Is Tamil Nadu underreporting deaths? By what percentage is the underreporting happening? A study by Arappor Iyakkam, a Chennai based anti-corruption watchdog, has revealed startling details. After looking at data from six government hospitals across the state in April and May 2021, the NGO found that deaths were 8.4 to 9.8 times more than that reported by these six hospitals. And if extrapolated to deaths recorded during April and May 2021 in the entire state, the report estimates that Tamil Nadu must have seen at least 1,08,721 and 1,26,841 people dying in these two months respectively as against 12,943 deaths reported in the state medical bulletins for April and May together.
The NGO initiated the study using the data provided by six hospitals for the past three years. The six hospitals are Government Rajaji Hospital, Madurai; Coimbatore Medical College Hospital; Mahatma Gandhi Memorial Medical College and Hospital, Trichy; Vellore Medical College; Karur Medical College; and Tirupur Government Headquarters Hospital. The six geographically different hospitals were chosen for the study since data on death certificates issued from these hospitals were uploaded for all three years - 2019 (a pre-pandemic year), 2020 and 2021. The study was conducted by collecting data on the number of death certificates issued by the six hospitals to the kin of the deceased between January and May in 2019, 2020 and 2021.
As per the data, the deaths reported by the six hospitals in April 2019 stood at 2,117, while it was 1,440 in April 2020 and 3,009 deaths in April 2021. During May 2019, the deaths reported by these hospitals stood at 2,320, It decreased in May 2020 to 1,821 but the hospitals reported a whopping increase in May 2021 - 8,690 deaths - indicating a sharp increase in the mortality rate.
The Arappor Iyakkam report said, “The dip in April 2020 may be attributed to the lockdown in April 2020 when coronavirus first wave was in its early phase. It could also be attributed to prevention of other deaths such as road accidents because of the lockdown and suspension of many surgeries. However, in April 2021, with the start of the second wave, we have seen a big increase in mortality.” The NGO then compared this data with the number of deaths declared in the government bulletins and found that the numbers were not matching.
In these six hospitals, the Tamil Nadu Department of Health and Welfare declared 66 deaths in April and 797 deaths in May. Hence, the report concluded, “Overall, mortality in these 6 hospitals is 13.6 times the reported COVID-19 deaths by government in these hospitals for months of April and May 2021. Deaths that are due to COVID-19 and its complications are likely to be 8.4 times to 9.8 times more than the number of deaths declared by the Department of Health and Welfare for these 6 hospitals.”
If extrapolated to the entire state, the report said, “Approximating the same underreporting factor of 8.4 to 9.8 times for the entire state, the likely number of deaths due to Covid in TN may be between 1,08,721 and 1,26,841 against the reported number of 12,943.”
Stating the discrepancies, Arappor Iyyakam has recommended that as a first step the Tamil Nadu government should accept that there is massive underreporting of coronavirus deaths and further ensure transparency by releasing death certificates, mortality data and consolidations of hospital and home deaths for the past three years. The NGO also demanded that the government mention the cause of death in the final death certificates uploaded online and provide medical certificates for cause of death.
The NGO urged the government to set up an independent committee to audit the deaths that happened during the pandemic and reissue the cause of death certificate to help eligible families receive COVID-19 compensation.