India grieves 200,000 dead with many more probably uncounted

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A health worker gives cardiopulmonary resuscitation (CPR) to a COVID-19 patient waiting to be attended to inside an ambulance outside a government COVID-19 hospital in Ahmedabad, India, Tuesday, April 27, 2021. The COVID-19 death toll in India has topped 200,000 as the country endures its darkest chapter of the pandemic yet. (AP Photo/Ajit Solanki)

NEW DELHI – Three days after his coronavirus symptoms appeared, Rajendra Karan struggled to breathe. Instead of waiting for an ambulance, his son drove him to a government hospital in Lucknow, the capital of India’s largest state.

But the hospital wouldn’t let him in without a registration slip from the district’s chief medical officer. By the time the son got it, his father had died in the car, just outside the hospital doors.

“My father would have been alive today if the hospital had just admitted him instead of waiting for a piece of paper,” Rohitas Karan said.

Stories of deaths tangled in bureaucracy and breakdowns have become dismally common in India, where deaths on Wednesday officially surged past 200,000. But the true death toll is believed to be far higher.

In India, mortality data was poor even before the pandemic, with most people dying at home and their deaths often going unregistered. The practice is particularly prevalent in rural areas, where the virus is now spreading fast.

This is partly why this nation of nearly 1.4 billion has recorded fewer deaths than Brazil and Mexico, which have smaller populations and fewer confirmed COVID-19 cases.

While determining exact numbers in a pandemic is difficult, experts say an overreliance on official data that didn't reflect the true extent of infections contributed to authorities being blindsided by a huge surge in recent weeks.

“People who could have been saved are dying now,” said Gautam Menon, a professor of physics and biology at Ashoka University. Menon said there has been “serious undercounting” of deaths in many states.