Centre questions WHO's Covid-19 mortalities estimation methodology

New Delhi: Indian Union Ministry for Health on Saturday questioned the Worl health Otganisaions estimates of mortalities in the country out of the Covid-19 pandemic. In a statement, the ministry claimed that the global health agency used a general mathematical model and applied it to a vast nation with geographical varieties and diverse populations, PTI reported.

After an article titled "India Is Stalling WHO's Efforts to Make Global Covid Death Toll Public", dated April 16, appeared in New York Times, the ministry said that it had conveyed to WHO its concerns on the methodology used multiple times.

The statement said the WHO model gives two highly different sets of excess mortality estimates when using the data from Tier I countries and unverified data from 18 Indian states. Such a wide variation in estimates raises concerns about the validity and accuracy of such a modelling exercise, it said.

India has written WHO six formal letters to raise queries regarding the methodology and use of unofficial data sets. It said that the "one size fits all" approach of the models might work for small countries like Tunisia but not India, which houses 1.3 billion people, the statement said.

The statement said that if the model is authentic and accurate, it should be authenticated by running it for all Tier I countries, and the result must be shared with all member states.

The statement claimed that the model assumes an inverse relationship between monthly temperature and monthly average deaths, which has no scientific backing. India is of continental proportions, diverse climatic and seasonal conditions, meaning all states have widely varied seasonal patterns. Therefore national level estimation of mortality rates is not valid, the statement argued.

The statement questions why Global Health Estimates (GHE) 2019 is used to estimate expected death figures for India, despite flagging multiple times that India has a robust system of data collection and management while Tier I countries have their historical datasets.

When the test positivity rate stood non-uniform in the country, it was not considered in the modelling purpose, the statement added.

It further said that India had undertaken COVID-19 testing at a much faster rate than WHO has advised, maintaining molecular testing as the preferred testing method and using Rapid Antigen as screening purpose only. But whether these factors were taken to account while modelling was done is unclear.

The approach followed in quantifying various containment measures in India by the WHO model is also seriously questionable. A subjective approach to quantifying containment measures will always involve a lot of bias, which was admitted by the WHO itself. Nevertheless, it was also used by the model, the statement said.

The statement then questioned the categorization of countries as Tier I/II. There were fluctuations in the Covid-19 reporting from Tier I countries, including the USA, Germany, and France, which defied knowledge of disease epidemiology. Also, the inclusion of Iraq, which is undergoing a complex extended emergency, in Tier I is particularly curious.

"While India has remained open to collaborating with WHO as data sets like these will be helpful from the policy-making point of view, India believes that in-depth clarity on methodology and clear proof of its validity are crucial for policymakers to feel confident about any use of such data.," the statement said.

"It is very surprising that while New York Times purportedly could obtain the alleged figures of excess COVID-19 mortality in respect to India, it was unable to learn the estimates for other countries!" the statement added.