Following media reports inferring undercounting of COVID-19 deaths from eight states, the Centre has clarified that given the robust and statute-based Death Registration System in India, while some cases could go undetected as per the principles of Infectious Disease & its management, missing out on deaths is completely unlikely.
This could also be seen in the case fatality rate, which as on 31st December 2020 stood at 1.45% and even after an unexpected surge observed in the second wave in April-May 2021, the case fatality rate today stands at 1.34%.
Moreover, the reporting of daily new cases and deaths in India follows a bottom-up approach, where districts report the number of cases & deaths to the State Governments and to the Union Ministry on a continuous basis. As early as May 2020, to avoid inconsistency or confusion in the number of deaths being reported, Indian Council of Medical Research (ICMR) had also issued 'Guidance for appropriate recording of COVID-19 related deaths in India' for correct recording of all deaths by States/UTs as per ICD-10 codes recommended by WHO for mortality coding.
Union Health Ministry has advised States and UTs for recording of deaths in accordance with laid down guidelines.Union Health Ministry has been advising States and UTs through formal communications, multiple video conferences and through deployment of Central teams for recording of deaths in accordance with laid down guidelines. States have been advised to conduct thorough audits in their hospitals and report any cases or deaths that could have been missed with a district and date-wise details so as to guide a data-driven decision making
The Union Health Ministry has regularly emphasized the need for a robust reporting mechanism for monitoring district wise cases and deaths on a daily basis. States consistently reporting lower number of daily deaths has been advised to re-check their data. A case in point is the Union Health Ministry writing to the State of Bihar to provide detailed date and district wise break-up of the reconciled number of deaths.