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“You can’t ignore the dead”

Dr Ashish K. Jha on the horror unfolding in India:

India reports another 400,000+ cases, 4000+ death day

A sustained level of horribleness

And its not correct

True number surely closer to 25,000 deaths, 2-5 million infections today

Lots of ways to estimate but here’s a simple one

Look at the crematoriums

During non-pandemic year 2019

About 27,000 Indians died on typical day

Crematoriums handle that level of deaths every day

Additional 4,000 deaths won’t knock them off their feet

Crematoriums across the country reporting 2-4X normal business

So best estimate 55K to 80K people dying daily in India

If you assume baseline deaths of 25-30K

COVID likely causing additional 25K to 50K deaths daily

Not 4,000

What about infections?

Lets start with Infection Fatality Ratio (IFR)

In India, at least 1% right now

You might say — woah, that’s high

In US its about 0.6% and India has a younger population

BUT

Indian healthcare system has collapsed,

People dying for lack of oxygen

So IFR of 1% is reasonable, may even too low

Which would put daily infections at 2.5 to 5M / day

So here’s the bottom line

India can’t be experiencing 4K deaths a day

If it were, it would barely be blip in the background

Instead, seeing crematoriums running 24/7 and running out of firewood

Means the # of deaths from COVID at least closer to 25K, may be much more

There’s an old saying in global health

You can ignore, fail to test for, or undercount whatever disease you want

But you can’t ignore the dead

In India, the dead are telling us the disease is much worse than the official statistics

And we have to listen

Fin

Originally tweeted by Ashish K. Jha, MD, MPH (@ashishkjha) on May 9, 2021.

We’re not listening.

Published inUncategorized