Among the larger states in India, undercounting was particularly pronounced in states like Madhya Pradesh, Gujarat, and Uttar Pradesh. In those regions, the number of COVID-19 deaths reported was a fraction of the actual loss of life most likely caused by the pandemic.
Published May 10, 2025 | 2:24 PM ⚊ Updated May 10, 2025 | 2:29 PM
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Synopsis: The real COVID-19 death toll is likely far higher than suggested by the official figures. An analysis of excess mortality paints a grim picture, showing that the country may have lost far more lives than acknowledged in government records. The wide variance in underreporting across states also underscores the challenges in data collection, death registration, and certification of cause of death.
India has moved past the peak COVID-19, but the numbers keep rising — not of infections, but of unanswered questions.
In 2021 alone, India registered over 21 lakh more deaths than pre-pandemic levels, a staggering 26% rise over 2020. Yet, official COVID-19 deaths account for just a fraction of this increase, raising serious concerns about massive underreporting of the true toll the virus has taken on the country.
The country’s official COVID-19 death toll, as of May 2025, stands at approximately 5,33,665. This figure, however, is a fraction of the actual deaths caused by the pandemic.
Recently, the government released the Report on Medical Certification of Cause of Death – 2021, which suggested that the total deaths in 2021 alone rose by over 21 lakh compared to pre-pandemic levels. Yet, only five lakh of those are officially attributed to COVID-19, revealing a massive underreporting of the pandemic-related fatalities across the country.
The total official COVID-19 death toll since the start of the pandemic represented merely 5.2% of the total excess deaths recorded in 2021. The Civil Registration System (CRS) data is the first official suggestion of the extent of the undercounting of deaths that occurred during the pandemic.
This discrepancy, which varies across states, suggests that India’s actual COVID-19 death count was likely far higher than the official figures. Some states, particularly in North and Western India, showed significant underreporting, with official death numbers missing millions of lives lost to the pandemic.
In a typical, non-pandemic year, the number of deaths in India increases only marginally by about 1–2% annually. This small rise is due to gradual population growth and demographic changes such as aging, but is often offset by improvements in healthcare and declining death rates.
Significantly higher increases — such as the 26% jump in deaths registered in 2021 — are abnormal and typically signal extraordinary events like pandemics or disasters. Between 2007 and 2019, the average annual deaths in India ranged from 8.1 million to 8.6 million, with a mean of about 8.35 million (83.5 lakh) deaths per year.
A World Health Organization report released in 2022 put the number of “excess” deaths in India in 2020 and 2021 at about 47 lakh, almost 10 times the official Indian figure of 4.8 lakh for those two years.
Among the larger states in India, undercounting was particularly pronounced in states like Madhya Pradesh, Gujarat, and Uttar Pradesh. In those regions, the number of COVID-19 deaths reported was a fraction of the actual loss of life caused by the pandemic.
For instance, Madhya Pradesh saw an increase of 178,000 deaths in 2021 compared to 2020. But only 10,788 deaths were officially attributed to COVID-19, meaning the official COVID-19 toll was roughly 65 times lower than the total excess deaths.
Similarly, in Uttar Pradesh, 478,682 additional deaths were recorded in 2021, but only 23,743 deaths were officially linked to COVID-19. This represented a 56.9× undercount, showing just how many deaths went unclassified or were attributed to other causes.
These discrepancies were not isolated cases: they reflect a broader issue of underreporting and poor documentation, a reality faced by many parts of India, especially during the devastating second wave of COVID-19 in 2021.
Turning to the southern part of the country, the figures varied widely across states.
Kerala, often recognised for its relatively transparent governance, displayed a higher degree of accuracy in its reporting. While the state saw a significant increase in deaths in 2021, with 339,648 registered deaths — a 35.3% rise compared to 2020 — the total number of deaths attributed to COVID-19 stood at 72,139.
This meant that COVID-19 deaths accounted for a considerable share of the total excess deaths, making up 21.2% of the deaths in 2021. Kerala’s transparency in death certification and health reporting was evident, and its handling of the crisis still stands as one of the few examples where the pandemic’s full toll has been reflected in official records.
However, in Karnataka, a state that also has a strong healthcare infrastructure, the situation was different. Karnataka’s registered deaths in 2021 were 666,402, marking a 20.8% increase over 2020.
But only 40,411 total deaths were officially attributed to COVID-19, pointing to a 16.5× undercount. This discrepancy highlighted that, while Karnataka was among the worst-hit states, there was a significant gap between reported COVID-19 deaths and actual mortality, especially during the peak of the second wave.
The situation in Tamil Nadu was similarly troubling. The state recorded 875,012 deaths in 2021, a 27.3% rise over 2020. Despite the large number of excess deaths, 38,086 of these were officially attributed to COVID-19 since the start of the pandemic. This indicated that the state’s official COVID-19 mortality figure was about 23 times lower than the actual number of excess deaths, suggesting that many pandemic-related deaths were either underreported or misclassified.
In Andhra Pradesh, a state with a population of over 50 million, the situation was just as concerning. While the official death count in 2021 was 556,102, an increase of 22.2%, the total COVID-19 death toll stood at 14,733, less than 3% of the increase in deaths. This put the state’s underreporting factor at 37.75×, one of the largest among South Indian states.
Perhaps most strikingly, Telangana stood out for its very low attribution of deaths to COVID-19. Despite the state seeing 234,425 deaths in 2021 — a 15.4% increase over the previous year — only 4,111 total deaths were officially linked to COVID-19. This gave the state a 57.01× undercount, one of the highest in India, reflecting serious gaps in data collection and health reporting.
The real COVID-19 death toll is likely far higher than suggested by the official figures. An analysis of excess mortality paints a grim picture, showing that the country may have lost far more lives than acknowledged in government records. The wide variance in underreporting across states also underscores the challenges in data collection, death registration, and certification of cause of death.
These discrepancies raise several questions about India’s pandemic preparedness, health infrastructure, and official transparency. The pandemic revealed massive gaps in how India tracks deaths, with many lives potentially lost due to a lack of access to healthcare, underreporting of cases, and misclassification of causes of death.
(Edited by Majnu Babu).
