India's government has rejected the figure, saying the methodology is flawed. Will we ever know how many Indians died in the pandemic?
In November 2020, researchers at the World Mortality Dataset - a global repository that provides updated data on deaths from all causes - asked authorities in India to provide information.
"These are not available," India's main statistical office told the researchers, according to Ariel Karlinsky, a scientist who co-created the dataset and is a member of an advisory group set up by the the WHO for its estimates of excess deaths caused by Covid globally during 2020 and 2021.
Excess deaths are a simple measure of how many more people are dying than expected compared with previous years. Although it is difficult to say how many of these deaths were due to Covid, they can be considered a measure of the scale and toll of the pandemic.
India has officially recorded more than half a million deaths due to the novel coronavirus until now. It reported 481,000 Covid deaths between 1 January 2020 and 31 December 2021, but the WHO's estimates put the figure at nearly 10 times as many. They suggest India accounts for almost a third of Covid deaths globally.
So India is among the 20 countries - representing approximately 50% of the global population - that account for over 80% of the estimated global excess mortality for this period. Almost half of the deaths that until now had not been counted globally were in India.
Its absence from global databases such as the World Mortality Dataset means that the only national numbers the country has are model-based estimates of all-cause excess deaths. (These models have looked at state-level civil registration data, a global burden of disease study, mortality reported by an independent private polling agency, and other Covid-related parameters.)
Earlier this week, the government released civil registration data showing 8.1 million deaths in 2020, a 6% rise over the previous year. Officials played it down, saying all the 474,806 excess deaths could not be attributed to Covid. According to official records, some 149,000 people died of Covid in India in 2020.
"Essentially, Indian death rates from Covid were not exceptionally low, only exceptionally undercounted," says Prabhat Jha, director of the Centre for Global Health Research in Toronto and a member of the expert working group supporting the WHO's excess death calculation
Three large peer-reviewed studies had found that India's deaths from the pandemic by September 2021 were "six to seven times higher than reported officially". A paper in The Lancet by the Institute for Health Metrics and Evaluation (IHME), an independent global health research centre, uses subnational all-cause mortality data from 12 Indian states. They come close to the WHO's estimation.