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Behind the Numbers: India Has Managed to Contain Covid-19 Deaths Despite Surge in Cases

By: Nikhil Narain


Last Updated: May 23, 2020, 08:23 IST

Representative Image. (REUTERS)

Representative Image. (REUTERS)

Germany, which was hailed as a model for containment of Covid-19 deaths, has a cases/deaths ratio similar to India.

There has been a recent and significant increase in Covid-19 cases in India. From an average of 3,829 cases in the six days between the May 10 and 15, the number has risen to 5,407 in the last six days between May 16 and 21.

However, this surge is not surprising. Relaxations were eased after Lockdown 2.0, which ended on May 3 and further concessions have been made when lockdown 3.0 ended on May 17. Also, testing has increased and India is moving closer to its peak which is expected sometime in June.

Given these factors, India’s rate of increase in cases hasn’t been even close to as alarming as it could have been. The growth in the number of new infections has still been linear and nowhere close to exponential as was predicted by some experts.

But what continues to surprise is the low number of Covid-19 deaths in India, even as the cases report a surge. According to tracking site worldometers, India hasn’t reached 200 single-day deaths on any day, the maximum being 175 on May 4.

Even as 5000-plus cases were recorded in the last four days, the number of deaths did not exceed 150 on even a single day. The average number of deaths just saw a marginal rise from 109 between May 10 and 15 to 138 between May 16 and 21.

These are low numbers when considered relatively given the ease in the lockdown restrictions and the stage the virus India is in currently.

We compare the average number of cases per death in India to some of the other severely affected countries in the world when they saw their worst surge in cases. Some of these countries (Western Europe and USA) are past their peak while some others like Brazil, Peru and Russia are yet to experience their worst.

India’s cases per death during May 16-21 (its worst period) is 39.18.

What is stunning is the disparity between India and almost all the other countries analysed. USA saw its worst period recording more than 30,000 cases on six consecutive days between April 6 and 11. Its average number of deaths in this period were 2,045. This implied that USA had a cases/death ratio of almost 16 during its worst surge period. The corresponding ratio for UK and Italy is 6.29 and 7.18.

Germany, which was hailed as a model for containment of Covid-19 deaths, has a ratio similar to India (37.27). It is also interesting that while Germany had its worst spike in cases between March 30 and April 4, the average number of deaths were highest only between April 13 to 18 – unlike most other nations where the worst periods for surge in cases and deaths coincided.

It is not surprising to see Russia recording 115 cases per death during its worst phase (May 7-12) – as there is serious under-reporting of deaths from the country.

Controlling the loss of lives has been the real success story for India so far. It has reported 3,600 Covid-19 deaths thus far. Among the 14 nations who have registered at least 70,000 cases, India’s mortality rate (MR) of 3.01% is the fourth-lowest only after Russia, Turkey and Peru. However, there are credible reports of under-reporting from Moscow and Istanbul.

And just for contrast, Brazil has a mortality rate of 6.44%, USA (5.94%), Spain (9.97%), Italy (14.24%), UK (14.36%) and France (15.52%).

India’s tests/death at 755 is second only after Russia. Brazil is recording one death for every 37 tests, France – 49, UK – 86, Italy – 100, USA- 140, Canada – 224 and Germany – 432.

There are many reasons why our mortality rate could be low - a high percentage of young and rural population, the BCG vaccine for tuberculosis, the hot temperature and a milder strain of the virus.

But amongst these there is one definite reason – the early and stringent lockdown. Lockdowns 1 and 2 managed to avert between 1.4 and 2.9 million coronavirus disease (Covid-19) cases and 54,000 deaths, according to government data released by Niti Aayog member Vinod Paul on Friday.

A recent study by the Boston Consulting Group, in which they adopted two approaches for projections, estimated 36 lakh to 70 lakh cases averted, and 1.2 lakh to 2.1 lakh lives saved as a direct consequence of the lockdown. Another estimate by the Public Health Foundation of India stated that 78,000 deaths had been averted.

Covid-19 is a highly contagious disease thus it is not surprising to see a surge in the number of cases in India. But this should not create panic. The only thing which matters in the end is the number of lives lost.

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