Preliminary Analysis of Excess Mortality in India During the Covid-19 Pandemic (Update September 26, 2021)

As both testing for SARS Cov-2 and death registrations are incomplete or not yet available in many countries, the full impact of the Covid-19 pandemic is currently unknown in many world regions.

We studied the Covid-19 and all-cause mortality in 19 Indian states (combined population of 1.27 billion) with available all-cause mortality data during the pandemic for the entire state or for large cities. Excess mortality was calculated by comparison with available data from years 2015-2019. The known Covid-19 deaths reported by the Johns Hopkins University Center for Systems Science and Engineering for a state were assumed to be accurate, unless excess mortality data suggested a higher toll during the pandemic. Data from one state were not included in the final model due to anomalies.

In several regions, fewer deaths were reported in 2020 than expected. The excess mortality in Mumbai (in Maharashtra) in 2020 was 137.0 / 100K. Areas in Andhra Pradesh, Delhi, Haryana, Karnataka, Madhya Pradesh, Tamil Nadu, and Kolkata (in West Bengal), saw spikes in mortality in the spring of 2021.

The pandemic-related mortality through August 31, 2021 in 18 Indian states was estimated to be 198.7 per 100,000 population (range 146.1 to 263.8 per 100K). If these rates apply to India as a whole, then 2.69 million people (range 1.98 to 3.57 million) may have perished in India as a result of the Covid-19 pandemic by August 31, 2021.