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With Low Positivity & Mortality Rates, UP Emerges as India's Covid-19 Success Story

A health worker in personal protective equipment (PPE) puts a swab sample into a vial at a school which was turned into a centre to conduct tests for the coronavirus disease (COVID-19), amid the spread of the disease, in New Delhi, India July 4, 2020. REUTERS/Adnan Abidi     TPX IMAGES OF THE DAY - RC28MH93ZQE7

A health worker in personal protective equipment (PPE) puts a swab sample into a vial at a school which was turned into a centre to conduct tests for the coronavirus disease (COVID-19), amid the spread of the disease, in New Delhi, India July 4, 2020. REUTERS/Adnan Abidi TPX IMAGES OF THE DAY - RC28MH93ZQE7

There is no district from UP amongst the 30 worst affected in India in terms of the number of cases.

Uttar Pradesh’s population- 23.15 crores (as per recent Census data) is roughly equal to the combined population of France, Italy, Spain and the United Kingdom. Surprisingly, despite being India’s most populous state it hasn’t featured in the Covid-19 analysis discourse.

While the worst-affected states like Maharashtra, Tamil Nadu, Delhi, Gujarat, West Bengal and even Madhya Pradesh were the nucleus of Covid-19 discussions, the debate around Uttar Pradesh has been missing.

One of the prime reasons for this is the relatively low number of cumulative cases reported from the state.

Uttar Pradesh ranks 5th in the number of cases amongst all states in India. Despite having a population almost double of Maharashtra, its aggregate is barely 14% of the state. In terms of Incidence Per Million (Number of Cases per Million Population), UP ranks amongst the lowest in the country. Only Meghalaya, Jharkhand, Bihar and Chhattisgarh fare better.

UP has reported 133 cases per million population. While Delhi reported- 5,189, Maharashtra – 1,777, Tamil Nadu – 1,566, Telangana – 741 and Haryana – 639, the maximum amongst the major states of India.

Although UP has increased its testing and conducted a total of 9,22,000 tests (which places it in the top 5), in terms of tests per million population, it is in the bottom three only better than Bihar and Telangana.

A massive population and comparatively poor testing numbers would usually explain the low Incidence (per million) in UP. But there is an anomaly.

Low Positivity Rate Despite Poor Testing

Despite the low testing, UP has a very low Test Positivity Rate of 3.25%, which is unusual and surprising. It means despite not testing adequately in proportion to its population, UP does not have many positive cases - this implies that a large sample of the number they are testing hasn’t contracted the virus.

This reveals that the pandemic isn’t as widespread in the state as compared to some other major states of the country.

Uttar Pradesh witnessed a rise in the number of cases in June. It reported its single-day highest spike of 1,332 cases on July 7. The only other day when it crossed 1,000-mark of daily cases was on July 5. But even with the return of scores of migrant workers back to their hometowns, the surge has not been as high as some of the other states.

Low Mortality Numbers

The most startling and significant statistic is the low number of deaths in the state. As many as 827 Covid-19 deaths have been reported across UP- a state which has nearly 24-crore residents.

UP has reported just 3 deaths per 1 million population. It is significantly lower than the national average of 15. Comparatively, it is also lower than most of the major states in India.

UP’s Mortality Rate (MR) also remains very low at 2.76%, marginally below the national average of 2.77%. For perspective, Delhi has a MR of 3.08%, West Bengal – 3.37%, Madhya Pradesh – 3.98%, Maharashtra – 4.26% and Gujarat – 5.25%.

NCR Districts Report Maximum Cases, Agra Highest Mortality Rate

Gautam Buddha Nagar (2,935 cases) and Ghaziabad (2,430 cases)- the two NCR districts report the highest number of cases. But unlike most states, the cases are not concentrated in one or two districts in UP – the spread is quite even which in turn means that no district has an alarming number of cases. Lucknow (1,684), Kanpur Nagar (1,452) and Agra (1,311) complete the top five in terms of case-load.

Agra and Meerut have a very high Mortality Rate of 7.09% and 6.97% and also report the highest number of Covid-19 fatalities from UP (93 and 89). Ghaziabad (63), Kanpur Nagar (62) and Firozabad (30) follow.

It is remarkable that there is no district from UP amongst the 30 worst affected in terms of the number of cases.

Furthermore, there is no district from UP amongst the 20 worst affected in terms of the number of Covid-19 deaths.

How has UP, with its population, inadequate health infrastructure and poverty managed to contain the spread of the virus and control the number of deaths?

There could be several factors- strict adherence to lockdown guidelines, monitoring and implementation of rules and regulations by the state authorities, is cited by many health experts as a major reason for the comparatively better situation of the pandemic in Uttar Pradesh.

Another possible factor could be the high percentage of the rural population in UP – at around 77%, the proportion is highest amongst the major states. With Covid-19 essentially being a big-city and urban virus (at least in India), UP may not have seen the worst of the pandemic.

In the end, one statistic sums up what UP has managed to achieve- the UK, France, Italy and Spain account for 1,37,745 Covid-19 deaths while Uttar Pradesh with a similar population as the four combined has just reported 827 deaths.

UP could just be the big Covid-19 success story from India.