On April 16, India gave a befitting reply to The New York Times accusing India of stalling World Health Organization (WHO) efforts to make the global Covid death toll public.

The NYT report also cast aspersions on Covid deaths data reported by the Indian government.

In a press release, the Ministry of Health and Family Welfare said that India had regular and in-depth technical exchanges with WHO over the issue of the Covid death toll.

The ministry raised concerns over the methodology used by the study to calculate the estimated number of deaths that might have actually occurred across the world. The ministry said that the analysis used the figures collected from the Tier-1 set of countries and used a mathematical modelling process for Tier-II countries including India. It added that India does not just question the result of the analysis but the methodology itself.

It further read that on several occasions, India shared its concerns with other member states via formal communications and issued six letters to WHO, once in November 2021, twice in December 2021, and again in January, February, and March 2022.

Four virtual meetings were also held over the issue. “During these exchanges, specific queries have been raised by India along with other member states, e.g. China, Iran, Bangladesh, Syria, Ethiopia and Egypt regarding the methodology, and use of unofficial sets of data,” it read.

The World Health Organization headquarters is in Geneva, Switzerland. The agency was founded as part of the United Nations after World War II and was intended to be a global leader in public health

The ministry said that the ‘one size fits all’ approach may work in smaller countries, but it may not apply to India, which has a population of over 1.3 billion. “The model gives two highly different sets of excess mortality estimates when using the data from Tier I countries and when using unverified data from 18 Indian states. Such wide variation in estimates raises concerns about the validity and accuracy of such a modelling exercise,” it read.

The Ministry added that if the model is accurate and reliable, it should be authenticated by running it for all Tier-1 countries. “India has asserted that if the model is accurate and reliable, it should be authenticated by running it for all Tier I countries and the result of such exercise may be shared with all member states,” the press release added.

The ministry also raised concerns over the inverse relationship between monthly temperature and average deaths as it has no scientific backing to establish such a particular empirical relationship.

Mentioning the variety of climatic and seasonal conditions across Indian states as well as within states, the Ministry said, “India is a country of continental proportions. Climatic and seasonal conditions vary vastly across different states and even within a state therefore, all states have widely varied seasonal patterns. Thus, estimating national level mortality based on these 18 states’ data is statistically unproven.”

It added that the modelling for Tier II countries is based on the Global Health Estimate 2019, which itself is just an estimate. The ministry raised the question of how previous sets of estimates could be based on the present modelling exercise while disregarding the data available in the country.

It also noted that while GHE 2019 was used for India, for Tier 1 countries, their own historical datasets were used. The historical data of India was ignored despite the fact that the country has a robust system of data collection and management.

The ministry pointed out that India had no age-sex death distribution, but WHO determined standard patterns for age and sex for all countries with reported data from 61 countries.

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It generalized the available data to other countries, including India. “Based on this approach, India’s age-sex distribution of predicted deaths was extrapolated based on the age-sex distribution of deaths reported by four countries (Costa Rica, Israel, Paraguay, and Tunisia),” the Ministry added.

It further read that WHO used a combination of binary variables such as income instead of realistic graded variables. WHO conveyed it was found to be most accurate for predicting excess mortality but did not provide any detailed justification on how these variables were found to be most accurate.

In India, the test positivity rate was never uniform at any given time. However, it was not considered for modelling purposes.

“Further, India has undertaken COVID-19 testing at a much faster rate than what WHO had advised. India has maintained molecular testing as the preferred testing method and used Rapid Antigen for screening purposes only. Whether these factors have been used in the model for India is still unanswered,” the Ministry said.

While WHO had agreed with India’s point of view about the subjective approach such as school closing, workplace closing, cancelling of public events, etc. as it was impossible to quantify various measures of containment in such a manner for a country like India. However, it was still used for this study.

The Ministry said during interactions with WHO, India highlighted the fluctuations in official reports from Tier 1 countries like the USA, France, and Germany.

“Further, the inclusion of a country like Iraq which is undergoing a complex extended emergency under Tier I countries raises doubts on WHO’s assessment in the categorization of countries as Tier I/II and its assertion on quality of mortality reporting from these countries,” it said. India is yet to receive any satisfactory response from WHO.

The Ministry said India is open to collaboration with WHO over such data sets that would be helpful for the policy-making point of view. However, India also demanded in-depth clarity on methodology and clear proof of the validity of such data.

The Ministry said while NYT could obtain the alleged figures of excess Covid-19 mortality in India, it was “unable to learn the estimates for other countries.”

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On April 16, NYT published a report titled “India Is Stalling the W.H.O.’s Efforts to Make Global Covid Death Toll Public”, asserting that India was not letting WHO publish estimated data of actual deaths that happened across the world. Notably, Congress leader Rahul Gandhi has also used the same report to target Bharatiya Janata Party-led government at the center.

The report suggested India saw over 4 million Covid-19 deaths, which was 8-times higher than the official number. Blaming the Modi government for the delay, NYT asserted that it was a sensitive issue for the Indian government as it was criticized for Covid-19 management.

References:

opindia.com