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The Hindu 12.6.21

With thanks original sources

The real time mortality impact of the COVID-19 pandemic is an important statistical measure to guide policy responses. But measuring the actual count is not an easy task. WHO, in January 2021, had estimated, based on excess deaths data in Europe and the American continents, that actual deaths were at least 1.6 times over the official count. The problem of under-counting, even in mature public health systems across the developed world, is largely because patients who die due to cardiovascular issues among others even after apparent recovery from COVID-19 are sometimes not tracked and registered as COVID-19-related deaths. This is why even in Kerala — with 100% registration of deaths and a relatively low case fatality rate — following criticisms about the methodology to evaluate whether a death was related to COVID-19, the health administration in the districts, rather than a State-level audit committee, will now audit deaths. But there is another class of under-counting across States, where health bulletins mislead by reporting a lower number of cases and deaths. This is the case with Bihar where the reported toll was suddenly increased by 72% following a Health Department review after the Patna High Court found discrepancies in figures cited by different agencies in Buxar district. Bihar is among the States in India with the lowest civil registration of deaths, with barely 34.1% of the dead being registered, according to the Civil Registration System (CRS) report of 2018. Estimations of the actual count of the dead are difficult to obtain in other States such as Uttar Pradesh as well, where public health systems are poor and neither the infections nor deaths have been effectively tracked, especially in rural areas, where many have died outside of hospitals.

One method to assess the actual number of deaths due to COVID-19 is by calculating the excess deaths during the given period when the pandemic has raged, compared to the baseline mortality occurring in similar time frames before the pandemic. This exercise also works best if death registrations are relatively high, which should be possible in most districts as registration of deaths has improved to 76% according to CRS 2018. Excess deaths analyses in Gujarat, Chennai and Kolkata based on collations of preliminary registration data by news organisations suggest that they were nearly 10, five and seven times higher, respectively, than reported fatalities during the second wave. If the CRS datasets, maintained by the Office of the Registrar General and Census Commissioner of India besides State registrars and municipal officials with a good quality of registration, are made available, it would enable better estimation of the actual mortality figures. In the meantime, only honest reporting of the deaths will help provide better mitigation strategies.

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1.Mortality (N)-the state of being subject to death. मृत्यु दर

2.Under-Counting (N)-a count or total that is less than the actual number or amount.

3.Cardiovascular (Adj)-relating to the heart and blood vessels. हृदय तथा रक्तवाहिकाओं संबंधी

4.Discrepancies (N)-a difference between conflicting facts or claims or opinions. विसंगतियों

5.Raged (V)-to happen in a strong or violent way.

6.Collations (N)-the process of collecting information and then arranging or considering it together.

7.Fatalities (N)-an occurrence of death by accident, in war, or from disease.

8.Mitigation (N)-a reduction in the harmful effects of something.

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The monsoon over the greater Mumbai region has come to be characterised by the unsettling annual spectacle of collapsing buildings, and this year is proving to be no different. An unsafe multi-storeyed building in a core area of the city has collapsed on to another, leaving at least 11 people dead and exposing once again, the decrepit base of dwellings in India’s much-romanticised economic powerhouse. The disaster has brought in its wake the familiar litany of accusations, of people occupying unsafe and illegal buildings, and civic authorities failing to act in time. Mumbai’s Mayor Kishori Pednekar has responded to criticism with a helpless exhortation to the city administration to remove dangerous structures. Going beyond these predictable impulses, the overburdened city needs a time-bound and accountable system of ensuring the safety of its housing stock. Coinciding with this year’s monsoon, the Maharashtra Housing and Area Development Authority identified 21 structures in Mumbai as being extremely dangerous, with an advisory to over 700 occupants to move to transit accommodation, while reconstruction is undertaken. Understandably, the occupants are reluctant, since the alternative housing is far away from their education and work locations. This is a conundrum that Maharashtra will have to address, treating it as a crisis that will only be aggravated by changes to monsoon rainfall intensity over time.

Coastal Maharashtra sits in the pathway of extreme monsoon weather events, which are forecast to increase in frequency due to ongoing warming of the Arabian Sea. Scientists including those of the Indian Institute of Tropical Meteorology have proposed, in the context of the deluge a few years ago, that accurate monsoon forecasting over central India, incorporating changes to sea surface temperature, would help governments prepare better to save lives and agriculture. For Mumbai, what this means is to accelerate its repair and rehabilitation programme for weak structures and replace those that cannot be salvaged. The city desperately needs channels for huge volumes of water to flow out, and a plan to create new urban wetlands where feasible to store the precipitation. A rejuvenated Mithi river — its planned clean-up has been delayed by the COVID-19 crisis — could offer some relief, but more waterbodies are needed. And it will take a mass housing programme to make life safer for the thousands in hovels. A far-sighted plan to shift people from squalid buildings to modern ones is also a health imperative; such a start must be made with the most dangerous structures. It is also unseemly for political parties to use a disaster such as the one in Malad as a cudgel against the government, considering that Mumbai’s civic base lies neglected over the decades regardless of who ruled.

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1.Decrepit (Adj)-weak and in poor condition, esp. from age or long use. जर्जर, पुराना

2.Dwellings (N)-a house, flat, or other place of residence. आवास

3.Litany (N)-a report or description.

4.Exhortation (N)-the act of strongly encouraging or trying to persuade someone to do something. प्रोत्साहन

5.Conundrum (N)-a problem that is difficult to deal with. समस्या

6.Deluge (N)-a severe flood. बाढ़

7.Rehabilitation (N)-the action of restoring something that has been damaged to its former condition. पुनर्वासन

8.Salvaged (V)-to try to make a bad situation better.

9.Precipitation (N)-water that falls from the clouds towards the ground, especially as rain or snow.

10.Hovel (N)-a small home that is dirty and in bad condition.

11.Squalid (Adj)-dirty, untidy, and in bad condition. घटिया

12.Imperative (N)-an essential or urgent thing. अनिवार्य

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