Dr. Gyan Chandra Kashyap
Context : India is still under the ruthless grip of Covid-19 in the second wave of the pandemic; overall, cases started declining across states in India, but states such as Maharashtra and Karnataka are among the worst affected states in the country.1 However, Karnataka’s covid-19 case fatality rate is the highest in the southern states in India.2 It was observed that Karnataka is lagging in death registration during the covid pandemic. The sharp decline in the out-and-out number of deaths registered by civil authorities during the Covid-19 crisis has been attached to a general lag of several months in the registration of deaths. Data on Karnataka’s birth and death registration tell that a total of 2,69,029 deaths were recorded between January and July 31, 2020, in the state contrasted to 2,79,835 in 2019 and 2,83,484 in 2018.3–4
COVID and Deaths in Karnataka: Evidence suggests that Karnataka has seen more than 28,000 deaths due to covid-19 in the past year (June 2020 to May 2021).5 However, around 12,000 deaths occurred in the last 30 days.6 Till date, the Karnataka death proportion would be 8.7% of total reported deaths happened in India.7 Moreover, according to the sample registration system (SRS), there was a steep decline in the death rate (7.2 to 6.3 deaths per 1000 population in Karnataka) in the last decade. Moreover, this decline can be observed in rural (8.3 to 7.2 per 1000 population) and urban (5.3 to 4.8 deaths per 1000 population) areas.8
Considering the latest estimate (6.3 deaths per 1000 population), the total number of deaths would be around 4.41 lakh (based on the projected population of Karnataka in the year 2021, 7 crores).9 In addition to this, several deaths could be counted as covid deaths, whether reported or not reported in Karnataka. Of course, these deaths will expand the crude death rate of Karnataka.
From the figure, we can understand that a huge number of covid deaths were reported (around 1,2000 in the last one month) while an equal number of deaths were reported in the first wave of covid-19 in Karnataka. During last month, seven days death average and a number of deaths were moving parallelly.10
Source: COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. https://github.com/CSSEGISandData/COVID-19
Source: Sample Registration System (SRS), Census of India
Vital Event Registration
Karnataka’s death registration system maintains records of all the deaths, births, and stillbirths electronically all over Karnataka. All these vital events that occur in rural areas are registered in eJanMa by Village Accountants through Nada Kacheri at Hobli level and in the urban local body area, and the Bruhat Bengaluru Mahanagara Palike (BBMP) area is also recorded in e-JanMa by health officers and health inspectors in their respective area
Across India, cities, and villages have assumed that government officials could not register all the casualties due to many issues during the covid-19 pandemic.11 In a large country like India, where around 1.35 billion people live in different settings (rural, urban, semi-urban), it is unfeasible to collect the information of deaths accurately, especially in a pandemic situation. In India, there are huge differences stated through various media in the actual number of deaths and deaths due to covid-19. Eventually, the government has provided the number of deaths data based on information collected of those demised individuals who tested positive and died during the treatment in a medical facility. At the same time, in most cases, the person who died after tested covid positive had comorbidities that have reported the cause of deaths as comorbidity, not the covid-19. A sizable number of deaths that happened at home were not counted in the covid deaths. Especially in the rural areas where testing was deficient, many people got infected with Covid-19, and due to the lack of medicine and proper treatment on time, they died, so all these deaths were not reported. Recently, thousands of dead bodies were found under the sand in the bank of river Ganga, and many were floating in the river Ganga was identified in Uttar Pradesh.12
Karnataka government’s decision on dead bodies that permit cremation, the burial of dead bodies at private lands and farmhouses owned by their families probably helped ease a bit of challenges as seen in UP and Bihar.13 For that, strict guidelines were issued by the health department. However, during the second wave of COVID -19 surge, many dead bodies were piling up before the last rights.14 Deaths at home increased during this period too. It is common knowledge that the deaths due to the unavailability of beds and hesitancy (because of covid infection fear) to visit hospitals, people preferred to stay at home in isolation. It was noticed that a sizable proportion of people died at home (in home isolation).15 Hence, it would be challenging to get the exact number of deaths that happened in home isolation. If we can get the number of deaths that happened in home isolation, the number of bodies cremated burial ground/farmhouse and at cremated any other places, along with that total number of covid deaths reported by the health department would be the approximate deaths in Karnataka. As the crude death rate of Karnataka was 6.3 per 1000 population and due to the enormous rise in the number of covid deaths, we can see the massive incline in the number of deaths in Karnataka (in SRS, 2022 report). Then we may be able to ascertain that the increase in crude rate is because of deaths due to COVID-19 in Karnataka.
- COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. https://github.com/CSSEGISandData/COVID-19