SRS data: Effective management of Covid saved lakhs of lives in UP
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The recently released data of Sample Registration System (SRS) for 2021 has generated a lot of discussion on Covid deaths. There has been some delay in releasing the SRS data for 2021.
Generally, when SRS data is released, health professionals focus on Infant Mortality Rate (IMR), Total Fertility Rate (TFR) and Maternal Mortality Ratio (MMR) but a spike in the crude death rate in SRS 2021 turned the focus on excess deaths in 2021.
The Civil Registration System (CRS) data has also been released, and it also shows excess deaths during the pandemic.
According to the data, in 2021, highest death rate was recorded in Kerala, followed by Punjab, Odisha, Gujarat, Karnataka, Tamil Nadu, Haryana, MP, Andhra Pradesh, Maharashtra, Uttar Pradesh, West Bengal, Rajasthan and Bihar
It has been calculated from CRS data that 37.4 lakh excess deaths took place in India during the pandemic while SRS data indicates that this number was 19.7 lakh.
The projection with SRS data seems more robust as the increased number in CRS could be due to the improvement in recording of deaths in states where the coverage is still not complete. Since SRS gives results based on sample survey, this is certainly a better indicator of what actually happened.
Death rate is one of the simplest measures of mortality and is expressed as number of deaths per 1000 population in each time frame and region.
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Though excess deaths during Covid are indicated from SRS data, a closer look reveals the performance of health systems in various states during the pandemic.
The year 2019 was normal and the death rate in 2020 did not see much change though Punjab comes out as an outlier. The year 2021 saw a major change in death rates for all major states as it was the year when the second wave of Covid-19 resulted in many deaths.
A change of one point in death rate gets converted into 10,000 more deaths per one crore of population.
It is clearly seen that Uttar Pradesh comes out as a shining example of Covid management with a change of mere 0.5 in death rate in 2021 over 2019 despite not very robust health infrastructure. Every other major state saw a change of more than one point in death rate of 2021 as compared to the data of 2019.
It can be said in retrospect that the strategies adopted by the Uttar Pradesh govt like replicating the experience of communicable diseases campaign since 2018, whole of govt and community approach, availability of sufficient medicine packets at every level including ASHAs, daily monitoring of situation by team 9 of Chief Minister Yogi Adityanath, Integrated Control and Command Centre (ICCC) for Covid in every district and use of ivermectin etc.
worked for the state and saved lakhs of lives.
It speaks volumes about the dedication and effectiveness of healthcare workers and other assisting departments in the battle against Covid. Had the death rate changed by +1.5 as that for the country, it would have translated into an over 2 lakh additional deaths in UP.
Had the increase been +2 as in the case of Kerala, it would have meant over 3 lakh additional deaths. The number of lives saved is an indication of the health system of UP rising to the occasion over the entire period of pandemic.
Another interesting data that has emerged is that in the country as a whole, the rural area was affected more adversely as compared to the urban area as far as Covid deaths are concerned.
This could have happened because of absence of focus or lack of healthcare services in the rural areas. The change in death rate in urban as well as rural areas from 2019 to 2021 is +1.5 each in the country as a whole whereas in UP, the change in death rate from 2019 to 2021 in urban area is 1.4 but the change in rural area is just 0.2.
Clearly, the state with more than 70% of rural population was able to save lakhs of lives.
The credit should go to the strategy of distributing medicines to anyone with symptoms without waiting for a test result in rural areas during second wave, oversight maintained and cooperation rendered by the community and the dedication and alertness of the healthcare and other workers. Even counting deaths can give us lessons for the future handling of pandemics.
(Amit Mohan Prasad is a retired IAS officer and served as ACS, UP govt, during Covid pandemic. Akaash Mohan, an engineer is a data enthusiast. Views expressed are personal)
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