Gauging pandemic mortality with civil registration data

Source: The Hindu

Synopsis: The Civil Registration System (CRS) is still an imperfect system, with potential sources of error.

Background

• Recently, Indian journalists from across the country assessed and reported on State-level all-cause mortality from the Civil Registration System (CRS) of various states.
• The data shows a large rise in excess mortality in the surge months of the second wave of April and May 2021.
• The increase in mortality ranges from reported deaths climbing to five times the usual monthly data in Madhya Pradesh and Andhra Pradesh. Whereas in Tamil Nadu and Kerala there has been a modest increase.
• Though the CRS data has highlighted the undercounting of COVID-19 deaths in India and remains the best source of data on all-cause mortality. There are some known sources of error that exist with the data.

Why the data from Civil Registration System is considered inaccurate?

• First, the CRS numbers underestimate total mortality.
  • For example, The Union government last published annual Civil Registration System data for 2019.
  • This data shows that India registered 92 of every 100 deaths as of 2019. But there was a large variation between States. Bihar, for instance, registered just half of all deaths.
  • Additionally, the online portals show lower numbers than what was published by the Union government for 2018 and 2019.
• The second possible source of error. If mortality was either naturally increasing over time, or if registration was getting better, or if both were taking place. If any of these three phenomena was taking place, the magnitude of excess mortality in 2020 and 2021 could be moderated by these processes.
  • For instance, let us assume that Madhya Pradesh achieved 100% registration by May 2021.
  • Given the flattening of mortality in the State, let us assume that the total mortality in 2021 in ‘normal’ times would have been about the same as the total estimated deaths for 2019 5.53 lakh deaths.
  • Even then, the numbers for Madhya Pradesh show over 1.18 lakh excess deaths in 2021, which is over 26 times the official COVID-19 death toll for the same period.
  • The other States, too, show excess mortality in 2021 even assuming full registration.

These sources of error indicate that the total number of deaths in India during the pandemic reported using Civil Registration System data might be underestimated.

Terms to know:

• Excess Deaths 
• Civil Registration System (CRS)