What’s in a name? That we call Corona; Will, by any other name, kill as cold.
Only a small minority has so far cared if the cause of death of their loved ones was recorded as COVID or not. The reality of their loss burdened them, not so much its cause. That is about to change, with the Supreme Court asking the government to institute financial compensation for death due to COVID.
On the plus side, Census 2021 will now take place without any attempt to fudge the data. And under-reporting of COVID deaths would cease, at least prospectively.
The statement that few cares about the cause of death is a little too sweeping. Three sets of people care, a great deal. Epidemiologists want precise numbers about the scale and pace of the pandemic spread. They care about accurate reporting.
Another set of people are those with an insurance linkage. There are a number of insurance policies that are worded so carefully as to exclude a previously unknown disease such as COVID from the causes that would trigger an insurance payout. The most egregious examples are health insurance and home loan insurance. Several health insurance plans initially refused to cover the cost of COVID treatment, but then the insurance regulator put its foot down and said normal health insurance schemes have to cover COVID as well.
Another kind of insurer reluctance that has escaped the regulator’s attention is home loan insurance. Someone taking out a mortgage is induced to buy an insurance policy on that home loan, on the understanding that in case the borrower dies, the family would be able to retain the home, as the remainder of the loan repayment would be met from the insurance payout.
But it turns out the small print more than plays the devil. In most such insurance schemes, the payout is conditional on death occurring from a specified list of contingencies. Naturally, no one had heard of COVID before December 2019 and so COVID does not figure among the deadly conditions that would justify the insurance claim.
The insurance regulator should outlaw such policies that arbitrarily restrict the conditions for insurance claim eligibility. After all, someone buys a home loan insurance to inflate the monthly instalment he has to pay to protect the rest of the family from being rendered roofless in case the borrower dies, not in case the borrower dies due to some specified set of causes listed in small print.
The third set of people who care about how the precise cause of death is listed are analytical philosophers, those who study language and debate, inconclusively, the relationship between names and what they signify and why they signify what they signify.
What, in any case, has the Census got to do with compensation for survivors of Covid victims, you might wonder. The relationship is not all that complex.
The actual toll of a pandemic can only be measured as the difference between the actual number of deaths, due to whatever recorded reason, and the number of deaths that should have been recorded, going by the past trend. The difference is called excess deaths.
We have had reports of practically every state government trying to under-report the toll of lives owing to COVID. If someone had heart disease, contracted COVID and died, the temptation is to put the death down to heart disease. The extent of COVID infection and the death toll is widely understood as indicators of the government’s efficacy, at least on the public health front. Hence the tendency to suppress the Covid death tally.
However, this would do nothing to change the excess death count. This number can be known either from data on the registration of deaths in the sample registration system (SRS) or from the Census. In advanced countries, the data is available almost in real-time. In India, the SRS data is available with a lag. The Census, due this year, would, whenever it takes place, yield data comparable with the previous, 2011 Census.
The Census is a highly decentralised system of data capture. It would be difficult to manipulate the data. However, this being India, it is difficult to be certain that the urge to keep the COVID toll down would not seep into the data compilation process, if not of the actual enumeration. After all, the compiled data can be revised to reflect the true picture after public anger over COVID has been replaced with something else.
With a policy of financial compensation for those who fall victim to COVID in place, no one would allow any under-reporting of the COVID death count. Everyone would try to obtain a death certificate showing COVID as the cause. If someone returning from a test centre for an RT-PCR test for the coronavirus falls to a stray bullet from a crowd of inebriated revellers brandishing their guns and firing aimlessly into the air, and the test comes in positive, the relatives would try their level best to get a COVID death certificate.
In other words, suppression of COVID deaths would be history. The struggle would be to stop exaggeration. And this is a political minefield. If in the process of trying to weed out fraudulent claims, some genuine claimants are turfed out, or if someone who did not deserve the compensation gets it, because some strategic palms were greased, public anger would mount. So, politically, it would be prudent to compensate most and peg the compensation amount low.
It would be no terrible disaster for the government to fork out a hefty amount as compensation. Suppose you have to pay compensation for 15 lakh people, which is nearly four times the official death toll, and pay every family ₹ 1 lakh as compensation, the bill would come to just Rs 15,000 crore. You could double that figure of compensation and it would still cost you half as much as the dole called the National Rural Employment Guarantee Scheme.
Count it as part of the stimulus bill. If the poor get compensated for the loss of their breadwinner, they would spend the money over a period of time, rather than hoard it. That would add to demand in the system, and incentivise recovery.
And people who get compensation would be grateful. Those who see the deserving get compensation would feel the system works and approve. And India would get a realistic census and reliable epidemiological data.
The government would do well to not try and wriggle out of paying compensation to the families of those who die due to COVID.
This article first appeared in The Federal Compensation for COVID deaths will make for a cleaner Census on July 3, 2021.
Read another piece on Politics and Twitter by T K Arun titled Stopping Fakes on Twitter! in IMPRI Insights
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About the Author:
T K Arun, Consulting Editor, The Economic Times, New Delhi.