The Union Health Ministry criticised on Saturday stating that a paper published in the academic journal Science Advances, describing its findings on life expectancy during the COVID-19 pandemic in India in 2020 is based on “untenable and unacceptable” estimates. Despite the claims of the authors about adhering to the standard methodology using the National Family Health Survey-5 (NFHS-5), the ministry highlighted that there are critical flaws.
“The most important flaw is that the authors have taken a subset of households included in the NFHS survey between January and April 2021, compared mortality in these households in 2020 with 2019, and extrapolated the results to the entire country,” it said, PTI reported.
The NFHS sample represents the country only as a whole, and the 23 per cent of households analysed from 14 states cannot be considered representative of the entire nation, it also said. “The other critical flaw is related to possible selection and reporting biases in the included sample due to the time in which these data were collected, at the peak of the COVID-19 pandemic,” the Ministry added.
Civil Registration System (CRS) Data
The paper incorrectly suggests the need for such analyses by claiming that important registration systems in low and middle-income countries, including India, are weak. “This is far from being correct. The Civil Registration System (CRS) in India is highly robust and captures over 99 per cent of deaths. This reporting has constantly increased from 75 per cent in 2015 to over 99 per cent in 2020,” the statement further added.
As per the ministry report, CRS data showed an increase of 474,000 death registrations in 2020 as compared to 2019, with similar increases in previous years (486,000 in 2018 and 690,000 in 2019). Not all deaths in a year are ascribed to the pandemic; some are due to an increasing trend in death registration and a growing population.
“It is strongly asserted that an excess mortality of about 11.9 lakh deaths reported in the ‘Science Advances’ paper in 2020 over the previous year is a gross and misleading overestimate,” the statement mentioned.
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It is important to note that excess mortality during the pandemic means an increase in deaths due to all causes, and it cannot be compared with deaths that are the result of COVID-19, it said.
The incorrect estimates released by the researchers are further confirmed by data from India’s Sample Registration System (SRS), which encompasses a population of 84 lakh in 24 lakh households across 8,842 sample units in 36 states and UTs, it also said.
The ministry stated that although the authors go to great lengths to demonstrate the comparability of the results from the NFHS analyses and SRS analyses for 2018 and 2019. But, they completely neglect to mention that the SRS data for 2020 shows very little, if any, excess mortality when compared to the 2019 data (crude death rate 6.0/1000 in 2020 vs. 6.0/1000 in 2019) and no decline in life expectancy.
The paper presents findings on age and sex that contradict existing research and program data on COVID-19 in India. It claims that excessive mortality was higher among females and younger age groups, particularly children aged 0-19. However, data from approximately 530,000 recorded COVID-19 deaths, along with research data from cohorts and registries, consistently show higher mortality rates in males compared to females (at a ratio of 2:1) and in older age groups.
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