India objects to WHO's methodology after report claims 4 million Covid deaths

India has objected to the methodology used by the World Health Organisation (WHO) for estimating the deaths caused by coronavirus disease (Covid-19) in the country.

The ministry of health and family welfare said in a statement that the same mathematical model cannot be used to calculate the Covid mortalities for a large country like India, geographically and population-wise, and for other countries with a smaller population.

The statement was in response to a New York Times article titled "India Is Stalling WHO's Efforts to Make Global Covid Death Toll Public" dated 16 April.

According to the report, the UN health agency has estimated a total of about 15 million deaths related to the virus by the end of 2021, more than double the official figures reported by countries individually.

The report claimed the WHO estimate will show India's death toll is at least four million, almost eight times the official numbers.

"But the release of the staggering estimate…has been delayed for months because of objections from India, which disputes the calculation of how many of its citizens died and has tried to keep it from becoming public," the report said.

The health ministry said in a statement released Saturday that "India's basic objection has not been with the result (whatever they might have been) but rather the methodology adopted for the same."

The health ministry stated India has been in a "regular and in-depth technical exchange" with WHO on the issue and has shared its concerns regarding the methodology through a series of formal communications, including six letters and virtual meetings.

India, along with other member states like China, Bangladesh, Iran and Syria, raised specific queries regarding the methodology and use of unofficial sets of data, according to the ministry.

"The concern specifically includes on how the statistical model projects estimates for a country of geographical size and population of India and also fits in with other countries which have smaller population," the ministry said.

It added that "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. WHO is yet to share the confidence interval for the present statistical model across various countries."

The ministry noted that the statistical model used by the WHO gives two "highly different sets of excess mortality" estimates of when using the data from Tier I countries and when using "unverified data from 18 Indian states". It argued that such wide variation in estimates raises concerns about the validity and accuracy of the modelling exercise.

"India has asserted that if the model accurate and reliable, it should be authenticated by running it for all Tier I countries and if result of such exercise may be shared with all Member States," the ministry stated.

The ministry said that the assumption of an inverse relationship between monthly temperature and monthly average deaths does not have any scientific backing to establish such a peculiar empirical relationship.

"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," it added.

It also objected to the WHO's methodology to calculate the age-sex death distribution for the country in which India's age-sex distribution of predicted deaths was extrapolated based on the age-sex distribution of deaths reported by Costa Rica, Israel, Paraguay and Tunisia.

"While India has expressed above and such similar concerns with WHO but a satisfactory response is yet to be received from WHO," the ministry said. "It is very surprising that while New York Times purportedly could obtain the alleged figures of excess Covid-19 mortality in respect to India, it was "unable to learn the estimates for other countries"!!"