“We operate around the clock at 100% capacity to cremate bodies on time,” Kamlesh Sailor, the chairman of the trust that runs the Gujarat crematorium in the diamond-cutting town of Surat, told Reuters.
With hospitals full, and oxygen and drugs scarce in an already creaky health system, several major cities are reporting much higher numbers of cremations and funerals under coronavirus protocols than official Covid-19 death toll, according to crematorium and cemetery officials, media and a review of government data.
India registered a record number of 273,810 new daily infections and 1,619 deaths on Monday. The total number of cases is now more than 15 million, the second after the United States.
Reliable data is at the heart of any government response to the pandemic, without which scheduling hospital, oxygen and drug vacancies becomes difficult, experts say.
Government officials say the difference in death rates could be caused by a variety of factors, including excessive caution.
A senior health official said the increase in cremation rates was due to bodies being cremated using Covid protocols “even if there is a 0.1% chance that the person is positive.”
“In many cases, patients come to the hospital in an extremely critical condition and die before being tested, and there are cases where patients are taken to the hospital dead and we don’t know whether they are positive or not,” the official said.
‘Refuse data’
But Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, said there was “data denial” in many parts of India.
“Everything is so muddy,” she said. “It feels like no one understands the situation very clearly, which is very annoying.”
In Surat, Gujarat’s second largest city, Sailor’s Kurukshetra crematorium and a second crematorium called Umra have cremated more than 100 bodies a day under Covid protocols for the past week – much higher than the city’s official daily death toll. about 25, according to employee interviews.
Prashant Kabrawala, trustee of Narayan Trust, which operates a third city crematorium called Ashwinikumar, declined to provide the number of bodies received under Covid protocols, but said cremations there have tripled in recent weeks.
“I have been going to the crematorium regularly since 1987 and have been involved in the day-to-day business since 2005, but I have not seen many corpses for cremation in all those years,” not even during a 1994 bubonic plague outbreak and floods in 2006, Kabrawala said.
Government spokesmen in Gujarat did not respond to requests for comment.
Mukherjee’s study of India’s first wave concludes that there were 11 times more infections than reported, in line with estimates from studies in other countries. There were also between two and five times as many deaths as reported, far above the global average.
Work day and night
In Lucknow, the capital of the densely populated northern state of Uttar Pradesh, data from Covid’s largest crematorium, Baikunthdham, shows double the number of bodies arriving on six different days in April than government data on Covid deaths for the entire city.
The figures do not take into account a second Covid-only crematorium in the city, or burials in the Muslim community that makes up a quarter of the city population.
The head of the Azad crematorium, who has only one name, said the number of cremations under Covid protocols has increased fivefold in recent weeks.
“We work day and night,” he said. “The incinerators are running full time, but still many people have to wait with the bodies for the final rites.”
A spokesman for the Uttar Pradesh government did not respond to a request for comment.
Elsewhere, local news outlet India Today reported that two crematoria in Bhopal, the capital of the central state of Madhya Pradesh, had cremated 187 bodies according to Covid protocols in four days this month, while the official Covid death toll was at five.
Last week, Sandesh, a Gujarati newspaper, counted 63 bodies leaving a single Covid hospital to be buried in the state’s largest city, Ahmedabad, on a day when government records showed 20 deaths from the coronavirus.
The medical journal Lancet noted last year that four Indian states, each making up 65% of Covid fatalities, each recorded 100% of their coronavirus deaths.
But less than a quarter of deaths in India are medically certified, especially in rural areas, meaning the actual Covid death rate in many of the other 24 Indian states may never be known.
“Most deaths are not recorded, so it is impossible to perform a validation calculation,” said Mukherjee.