, Dr. Jugal Kishor said, “A lot of patients used to come to our hospital from Bihar, UP, Rajasthan, Haryana and all. over the country. But non-Covid patients from other states were very few during 2020, when the lockdown was strict. This year, the lockdown was not that strong and we got more patients from other states. So the undercount factor for 2020 can be explained as being below one. “
Dr. Kishor said, “Delhi’s COVID deaths reporting system initially had some problems and some ups and downs, but later it was rectified.”
“Still, there was under-reporting of COVID deaths because tests could not be conducted or the deaths occurred at home. But Delhi has better reporting of deaths than other states, which is also due to high media presence in Delhi,” he said.
(With inputs from Nikhil M. Babu)