{"id":184305,"date":"2022-05-13T20:47:50","date_gmt":"2022-05-13T15:17:50","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=184305"},"modified":"2022-05-14T10:58:56","modified_gmt":"2022-05-14T05:28:56","slug":"whos-methodology-has-been-robust","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/whos-methodology-has-been-robust\/","title":{"rendered":"WHO\u2019s Methodology Has Been Robust\u2019\u00a0"},"content":{"rendered":"\n<p><b><span data-contrast=\"none\">News:<\/span><\/b><span data-contrast=\"none\"> Recently,<\/span> <span data-contrast=\"none\">the World Health Organisation estimated the excess mortality caused by the pandemic<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h5><b><span data-contrast=\"none\">What is the scope of WHO\u2019s estimate?<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h5>\n<p><span data-contrast=\"none\">WHO is measuring the excess mortality to understand the net effect of a pandemic. <\/span><\/p>\n<p><span data-contrast=\"none\">Here, excess mortality means the difference between what would have been expected to be the mortality if there had been no pandemic as compared to the actual mortality occurring which include covid deaths, deaths due to the disruption of other essential health services and worsening of social determinants like poverty.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h5><b><span data-contrast=\"none\">India\u2019s institutional measures for recording death<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h5>\n<p><b><span data-contrast=\"none\"><span style=\"text-decoration: underline;\">The Civil Registration System (CRS)<\/span>: <\/span><\/b><span data-contrast=\"none\">It is organised by the <\/span><b><span data-contrast=\"none\">Registrar General of <\/span><\/b><b><span data-contrast=\"none\">India (RGI),<\/span><\/b> and is <span data-contrast=\"none\">uniformly operated across India. The <\/span><span data-contrast=\"none\">states are required to implement it, and they don\u2019t have any flexibility. <\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Issues in CRS<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">: <\/span><span data-contrast=\"none\">This system faces a number of issues. The death registration in CRS is weak. In fact, the certification of cause of death is as low as 21%.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\"><span style=\"text-decoration: underline;\">India\u2019s Sample Registration System (SRS)<\/span>:\u00a0<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"><br \/>\n<\/span><\/p>\n<p><span data-contrast=\"none\">It is implemented by RGI to overcome weaknesses in CRS and get a better sense of mortality in India. Therefore, people are sent to survey villages, to verify death registration, search for missing deaths and explore causation. By convention, it is considered to be the <\/span><b><span data-contrast=\"none\">gold standard<\/span><\/b><span data-contrast=\"none\"> for mortality.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Issues<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">: <\/span><span data-contrast=\"none\">India\u2019s Sample Registration System (SRS) is the main source of mortality data. However, <\/span><span data-contrast=\"none\">SRS usually comes out after a <\/span><b><span data-contrast=\"none\">two-year lag<\/span><\/b><span data-contrast=\"none\">. Therefore, unfortunately, SRS data is not available for 2020 and 2021.\u00a0<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h5><b><span data-contrast=\"none\">What are the issues in the estimation of excess mortality?<\/span><\/b><\/h5>\n<p><span data-contrast=\"none\">As per <\/span><b><span data-contrast=\"none\">SRS<\/span><\/b><span data-contrast=\"none\"> and <\/span><b><span data-contrast=\"none\">CRS report<\/span><\/b><span data-contrast=\"none\"> in 2019, Only 13 states and 4 UTs recorded 100% reporting which did not include large and populous states. Therefore, we cannot rely upon the death reporting done during covid when there was so much disruption.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Another important issue is that the Covid deaths were collected through<\/span><b><span data-contrast=\"none\"> a parallel system (<\/span><\/b><span data-contrast=\"none\">collected directly from<\/span> <span data-contrast=\"none\">district administrators reporting it from laboratories and from hospitals), not through the civil registration and vital statistics system. Therefore, they had no <\/span><b><span data-contrast=\"none\">cross-reference<\/span><\/b><span data-contrast=\"none\"> with the rest of the system. Like CRS and SRS.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h5><b><span data-contrast=\"none\">Why WHO approach and its estimation about the bulk of the excess deaths in 2021 is correct?<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h5>\n<p><span data-contrast=\"none\">There are numerous <\/span><b><span data-contrast=\"none\">direct<\/span><\/b><span data-contrast=\"none\"> and <\/span><b><span data-contrast=\"none\">indirect<\/span><\/b><span data-contrast=\"none\"> effects of using the <\/span><b><span data-contrast=\"none\">excess mortality <\/span><\/b><span data-contrast=\"none\">indicator. For example, it helps to take into account mortality which occurs due to indirect causes. Therefore, <\/span><b><span data-contrast=\"none\">the WHO\u2019s methodology<\/span><\/b><span data-contrast=\"none\"> has been robust. If anything, it\u2019s an underestimate.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">The WHO has used death data from those states which have put the death data in the public domain. Thereafter, WHO has extrapolated the data for the whole country.\u00a0<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">WHO\u2019s numbers are in sync with a<\/span><span data-contrast=\"none\">t least <\/span><b><span data-contrast=\"none\">five other studie<\/span><\/b><span data-contrast=\"none\">s. They have all come to similar conclusions.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h5><b><span data-contrast=\"none\">Way Forward<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h5>\n<p><span data-contrast=\"none\">Government should release its <\/span><b><span data-contrast=\"none\">own estima<\/span><\/b><span data-contrast=\"none\">te of excess mortality data as soon as possible. The data should not remain confined to the government itself.\u00a0<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">The best way to validate it is to <\/span><b><span data-contrast=\"none\">triangulate<\/span><\/b><span data-contrast=\"none\"> it across <\/span><b><span data-contrast=\"none\">different methods<\/span><\/b><span data-contrast=\"none\">. That holds out the validity of WHO\u2019s study.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>News: Recently, the World Health Organisation estimated the excess mortality caused by the pandemic\u00a0 What is the scope of WHO\u2019s estimate?\u00a0 WHO is measuring the excess mortality to understand the net effect of a pandemic. Here, excess mortality means the difference between what would have been expected to be the mortality if there had been&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/whos-methodology-has-been-robust\/\">Continue reading <span class=\"screen-reader-text\">WHO\u2019s Methodology Has Been Robust\u2019\u00a0<\/span><\/a><\/p>\n","protected":false},"author":10328,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[1230,9],"tags":[212],"class_list":["post-184305","post","type-post","status-publish","format-standard","hentry","category-9-pm-daily-articles","category-public","tag-gs-paper-2","entry"],"jetpack_featured_media_url":"","views":{"total":0,"cached_at":"","cached_date":1704903289},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/184305","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/10328"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=184305"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/184305\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=184305"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=184305"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=184305"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}