India COVID-19 Excess Deaths Study: “On the nationwide figures, the 5.2 deaths per 1000 resident would indicate over 6 million deaths nationwide if the results could be extrapolated to the entire country,”

[sharon sanders]

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The study uses data on "all-cause mortality" within the district, i.e. the death rate from all causes of death for the population in the given time period are considered.

“On the nationwide figures, the 5.2 deaths per 1000 resident would indicate over 6 million deaths nationwide if the results could be extrapolated to the entire country,” Professor Ramanan Laxminarayan, an economist and epidemiologist and the study's lead author, told ABC News. He is the founder of the University of Washington's Center for Disease Dynamics, Economics and Policy in DC, which contributed to the project.

Deaths were substantially higher in older age groups.

Greater increases in mortality were observed in communities with lower socioeconomic status during the second wave of infections from March 1-June 30, 2021, but not during the first.

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https://abcnews.go.com/Health/indias-staggering-covid-19-death-toll-million-study/story?id=81897534

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Available online 22 December 2021

Articles
All-cause mortality during the COVID-19 pandemic in Chennai, India: an observational study
Author links open overlay panelJoseph ALewnardPhD^aAyeshaMahmudPhD^bTejasNarayan^cBrianWahlPhD^deT SSelvavinayagamMBBS^fChandraMohan BMBBS^fRamananLaxminarayanPhD^dgh

https://doi.org/10.1016/S1473-3099(21)00746-5

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Discussion

We estimated that 5·2 excess deaths occurred per 1000 residents during the COVID-19 pandemic in Chennai, representing a 41% increase over typical mortality levels. Most excess deaths occurred during the second wave of the pandemic, when mortality peaked at levels 4·75-times higher than pre-pandemic observations. However, fewer deaths were registered among children than expected on the basis of pre-pandemic observations. Communities with lower socioeconomic status had reductions in mortality during the early lockdown, but also had the greatest increases in mortality during the second wave. Therefore, such communities had a disproportionate burden of excess deaths overall. These observations provide insight into the impact of the pandemic across demographic groups in an urban setting within India, where knowledge of morbidity and mortality associated with COVID-19 remains incomplete.

Our estimates of excess mortality during the COVID-19 pandemic in Chennai exceed those from numerous higher-income settings. Although the USA, UK, Italy, and Spain have older populations than that of India, these countries recorded 1·6–2·1 excess deaths per 1000 residents through June, 2021,⁶ compared with 5·2 in Chennai. Seroprevalence studies in Chennai identified 41% prevalence of antibody reactivity in October–November, 2020,¹¹ and 82% in June–July, 2021,¹² at the conclusion of the first and second waves. Our findings show considerable excess mortality associated with this uncontrolled SARS-CoV-2 spread, confirming predictions from early modelling studies13, 14 and underscoring the practical limitations of efforts to mitigate COVID-19 mortality through shielding of older or high-risk individuals amid extensive community transmission.¹⁵ The high burden of COVID-19 associated mortality in this setting, and the concentration of excess deaths in socioeconomically disadvantaged communities, casts doubt on hygiene-related hypotheses of reduced SARS-CoV-2 severity in low-income and middle-income countries due to prevalent immunity from other infections.16, 17 Assuming that most observed excess deaths were COVID-19-related fatalities, the infection-fatality ratio in Chennai corresponding to 5·2 deaths per 1000 people and 82% seroprevalence as of July, 2021, would be 0·6%, resembling estimates from demographically similar settings.¹⁸

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00746-5/fulltext

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