AILSA CHANG, HOST:

When India became the epicenter of the COVID-19 pandemic, public health experts warned that the actual death toll was much larger than the official count. But how much larger? Well, one new study says it could be 10 times the official death toll. Reporter Sushmita Pathak joins us now from Mumbai.

Hi, Sushmita.

SUSHMITA PATHAK, BYLINE: Hello.

CHANG: So what did this study find?

PATHAK: So this was a study by researchers from Harvard and the Center for Global Development. They looked at mortality in India during the pandemic, so all kinds of deaths that occurred during the pandemic. And then they compared that with mortality in previous years. That's how they were able to estimate how many excess deaths, extra people, had died during the pandemic. The assumption is that COVID-19 was the primary cause. And the number that they arrived at is staggering. It's in the millions. But India's official death toll is 414,000.

CHANG: Wow. There's such a disparity there. How did researchers arrive at this new estimate? Like, how can they be certain all of those deaths were from COVID?

PATHAK: So they used a few different methods. First, they looked at civil death registers. So these would be death certificates. But again, this information was only available from some state governments in India. The second thing they looked at was infection rates. India has conducted these big national surveys to check for coronavirus antibodies in the population, which gives you a sense of how many people were infected. The researchers used fatality rates from other countries to extrapolate what percentage of Indians who have got the virus may have died. Finally, the third source of data was an economic survey by an Indian think tank, which mostly has information about topics like unemployment but also about mortality.

CHANG: Interesting. Well, why have the official numbers been so low?

PATHAK: Well, India has always been bad at registering deaths. Even before the pandemic, only about 20% of deaths used to be medically registered. During the second wave this past spring, the health system was so overwhelmed that people were dying at home unable to get in the hospital. A lot of people died on the streets outside the hospital. So a lot of deaths were missed.

In recent months, many states have been revising their official death numbers to include those kinds of deaths. But Prime Minister Narendra Modi and his administration have mostly brushed off reports that the official death toll is a vast undercount. On several occasions, the government has touted India's seemingly low death rate from COVID. In fact, researchers have noted that this illusion about low death rate made Indians complacent last year, which led to the devastating second wave this year.

CHANG: Well, how would you characterize the way India's been managing COVID now?

PATHAK: Well, things are very different from what they were this past spring. Cases have been going down since infections peaked in May. That's when India was confirming some 400,000 new cases a day. Today, the health ministry confirmed about 30,000 new infections, the lowest in four months. So public transport is open. Offices are open. Tourists are crowding holiday spots.

But in recent weeks, new cases have kind of plateaued. They're not declining as fast as they were about a month ago. And officials and doctors are warning again and again that a third outbreak is looming. Some experts say it's going to come in the fall. And to add to India's worries, the vaccination campaign isn't going as fast as experts say it should. Only about 6% of Indians are fully vaccinated. So we're just sort of holding our breath and checking the new cases every day, sometimes obsessively, to look for any signs of an uptick.

CHANG: That is reporter Sushmita Pathak speaking to us from Mumbai.

Thank you, Sushmita.

PATHAK: Thank you.

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