India objects WHO's method to measure COVID mortality; Health Ministry points out flaw

In a press release dated April 16, the Ministry of Health rebutted the Western media claims that India has been stalling the WHO's efforts to make the global COVID death toll public. Raising objections to World Health Organisation's methodology to calculate COVID-19 mortalities in the country, India said using such mathematical modelling cannot be applied to assess the death figures given the geographical area and vast population of the country. 

The concern primarily doubts the statistical model that projects an estimate for a country of geographical size and population of India, unlike other nations with smaller populations and areas.

"India’s basic objection has not been with the result (whatever they might have been) but rather the methodology adopted for the same," the press release stated.

Having mentioned that the country has repeatedly tried to get in touch with competent authorities in WHO, the Ministry cited 11 instances with dates wherein India had pointed out similar doubts.

Why did India object to WHO's COVID mortality assessment?

Iterating that WHO's model should be authenticated after running it for all Tier 1 countries and sharing its results with 'all member states', India said that such wide-ranging variations may raise concerns about the evaluation's 'validity and accuracy'. 

"Such size fit all approach and models which are true for smaller countries like Tunisia may not be applicable to India with a population of 1.3 billion," the press release read. 

"The model gives two highly different sets of excess mortality estimates when using the data from Tier I countries and when using unverified data from 18 Indian States. Such wide variation in estimates raises concerns about the validity and accuracy of such a modelling exercise," it further reasoned. 

What is India's issue with WHO's COVID death assessment?

The Health Ministry submitted that WHO determined standard patterns for age and sex for the countries with reported data (61 countries) and then generalised them to other countries (incl. India) that had no such distribution in their mortality data. "Based on this approach, India's age-sex distribution of predicted deaths was extrapolated based on the age-sex distribution of deaths reported by four countries (Costa Rica, Israel, Paraguay and Tunisia)," it said. 

What did India suggest to WHO?

Stating that the variation in the COVID-test positivity rate was not taken into consideration, India mentioned that even the WHO 'agreed about the subjective approach of this' mortality assessment method. "While India has expressed above and such similar concerns with WHO, a satisfactory response is yet to be received from WHO," it added. 

In an interesting response, the Ministry of Health pointed out the bias that was indicative in an article by New York Times. "It is very surprising that while New York Times purportedly could obtain the alleged figures of excess COVID-19 mortality in respect to India, it was 'unable to learn the estimates for other countries'!!" the