The Mortality Burden from COVID in Low-Income Settings: Evidence from Verbal Autopsies in India

Abstract

AbstractMeasuring the mortality burden of SARS-CoV-2 in lower-income countries is difficult because death registries are incomplete and lack cause of death. We address this problem in India, which had the second-highest number of officially reported cases. We completed WHO-compliant verbal autopsy (VA) surveys on roughly 20,000 deaths drawn from a population-representative sample. SARS-CoV-2 deaths spike in June 2020, just after India’s lockdown, and in May 2021, after its second wave. During those spikes the virus is responsible for 23.3% and 35.8% of all deaths, respectively. Cardiovascular deaths also spike during the start of the pandemic. We find that the death rate rises by 81% during the pandemic, SARS-CoV-2 is responsible for 33% of these excess deaths, and cardiovascular disease for 23% of these deaths.