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

“We work around the clock at 100% capacity to burn corpses on time,” Kamlesh Sailor, the president of the trust that operates the Gujarat crematorium in the diamond polishing town of Surat, told Reuters.

With hospitals full and the lack of oxygen and medication in an already creaky health system, several major cities are reporting far greater numbers of cremations and burials under coronavirus logs than official Covid-19 fatalities, according to a review of the crematorium and cemetery workers, media and authorities Government data.

India saw a record 273,810 new infections per day and 1,619 deaths on Monday. The total number of cases is now 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 hospital vacancies, oxygen and medication will become difficult, experts say.

Government officials say the death gap can be caused by a number of factors, including excessive caution.

A senior state health official said the increase in the number of cremations was due to corpses being cremated under Covid protocols “even if the likelihood of the person being positive is 0.1%.”

“In many cases, patients come to the hospital in extremely critical condition and die before being tested. There are cases where patients are taken to the hospital dead and we don’t know if they are positive or not,” the official said .

‘Data refusal’

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 is very annoying.”

In Surat, Gujarat’s second largest city, Sailor’s Kurukshetra crematorium and a second Umra crematorium called Umra have cremated more than 100 bodies per day according to Covid protocols over the past week – far more than the city’s official daily death toll of around 25 interviews with workers.

Prashant Kabrawala, trustee of the Narayan Trust, which manages a crematorium in the third city called Ashwinikumar, declined to provide the number of corpses received under Covid protocols, but said cremations there had tripled in recent weeks.

“I have been going to the crematorium regularly since 1987 and have been involved in its day-to-day work since 2005, but I haven’t seen so many bodies come to be cremated in all these years,” even during an outbreak of bubonic plague in 1994 and floods in 2006 said Kabrawala.

Government spokesmen in Gujarat did not respond to requests for comment.

India isn’t the only country where coronavirus statistics are being questioned. However, worker testimony and a growing body of academic literature suggest that deaths in India are underreported compared to other countries.

Mukherjee’s first-wave research in India concluded that studies in other countries estimated that there were 11 times more infections than reported. There were also two to five times as many deaths as reported, well above global averages.

Work day and night

In Lucknow, the capital of the populous northern state of Uttar Pradesh, data from the largest crematorium only in Covid, Baikunthdham, shows twice as many bodies as 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 crematorium only in Covid in the city or burials in the Muslim community, which make up a quarter of the city’s population.

The head of the crematorium, Azad, who has only one name, said the number of cremations under Covid protocols has increased fivefold in the past few weeks.

“We work day and night,” he said. “The incinerators run all day, but many people still have to wait with the corpses for the final rites.”

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A spokesman for the Uttar Pradesh government did not respond to a request for comment.

Elsewhere, the local India Today news agency reported on two crematoria in Bhopal, the capital of central Madhya Pradesh. In four days this month, 187 bodies were cremated according to Covid protocols, while the official Covid death toll was five.

Last week, Sandesh, a Gujarati newspaper, counted 63 bodies leaving a single hospital in Covid to be buried in the state’s largest city, Ahmedabad, on a day that government data showed 20 coronavirus deaths.

The Lancet Medical Journal found last year that four Indian states, which account for 65% of national Covid deaths, each recorded 100% of their coronavirus deaths.

But less than a quarter of deaths in India are medically certified, especially in rural areas, meaning the true Covid death rate in many of India’s other 24 states may never be known.

“Most deaths are unregistered, so it is impossible to do a validation calculation,” said Mukherjee.