India broke the daily record of coronavirus deaths on Tuesday, with official data reporting 4,529 people succumbing to the virus, leaving a nation numbed by the scale of devastation and loss even as daily infections trended lower, offering some hope amid the misery.

With this, India has counted 283,248 covid deaths, around 36% of which came in the past month alone. The US had recorded 4,475 deaths on 12 January, the previous record, according to Our World in Data.

Epidemiologists, however, say the official death toll and infection figure significantly undercount the true number as the virus spreads to India’s villages, where health infrastructure and testing facilities range from weak to non-existent.

Far from a peak

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Far from a peak

Still, it is normal for deaths to peak a few weeks after infections, but there may be other reasons, too, that are peculiar to the second wave.

Several patients now being counted as dead due to covid may have succumbed weeks ago. On Tuesday, Maharashtra added 1,291 deaths, but 612 of these patients died more than a week ago. Karnataka, too, is now acknowledging several earlier deaths as due to covid, and so has Uttarakhand for the past two days.

Most Covid-19 deaths in a day

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Most Covid-19 deaths in a day

As these states, and more, continue to add past deaths, not only will the daily toll stay high, but it will also give a truer picture of the scale of damage to Indians’ lives. Epidemiologists said the reason India is missing covid deaths is that many die without a positive covid test, and several others get lost in bureaucratic definitions.

The Institute of Health Metrics and Evaluation at Washington University estimates the actual daily toll in India to be three times the official number.

In 2020, several states saw the number of fatalities peak around two weeks after the number of cases peaked. This is true for other countries as well. However, for India’s second wave, the trail could be longer due to the corrections in counting.

The decline in deaths, as well as cases, is likely to be relatively slower than the pace at which they rose in March and April because the pool of active cases is very high, said Rajib Dasgupta, a professor of public health at Jawaharlal Nehru University. India has 3.2 million patients under treatment, over three times the first wave peak.

Chandrakant Lahariya, a Delhi-based epidemiologist, also said the peak in the death count could be some time away as improved treatment protocols and early care-seeking in the second wave have kept patients alive for longer.

Public outcry over undercounting could also slightly improve reporting, while another push may come from the pandemic moving towards southern states, where reporting of deaths is expected to be more accurate, Lahariya said.

Epidemiologists also warned that the rural surge of the pandemic may still leave several deaths uncounted.

Meanwhile, most states are seeing improved case-adjusted fatality rates, or deaths as a share of cases reported two weeks prior. In mid-April, 16 of every 1,000 covid-19 patients were losing their lives, but this has come down to 11. Among major states, the number has worsened in Maharashtra, Punjab, and Tamil Nadu.

India’s daily infection count last crossed 400,000 on 8 May and has now slid below 300,000. Mathematical models suggest the wave may taper down further in the next few weeks and subside by early July.

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