A front lineman in personal protective equipment (PPE) sprays a flammable liquid on a burning funeral pyre of a man who died of coronavirus disease (COVID-19), in a crematorium on the outskirts of Mumbai, India, April 15, 2021. REUTERS / Francis Mascarenhas / File Photo
Gas and firewood furnaces at a crematorium in the West Indian state of Gujurat ran without interruption for so long during the COVID-19 pandemic that metal parts began to melt.
“We operate around the clock with 100% capacity to cremate bodies on time,” said Kamlesh Sailor, the chairman of the trust that runs the crematorium in the diamond-cutting town of Surat.
And now that hospitals are full and oxygen and drugs are scarce in an already creaky healthcare system, several major cities are reporting much higher numbers of cremations and funerals under coronavirus protocols than the 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 mismatch in the death count can be caused by a variety of factors, including undue caution.
A senior health official said the increase in cremation rates was due to the fact that bodies were 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.
‘VERY IRKSOME’
But Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, said many parts of India are “denying data.”
“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 known as Umra have cremated more than 100 bodies per day per day over the past week according to COVID protocols, far more than the official daily COVID death toll of the city of 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 had tripled in recent weeks.
“I have been going to the crematorium regularly since 1987 and have been involved in its day-to-day operation since 2005, but I have not seen so many corpses for cremation in all those years,” not even during a bubonic plague outbreak in 1994 and floods in 2006 .
Government spokespersons in Gujurat did not respond to requests for comment.
India is not the only country whose coronavirus statistics are being questioned. But workers’ testimonials and a growing body of academic literature suggest that deaths in India are underreported compared to other countries.
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.
WORKDAY AND NIGHT
In Lucknow, the capital of the densely populated northern state of Uttar Pradesh, data from the largest COVID-only 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, India Today reported that two crematoriums in Bhopal, the capital of the central state of Madhya Pradesh, have 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 true 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.
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