The official COVID-19 death toll for 2021, as reported by the Union ministry of health and family welfare (MoHFW), stood at about 0.33mn. However, the civil registration system (CRS) data indicates that excess mortality—the number of deaths above what would normally be expected—was nearly six times higher, raising serious questions about the accuracy of India's pandemic-related mortality data.
While excess deaths may include fatalities indirectly related to the pandemic, such as those due to healthcare disruptions, delayed treatment, or mental health crises, the sharp and sudden spike in mortality in 2021 corresponds precisely with the timing of the deadly Delta wave which overwhelmed hospitals and caused oxygen shortages across the country.
Analysts and independent researchers have long argued that India's official COVID death counts grossly under-represented the real toll. The CRS data now lends institutional weight to those assessments. In 2020, the total number of registered deaths was 8.12mn. The sudden jump of nearly 2.1mn deaths in the following year has no precedent in recent vital statistics data which had otherwise followed a slow, incremental trend.
Interestingly, the rise in registered deaths occurred, despite under-reporting from key states such as Uttar Pradesh (UP) and Bihar which have historically faced criticism for gaps in civil registration coverage. The number of registered births, by contrast, saw a marginal decline—from 24.22mn in 2020 to 24.20mn in 2021—suggesting that the increase in mortality was not offset by higher fertility.
The gender breakdown of registered deaths shows that 60.8% of deaths were male and 39.2% female, consistent with previous years. However, the absolute rise in male deaths could also be reflective of gendered vulnerability to COVID-19 and associated co-morbidities. Institutional deaths, those occurring in hospitals or health facilities, accounted for only 26.5% of all registered deaths, a low figure that again hints at the large number of deaths occurring at home or outside formal medical care, especially during the pandemic's peak.
The CRS figures underscore the need for transparent, timely and disaggregated mortality data, especially during public health emergencies. It also highlights strengthening India’s civil registration and health surveillance systems which are essential not only for accurate statistics but also for formulating responsive health policies.
Despite the evident surge in mortality, the government has not revised its official COVID death toll based on excess mortality estimates. The World Health Organisation (WHO) and several independent modelling studies had earlier estimated India’s pandemic death toll to be between 3mn to 4mn, based on indirect indicators—figures now bolstered by the government’s own civil registration data.
The CRS report is compiled from data submitted by states and Union Territories (UTs) and is considered the most comprehensive source of annual birth and death statistics. While not all deaths in India are medically certified, the rising coverage and completeness of registration make this year’s figures especially critical in understanding the broader impact of COVID-19.
As India plans for future public health challenges, the excess deaths recorded in 2021 stand as a stark reminder of the importance of timely data, transparency and preparedness.
One relatively simple way to prove that the States and the Centre were lying was to use publicly available data in the websites of municipalities that make death certificates available online.
If you did this and counted the number of deaths in April/May/June/July of 2019, 2020 and 2021, you would have observed a very modest increase or even a slight decline in 2020 during the 1st wave of Covid. However, this was followed by a huge spike in 2021 during the delta wave.
The 2020 wave was not that severe across India, and it is possible that the increase in Covid deaths was offset by a decline in traffic fatalities as movement was severely restricted during the lockdowns. However, the number of deaths during the delta wave in 2021 was so high that nothing could mask it in the numbers. So, there is nothing surprising in these numbers at all. The only surprise is that it took so long to do the analysis.