IN the aftermath of the devastating COVID-19 pandemic – India finally confronts a harsh reality: the true toll of the pandemic was far greater than official counts ever recognised. Government figures now confirm what public health officials, data journalists, and international agencies had been warning all along – that COVID related deaths were greatly underestimated.

India witnessed more than 21.5 lakh excess deaths in 2021 – nearly six times the official 2021 COVID-19 death toll of 3.3 lakh, according to a recent analysis published by The Hindu. "Excess deaths" refer to deaths above regular mortality trends; while not necessarily all of them caused directly by COVID-19, the virus was likely to have been a significant contributory cause of most of them.

At the national level, the official data show 1.5 lakh COVID fatalities in 2020 compared to 3.8 lakh excess deaths. In 2021, the gap was enormous: while 3.3 lakh deaths were officially reported because of COVID-19, excess deaths totalled 21.5 lakh. This data, from the Office of the Registrar General and Census Commissioner and The Hindu Centre for Politics and Public Policy, suggests a huge underreporting of death – with the greatest undercount ratio documented in Gujarat. The number of deaths registered in India rose spectacularly in 2021 to over 1 crore – a rise of 27 per cent from the previous year, largely due to the pandemic.

Discrepancies were particularly large in others. Gujarat formally reported 5,812 COVID deaths during 2021 but excess death was 44 times larger. Madhya Pradesh and Uttar Pradesh reported close to 19.5 times excess deaths that were formally reported. The report also inferred states' overt underreporting, both in formally reported COVID deaths and in the issuing of death certificates.

The truth of excess deaths is not emerging all of a sudden. In 2021, a Reporters' Collective report exposed stark disparities in Gujarat's COVID death toll. Comparing figures from 68 municipalities, it reported 16,892 excess deaths during the period March 2020-April 2021. Projected to the state level, this put Gujarat's actual death toll at a minimum of 2.81 lakh – over 27 times the official tally. Those alone had reported 10,238 excess deaths in April 2021 alone – more than the official tally for the entire pandemic in the state. The report had relied largely on death registers, illustrating just how enormous the undercounting has been in the state. 

A 2022 paper in The Lancet aimed to measure excess pandemic mortality in 191 countries and territories – 252 subnational areas – between January 1, 2020, and December 31, 2021. It determined that India recorded the highest cumulative excess deaths globally, at an estimated 40.7 lakh. The real burden of the pandemic was much higher than indicated, the study stated. India's national excess death rate was approximately 152.5 per 100,000 population – well above the officially reported COVID-19 fatality rate of 18.3 per 100,000 population. Eight states in India had excess deaths of over 200 per 100,000 population, and seven states had excess deaths of over 2 lakh. Excess mortality in Gujarat was estimated as 1.03 to 1.49 lakh (78.2-113.3 per 100,000) and Uttar Pradesh had between 4.18 to 6.02 lakh excess deaths (87.4-125.8 per 100,000). 

In 2024, a study authored by ten demographers and economists from top global institutions was covered by Al Jazeera. It estimated that India had 1.19 million more deaths in 2020 – during the first wave – compared with 2019, a figure roughly eight times the official toll of 1.48 lakh. The National Family Health Survey estimates also reflected extreme inequalities in the impact of the pandemic, it added. It found that Muslim life expectancy dropped by 5.4 years – the steepest decline for any single group – and indicated the community's marginalisation during the crisis. Dr                         T Sundararaman, a public health specialist, put a sense of pressing urgency on healthcare inequality action from the government when he said: "The efforts of the government have been very short of what is needed. Nothing can be achieved by avoiding these studies." 

Nonetheless, the Government of India never accepted the results, questioning methods and declining to release official figures to verify or debunk them.

Those supporting the higher estimates, comprising health authorities and statistics experts, repeatedly urged the government to release the 2021 Sample Registration System (SRS) figures – India's most reliable death database. But it remained in the dark – not for a year, or two, but well into the third year after the coronavirus peak.

Now, quietly and with little public attention, the SRS data for 2021 has finally been released. They pretty much confirm what many suspected all along: deaths during the pandemic far exceeded official tallies.

The government now estimates the 2021 excess deaths at 15.7 lakh – factoring in natural growth of mortality and better death registration. Even with this lower figure, the total pandemic death toll for 2020 and 2021 combined is 15.54 lakh – close to three times the official 4.81 lakh.

As Dr T Sundararaman rightly puts it: "In public health terms, it does not matter whether these deaths occurred directly due to COVID-19, unreported infection, or denial of access to healthcare – what is important is that a huge number of excess deaths took place, and this is now confirmed by government data."

India maybe wasn't as badly hit as some like Italy, the US, or the UK – at least partially due to the fact that its population is young and rural, apart from the vaccination programme using private sector vaccines. Lockdowns emptied cities – but city slums took the brunt. Better planning in terms of oxygen production and supply chain management could have saved more lives. 

As with other countries with high excess mortality, excess deaths are a good indicator of the true impact of the pandemic – though they should not be confused with actual COVID deaths. However, the best news is not necessarily the figures themselves, but the fact that the government de facto accepted that the deaths did occur.

These statistics cannot reverse the past, but they lead us to revise our view of it. They show Gujarat's stark contrasts – the widest divergence between reported coronavirus deaths and registered deaths. They also emphasize lack of transparency in the midst of crisis.

This is more than a statistical update – it is a low-key, long-overdue correction of the public record. No surprise, no apology, no headline; attention remains elsewhere, on the jingoism of 'war with Pakistan'. But the fact of publishing the data, low-key and belated as it is, is an implicit admission.

And lastly, these excess fatalities are more than numbers. They're lost lives, shattered families, and trauma to a country – long pushed beneath its own conscience. Seeing them, even now, is important. It is the first step towards finding the right lessons – and offering respect to the memory of people the government did not account for.