How reliable are India and Pakistan’s supply chains in the current environment?

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A disturbing article in the usually sober British newspaper The Telegraph makes for difficult reading for consumers with supply chains dependent on the Pakistan or Indian subcontinent. It suggests, for different reasons, both countries are significantly underreporting the level of coronavirus deaths.

In the process, both countries could be a ticking time bomb for a return to more extreme lockdown measures this year just as both economies are supposedly coming out of hibernation.

In India, the article reports, there is a deliberate policy in some states to avoid putting any mention of COVID-19 on death certificates, thus dramatically reducing the numbers of deaths from that cause hitting the national statistics.

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The paper cites the state of West Bengal as one where any reference to COVID-19, even for patients confirmed after tests, to appear on a death certificate is only permitted after approval of a secretive committee said to be made up of government-appointed doctors. The paper quotes sources saying Kolkata medical colleges and hospitals were unofficially instructed by the state government to perform low testing to reduce the recorded number of reported COVID-19 cases. Doctors are quoted as saying they would lose their jobs if they challenged the instruction or complained in public.

Residents near the city of Barrackpore, 30 miles north of Kolkata, have accused officials of using the local crematorium in the middle of the night to secretly dispose of bodies.

In Pakistan the problem is reported as being significantly different. Instead of the authorities hiding COVID-19 related deaths from the statistics, it is the population at large that is inadvertently causing an underreporting. Apparently, in Pakistan if a patient dies in hospital their funeral is strictly controlled, allowing only a handful of family mourners — so people are simply avoiding taking family members to the hospital. Deaths not occurring in hospitals go unreported, significantly distorting the true extent of the disease’s spread, even from the authorities.

It has been a source of puzzlement to the international community that India and Pakistan had appeared to have got off relatively lightly compared to China, Europe and North America. Poor health care, densely populated cities, communal living and existing lung disease were expected to make the countries particularly susceptible.

Instead, official death tolls have been surprisingly low.

By May 22, India had reported only 3,435 deaths and Pakistan only 1,017, compared with nearly 100,000 in America.

Even within cities, data differs wildly.

The article reports death tolls in the capital Delhi from different authorities have been dramatically different. The municipal corporations of North and South Delhi this week have told the Delhi government they have recorded 426 coronavirus-positive cremations or burials. Yet, the Delhi government’s official health bulletin put the city’s COVID-19 death toll at just 194.

Many businesses are now coming out of forced lockdown; migrant workers and laborers will be drifting back from their villages to work in the cities. Hotspots are a significant feature, but insufficient testing makes the identification of outbreaks unreliable unless a really large surge forces a reappraisal.

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Under such circumstances, the potential for a manufacturing site, city, or even whole region to see a spike and be closed down again is a significant risk and one consumers with supply chains relying on product from the subcontinent would do well to keep under close review.

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