Non-stop cremations cast doubt on India's counting of COVID dead

Sandesh

19/04/2021 15:26

By Sumit Khanna, Alasdair Pal and Saurabh Sharma
    AHMEDABAD, India, April 19 (Reuters) - Gas and firewood
furnaces at a crematorium in the western Indian state of Gujurat
have been running so long without a break during the COVID-19
pandemic that metal parts have begun to melt.
    "We are working around the clock at 100% capacity to cremate
bodies on time," Kamlesh Sailor, the president of the trust that
runs the crematorium in the diamond-polishing city of Surat,
told Reuters.
    And with hospitals full and oxygen and medicines in short
supply in an already creaky health system, several major cities
are reporting far larger numbers of cremations and burials under
coronavirus protocols than official COVID-19 death tolls,
according to crematorium and cemetery workers, media and a
review of government data.
    India on Monday registered a record 273,810 new daily
infections and 1,619 deaths. Its total number of cases now
stands at more than 15 million, second only to the United
States.
    Reliable data is at the heart of any government response to
the pandemic, without which planning for hospital vacancies,
oxygen and medicine becomes difficult, experts say.
    Government officials say the mismatch in death tallies may
be caused by several factors, including over-caution.
    A senior state health official said the increase in numbers
of cremations had been due to bodies being cremated using COVID
protocols "even if there is 0.1% probability of the person being
positive".
    "In many cases, patients come to hospital in an extremely
critical condition and die before they are tested, and there are
instances where patients are brought dead to hospital, and we do
not know if they are positive or not," the official said.
    
    'VERY IRKSOME'
    But Bhramar Mukherjee, a professor of biostatistics and
epidemiology at the University of Michigan, said many parts of
India were in "data denial".    
    "Everything is so muddy," she said. "It feels like nobody
understands the situation very clearly, and that's very
irksome."
    In Surat, Gujarat's second largest city, Sailor's
Kurukshetra crematorium and a second crematorium known as Umra
have cremated more than 100 bodies a day under COVID protocols
over the last week, far in excess of the city's official daily
COVID death toll of around 25, according to interviews with
workers.
    Prashant Kabrawala, trustee of Narayan Trust, which manages
a third city crematorium called Ashwinikumar, declined to
provide the number of bodies received under COVID protocols, but
said cremations there had tripled in recent weeks. 
    "I have been regularly going to the crematorium since 1987,
and been involved in its day-to-day functioning since 2005, but
I haven't seen so many dead bodies coming for cremation in all
these years," even during an outbreak of the bubonic plague in
1994 and floods in 2006. 
    Government spokesmen in Gujurat did not respond to requests
for comment. 
    India is not the only country to have its coronavirus
statistics questioned. But the testimony of workers and a
growing body of academic literature suggest deaths in India are
being underreported compared to other countries. 
    Mukherjee's research of India's first wave concludes that
there were 11 times more infections than were reported, in line
with estimates from studies in other countries. There were also
between two and five times as many deaths than were reported,
far in excess of global averages.
 
    WORKING DAY AND NIGHT
    In Lucknow, capital of the populous northern state of Uttar
Pradesh, data from the largest COVID-only crematorium,
Baikunthdham, shows double the number of bodies arriving on six
different days in April than government data on COVID deaths for
the entire city. 
    The figures do not take into account a second COVID-only
crematorium in the city, or burials in the Muslim community that
makes up a quarter of the city's population.   
    Crematorium head Azad, who goes by only one name, said the
number of cremations under COVID protocols had risen five-fold
in recent weeks. 
    "We are working day and night," he said. "The incinerators
are running full time but still many people have to wait with
the bodies for the last rites."
    A spokesman for the Uttar Pradesh government did not respond
to a request for comment. 
    Elsewhere, India Today reported two crematoriums in Bhopal,
the capital of the central state of Madhya Pradesh, 187 bodies
were cremated following COVID protocols in four days this month,
while the official COVID death toll stood at five.
    Last week Sandesh, a Gujarati newspaper, counted 63 bodies
leaving a single COVID-only hospital for burial in the state's
largest city, Ahmedabad, on a day where government data showed
20 coronavirus deaths. 
    The Lancet medical journal noted last year that four Indian
states making up 65% of COVID fatalities nationally each
registered 100% of their coronavirus deaths.
    But fewer than a quarter of deaths in India are medically
certified, particularly in rural areas, meaning the true COVID
death rate in many of India's 24 other states may never be
known.
    "Most of the deaths are not registered so it's impossible to
do a validation calculation," Mukherjee said. 

 (Reporting by Sumit Khanna in Ahmedabad, Saurabh Sharma in
Lucknow and Alasdair Pal in New Delhi)
 ((Alasdair.Pal@thomsonreuters.com; +91 114 954 8060; Reuters
Messaging: alasdair.pal.reuters.com@reuters.net))