2021 in numbers: Rural hospital deaths increased 45% compared to 2020 in Jan-May
2021 in numbers: In all, 480,000 people have died due to the Covid-19 pandemic in the country since March 2020, according to figures compiled from state bulletins. 69% of these deaths took place in 2021.
The Covid-19 pandemic has added an additional disease burden, resulting in over 480,000 deaths since March 2020 according to state bulletins on the pandemic compiled by HT, with 69% of them occurring this year alone. This means more people have likely died this year than before the pandemic. However, this trend is not likely to be uniform across age groups or in all months. Here are two charts that show how the trends in all-cause deaths unfolded until May this year.
India’s official and most comprehensive source of data on all-cause deaths is the data from the Civil Registration System (CRS), which gives the number of registered deaths. However, this data is published with a time lag and is available only up to 2019-20.
Deaths occurring in health facilities alone on the other hand is available from the Health Management Information System (HMIS) of the National Health Mission up to May 2021. To be sure, even this data captures only a fraction of deaths in the country.
The CRS recorded 7.6 million deaths in 2019-20, while the HMIS recorded just 2.6 million. This is because the HMIS collects data from largely government facilities in rural areas. However, the HMIS numbers can still point to trends in deaths this year.
According to the December 26 update of the HMIS – the data is being updated as more health facilities upload to the system and errors are corrected – there were 1,432,783 deaths in January-May 2021. This is 45% more than in 2020, when 987,945 deaths took place in the same period, and 33.1% more than the 1,076,268 deaths that took place in these months in 2019.
Not all kinds of such hospital deaths necessarily increased to the same degree.
Adult and adolescent deaths, which make up around 90% of deaths in HMIS figures, increased by a higher degree than the overall average – 51.4% compared to January-May 2020 – while maternal deaths increased by 33.4%. The deaths of children and infants on the other hand decreased by 13%. This trend was also not uniform across months. Deaths in 2021 were less than in 2020 in January (4.3% decrease) and February (0.1% decrease). But in March, April, and May, deaths this year were 10.3%, 79.6%, and 165.3% more than in 2020. In varying degrees, this trend holds true for both maternal deaths and adult and adolescent deaths.
The above trends suggest that deaths due to Covid-19 had a role to play in the increase in deaths in 2021. This is because the second wave of the pandemic started in February and peaked in May. The rising curve of Covid-19 infections in these months could be a reason for the rise in excess deaths – over and above the deaths in earlier years.
While increased pressure on health facilities due to Covid-19 cases could by itself increase the number of hospital deaths due to all causes, there is reason to believe that some of the excess deaths were directly due to Covid-19. HT had argued this (https://bit.ly/3EIjAZb) with an earlier update in the HMIS in July this year. The main reason is that deaths due to causes such as respiratory diseases or infections and those due to fever registered a very high degree of increase compared to other causes.