Survey evidence of excess mortality in Bihar in the second COVID-19 surge

The second surge of COVID-19 had a large mortality impact in India. However, there are few reliable estimates of the magnitude of this impact for India’s poorer states. This note presents results of a small-scale phone survey in Bihar which interviewed a random sample of beneficiaries of the state’s Public Distribution System. This pilot survey was conducted in June 2021 and asked more than 500 respondents about any deaths in their household since April 1, 2021.We observe an annualized Crude Death Rate of 24.3 deaths per 1,000 [95% CI 13.0-37.4] during the second surge of the pandemic in Bihar. The observed death rate is more than four times baseline mortality (5.8 deaths per 1,000 per year). The probability that mortality during the second surge was at least thrice the level of baseline mortality is 0.88. This large surge in mortality warrants an urgent public discussion on state priorities in Bihar. It also suggests the viability of and need for continuous large-scale mortality surveys.