India issued a statement on Saturday, questioning the UN health agency WHO’s methodology in compiling the report on COVID-19 mortalities in the country, in a rebuttal to the New York Times article titled ‘India Is Stalling WHO’s Efforts to Make Global Covid Death Toll Public’ published on 16 April.
The Union health ministry in the statement said that India has on several occasions shared its concerns with the global health agency over the methodology used.
India argued that the mathematical model used by WHO to reach the estimate of deaths cannot be used for such a vast nation as India, considering its enormous size and population.
The World Health Organisation data shows India’s coronavirus death toll is at least four million while India has stood by its own count of about 520,000, The New York Times reported. The WHO data would give India the highest tally in the world.
The WHO uses mathematical modelling for Tier 2 countries like India, whereas for Tier 1 countries like USA, Germany, France, the data sets submitted by the countries are used.
India does not reject the global health agency’s estimates but questions the methodology used.
India is not the only country raising this issue. China, Bangladesh, Syria, Iran, Egypt, Ethiopia has also questioned the validity of the methodology and sources of information which they claim as “unverified data.”
India asks that the model should be run in all Tier 1 countries and it’s results shared with other countries, to determine its validity and accuracy. It also attacked the model for its rigidity and lack of flexibilty. The same model is used for countries as small as Tunisia (population =12 million ) and as large as India (population = 1.3 billion).
“Such one size fit all approach and models which are true for smaller countries like Tunisia may not be applicable to India with a population of 1.3 billion,” the Union health ministry said.
India is a country of continental proportions, climatic and seasonal conditions vary vastly across different states and even within a state and therefore, all states have widely varied seasonal patterns.
“Thus, estimating national level mortality based on these 18 states data is statistically unproven,” the statement stated.
Ministry said the use of “subjective approach” on the estimates to create death estimates was questionable. It said that the containment was a “subjective approach” to quantify and that the measures varied among states and districts in the country.
The statement also said it was surprising the The New York Times could obtain the figures of excess COVID-19 mortality for India but was “unable to learn the estimates for other countries.”
“The test positivity rate for Covid in India was never uniform throughout the country at any point of time. But, this variation in Covid positivity rate within India was not considered for modelling purposes. Further, India has undertaken COVID-19 testing at a much faster rate than what WHO has advised. India has maintained molecular testing as preferred testing methods and used Rapid Antigen as screening purpose only. Whether these factors have been used in the model for India is still unanswered,” the statement stated.
“While India has remained open to collaborate with WHO as data sets like these will be helpful from the policy making point of view, India believes that in-depth clarity on methodology and clear proof of its validity are crucial for policymakers to feel confident about any use of such data,” read the statement.
The WHO calculation combined national data on reported deaths with new information from localities and household surveys, and with statistical models that aim to account for deaths that were uncounted or missed, according to NYT.
The UN health agency has calculated that 15 million people have died as a result of the pandemic across globe by the end of 2021, far more than earlier estimates, but has yet to release those numbers.
It is more than double the official total of six million reported by countries individually.
More than a third of the additional nine million deaths are estimated to have occurred in India, UN agency claims.