COVID-19 deaths are being underreported across India, an investigation by The Wire Science has found. Such non-reporting falls broadly into two categories.
In the first category, a city counts only those deaths of patients who tested positive for the virus – i.e. ‘confirmed COVID-19 deaths’ – in its official toll. When patients who have symptoms of COVID-19 but aren’t tested, test negative or have an inconclusive result die, their deaths aren’t included.
While epidemiologists refer to such deaths variously as ‘suspected COVID-19 deaths’, ‘probable COVID-19 deaths’ and ‘clinically diagnosed COVID-19 deaths’ – based on several criteria – this article will use the blanket term ‘suspected deaths’ for all of them.
Despite there being other ways to diagnose COVID-19 patients, most Indian states are not reporting suspected deaths. The Wire Science spoke to municipal officials, health-department officials and officials from the Integrated Disease Surveillance Programme in seven states and union territories: Maharashtra, Gujarat, Telangana, Tamil Nadu, Uttar Pradesh, Madhya Pradesh and Puducherry, all of whom said they weren’t including suspected deaths in their published COVID-19 death tolls.
Suspected deaths make up a major blindspot for India because all nucleic acid tests used to confirm COVID-19, like CBNAAT and RT-PCR, sometimes return false negatives. So even a patient who is infected with the virus can test negative. More than 30% of RT-PCR results can be falsely negative depending on when the patient’s sample was collected.
Another issue with not reporting suspected deaths is that several states still conduct too few RT-PCR tests, ergo many infections may never be confirmed. When some of these people die, not counting them among COVID-19’s victims can deflate the disease’s death toll.
A series of reposts:
COVID-19 deaths are being underreported across India, an investigation by The Wire Science has found. Such non-reporting falls broadly into two categories.
In the first category, a city counts only those deaths of patients who tested positive for the virus – i.e. ‘confirmed COVID-19 deaths’ – in its official toll. When patients who have symptoms of COVID-19 but aren’t tested, test negative or have an inconclusive result die, their deaths aren’t included.
While epidemiologists refer to such deaths variously as ‘suspected COVID-19 deaths’, ‘probable COVID-19 deaths’ and ‘clinically diagnosed COVID-19 deaths’ – based on several criteria – this article will use the blanket term ‘suspected deaths’ for all of them.
Despite there being other ways to diagnose COVID-19 patients, most Indian states are not reporting suspected deaths. The Wire Science spoke to municipal officials, health-department officials and officials from the Integrated Disease Surveillance Programme in seven states and union territories: Maharashtra, Gujarat, Telangana, Tamil Nadu, Uttar Pradesh, Madhya Pradesh and Puducherry, all of whom said they weren’t including suspected deaths in their published COVID-19 death tolls.
Suspected deaths make up a major blindspot for India because all nucleic acid tests used to confirm COVID-19, like CBNAAT and RT-PCR, sometimes return false negatives. So even a patient who is infected with the virus can test negative. More than 30% of RT-PCR results can be falsely negative depending on when the patient’s sample was collected.
Another issue with not reporting suspected deaths is that several states still conduct too few RT-PCR tests, ergo many infections may never be confirmed. When some of these people die, not counting them among COVID-19’s victims can deflate the disease’s death toll.
(To be continued)