On a sweltering April night in Ahmedabad, the largest city in the Indian state of Gujarat.
Shayar Rawal rode his motorbike to a COVID designated government hospital at 11:55 pm. Over the next 24 hours, he had just one task to count the number of dead bodies being brought to the mortuary.
Rawal-a reporter at the Gujarati daily news paper Divya Bhaskar-counted four deaths in the first hour. Grieving relatives collected five more dead bodies in the next hour. When the number reached 100, he says, reality sunk in.
"I knew the government was hiding numbers, but this was way more than what I had expect-ed," Rawal says.
Officially, the city recorded just 15 COVID-19 deaths that day. But by the end of his vigil, Rawal had counted 112 bodies-and that was just the dead from one city hospital. Over the next few weeks, his colleagues also counted bodies at crematoria and burial grounds and accessed death certificates from districts across the state. Their final analysis revealed that the death toll over nine weeks in the state of Gujarat was 10 times higher than the official figure, In response to the Divya Bhaskar report, the state government gave multiple reasons for the discrepancy, from saying deaths with
comorbidities cannot be counted as COVID-19 deaths to claiming that duplicates of death certificates had been issued. National Geo-graphic's questions to the state government went unanswered
"There are fundamental, inherent challenges says Samira Asma, assistant director general for data, analytics, and delivery for impact at the World Health Organization. Even in wealthy nations, officials are grappling with incorrect diagnoses, irregularities in the data tracking, and other factors that can obscure the virus's true impact. "So because of this, we don't have a complete understanding of the entire scope of the pandemic"
But the past year has also been a stark remind-er of inequalities throughout the world-in-cluding the resources needed to collect timely and accurate data on deaths. In an assessment conducted in 2019, the WHO found that about two-thirds of the countries in the world lack strong civil registration and vital statistics sys-tems that keep a count of births and deaths.
This disparity is having dangerous conse quences with COVID-19. The World Health Statistics Report released last month stated that there were 3 million deaths directly and indirectly attributed to the SARS-CoV-2 vi-rus-that's 1.2 million higher than the official figures reported by countries and then tallied by the WHO
The lack of robust data in low and middle income countries such as India means grass-roots efforts such as Rawal's are crucial in de termining the true death toll, which in tum affects our understanding of the pandemic's global trajectory.
"To have an accurate understanding of historic mortality is key in knowing how effective dif ferent interventions have been, but also in helping us to more accurately forecast what may happen in the future of the pandemic," says Oliver Watson, a postdoctoral researcher in infectious disease epidemiology at Imperial College London.
Souror National Geographic