The Global Problem of Underreporting COVID-19 Deaths

The underreporting of COVID-19 deaths has been in the spotlight in India as local governments’ reporting practices have come under scrutiny in several media publications. Newly released analysis from the University of Washington suggests that while the problem is grave in India, it is by no means the only country which struggles with severe underreporting of COVID-19 deaths.

The University of Washington Institute for Health Metrics and Evaluation estimates that the total number of deaths from COVID-19 in India is almost three times as high as reported. The situation is similar in Mexico, which has an estimated 180 percent additional non-reported deaths. Russia is even suspected to have an actual death toll almost 5.5 times as high as its reported one.

Among the most affected countries, Brazil and the U.S. fared slightly better, with estimated actual deaths around 50 percent higher than reported deaths.

Around the world, actual coronavirus deaths are estimated to exceed reported deaths by 113 percent. The researchers said that underreporting happened for a lack of testing in deaths that occurred outside of hospitals, especially in countries with a lack of access to health services, but also that weak reporting systems could have an impact.

Discrepancies in causes of death and reporting in India had long been suspected, but first concrete reports from Gujarat in mid-April captured nationwide attention. The Hindu, for example, counted almost 700 bodies cremated or buried under COVID protocols in just seven cities on April 16, while the official count for that day was just 78 COVID deaths for the whole state. The Times of India collected local reports from different areas of the country, showing actual death tolls four to 24 times higher than official reports. Some analysis found that causes of death like “comorbidities” or “cardiac arrest” were listed for victims coming from COVID wards.

The University of Washington estimates that actual coronavirus deaths are three to four times higher than reported in most Indian states. The exception is Maharashtra, where they are estimated to only be twice or 2.5 times as high. The state that includes Mumbai has reported an outsized share of COVID-19 cases and deaths throughout the pandemic.