India's Covid-19 deaths relative to infections hit a record high in June after cases peaked in early May, an analysis of government data shows, amid pressure on authorities to accurately report deaths from a second wave of the virus.
A big rise in infections in April and May, driven largely by the more infectious and dangerous Delta variant, brought India's health system to its knees.
India has officially reported 403,310 deaths out of 30.6 million people who have contracted the virus.
While the country of 1.35 billion people has reported fewer deaths than the United States and Brazil some experts believe its actual case and fatality numbers are several times higher.
Based on data reported by state authorities and collated by the federal health ministry, the Covid-19 case fatality rate (CFR) jumped to about 3% in June from 1.26% in October, the first full month after the peak of its first wave of infections.
India's overall reported CFR is 1.31%, one of the lowest in the world, which the government has highlighted as a sign of the effectiveness of its pandemic response.
By contrast, the more developed southern states better reported data when they got hit later, he said, adding that more deaths are being recorded now following a public outcry over undercounting.
The populous and poor northern state of Bihar, for example, raised its death count by about 4,000 on a single day in early June after a court ordered an audit.
India's worst affected state of Maharashtra also raised its Covid-19 death toll sharply higher after the discovery of thousands of unreported cases.
The pandemic has killed at least 3,987,613 and infected 185,059,064 people worldwide since the virus first emerged in December 2019, according to an AFP compilation of official data at 1400 GMT on Tuesday.
Also Read: India logs lowest daily Covid toll in around 90 days
Deadly delta
While reported infections have fallen fast since the May peak, deaths are not going down at the same rate, worrying some experts as lockdowns have been eased in many parts of the country.
"The Delta variant is both the most contagious variant and among the most dangerous variants in terms of infection fatality rates," said Christophe Z Guilmoto, a demographer at the French Institute of Research for Development in New Delhi, who has studied Covid-19 mortality in India.
To keep deaths low in any future wave, authorities will have to place restrictions early, when the rate of positive Covid-19 results rises, said Rajib Dasgupta, head of the Centre of Social Medicine & Community Health at Jawaharlal Nehru University.
He said authorities would also have to ramp up clinical care capabilities together with case forecasting models, genomic surveillance data and molecular epidemiologic analyses.
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