Covid-19 death toll was higher than official count: Study

The official COVID-19 death toll published by the Directorate General of Health Services (DGHS) during the pandemic was not accurate. This issue has resurfaced in at least two separate studies, both indicating that the number of COVID-related deaths was higher than government records show.

Scientists and researchers from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) conducted separate studies on pandemic-era deaths in Sitakunda upazila of Chattogram district and in areas under Dhaka North City Corporation. One study focused on a rural area, while the other covered an urban region.

Bangladesh reported its first COVID-19 case on 8 March, 2020, and the first death from the virus on 18 March of that year. According to data from the DGHS as of 13 June, a total of 29,502 people have died from COVID-19 in the country over the past five and a half years. The then-ruling Awami League government repeatedly claimed that effective measures kept the country’s COVID-19 death toll relatively low.

However, multiple studies during the pandemic suggested that the overall death rate was significantly higher than normal. On 10 March, 2022, the medical and public health journal ‘The Lancet’ published an estimate indicating that Bangladesh had experienced 413,000 excess deaths during 2020 and 2021 due to the pandemic.

Two more studies on the same issue have since been published. The Sitakunda-area study on pandemic mortality appeared in the Journal of Global Health in 2024, while the study on Dhaka North City Corporation was published this year. Researchers have said that another study on deaths during pandemic period in Dhaka city is nearing completion.

According to researchers of the icddr,b, the government’s death toll does not reflect reality. During the early phase of the pandemic, access to testing and treatment was limited.

Many COVID-19 patients died at home without ever being diagnosed, and many cases went unrecorded. Some people concealed their illness or did not disclose deaths.

In some instances, burials were conducted secretly. The officials death toll includes only hospital deaths, omitting those who died with all COVID-19 symptoms but never went to hospital.

Mohammad Mushtuq Husain, former Chief Scientific Officer at the Institute of Epidemiology Disease Control and Research (IEDCR), told Prothom Alo, “The World Health Organization has stated in its own research that the global death toll from COVID-19 is likely three times higher than reported figures. The icddr,b study is important and brings us closer to the truth. The government does not count deaths from indirect causes, so the official numbers remain lower and underreported."

The researchers form icddr,b collected data on COVID-era deaths in Sitakunda upazila of Chattogram district between February and June 2021. The research team gathered information from 25,669 households. Their focus was to record the number of deaths in these households across three years—2018, 2019, and 2020—along with the ages of the deceased. Of these, 2020 was the year marked by the COVID-19 pandemic.

Data analysis revealed that there were 493 deaths among these households in 2018 and 494 in 2019—just one more than the previous year, a difference statistically insignificant.

However, the number of deaths rose sharply in 2020. That year, 761 deaths were recorded in these households, 267 more than the previous year. This marks a 54 per cent increase in deaths in 2020 compared to the average of the previous two years in Sitakunda.

At the end of 2020, the local health department reported only eight confirmed COVID-19 deaths in Sitakunda, with an additional 15 deaths exhibiting COVID-like symptoms.

The study based on Sitakunda was led by Anika Tasnim Hossain, an Associate Scientist at the Maternal and Child Health Division of icddr,b.

Anika Tasnim told Prothom Alo, “We tried to account for both direct and indirect causes of death. Our findings suggest that deaths also increased due to pandemic-related factors. People could not leave their homes, they feared going to hospitals, and many did not receive timely treatment. These issues contributed to the higher death toll.”

Records kept at graveyards are one of the means to know the death toll. Graveyards come under pressure when deaths rise suddenly. Considering this, icddr,b scientists and researchers also collected and analysed data from graveyards to assess pandemic mortality.

They selected the following six graveyards under Dhaka North City Corporation for their study: Uttara Sector 12 graveyard, Uttara Sector 14 graveyard, Uttara Sector 4 graveyard, Banani graveyard, Rayerbazar graveyard, and Mirpur Intellectual graveyard.

Of these, Banani graveyard, established in 1974, is the oldest, while Uttara Sector 14 graveyard, established in 2019, is the newest.

Researchers gathered data on 102,754 deaths from these six graveyards. Among these, 32,108 deaths occurred between 1974 and 2000, while the remaining 70,585 occurred between 2001 and 2023. For their study, they analysed the 70,585 deaths that took place between January 2001 and December 2023.

Their analysis showed that, compared to 2018–19, burials in these six cemeteries increased by 69 per cent in 2020. In 2023, the burial rate was still 31 per cent higher than in pre-pandemic years.

Researchers believe that this excess mortality during the pandemic period was due to COVID-19, although these numbers did not appear in official government statistics.

Ahmed Ehsanur Rahman, an icddr,b scientist and a member of the Health Sector Reform Commission who was involved in both studies, told Prothom Alo, “Although our studies were small in scale, the findings point to an urgent need for a strong death registration system in Bangladesh.

Every death matters, and it is essential to account for each one. The COVID-19 pandemic has left behind a tragic legacy of unregistered deaths. Now is the time to confront the true figures of mortality.”