Other experts said India’s refusal to cooperate with the WHO analysis was rooted in the country’s history in which it ignored how data can inform policy-making.

“It’s normal that we miss some of the Covid deaths,” said Dr. Bhramar Mukherjee, a professor of biostatistics at the University of Michigan School of Public Health, who worked with WHO to review the data. But, she added, “No one has been so resistant.”

The Ministry of Health in New Delhi has not responded to requests for comment. WHO officials said India’s 2020 death rates were released too late to be factored into their calculations, but they would “assess the data carefully”.

Countries that report Covid deaths more accurately have also been at the center of disputes over the reliability of excess death estimates. In Germany, for example, WHO experts estimate that 195,000 more people than usual had died during the pandemic, a significantly higher number than the 112,000 Covid deaths recorded there.

But Giacomo De Nicola, a statistician at the Ludwig Maximilian University of Munich who has studied Germany’s high death rate, said the country’s rapidly aging population meant the WHO analysis may have underestimated the number of people expected to die. die in a normal year. That, in turn, could have led to overestimations of the number of additional deaths.

He said the experts assembled by the WHO were responsible for trends in mortality, but not directly for changes in the age structure of the population. As Germany faced excessive deaths, he said, the WHO estimate for the country appears “very high”.

Overall, the WHO calculations were more conservative than separate analyzes previously released by The Economist and the Institute for Health Metrics and Evaluation.

Some experts said the WHO analysis benefited from relying more heavily than other estimates on actual data, even if they were incomplete, as opposed to statistical modelling.

Oscar LopezKaran Deep SinghSofia VillamilChristopher F. SchuetzeIvan NechepurenkoRichard C. PaddockMuktita SuhartonoMitra TajoJulie TurkewitzMerna Thomas and Salman Masood reporting contributed.

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