Covid-19: What you need to know today
On Tuesday, HT’s health editor Sanchita Sharma wrote, citing unreleased health ministry data that she sourced, that men account for 69% of all Covid-19 deaths in India, and people over the age of 50 for 76.7%.
The data isn’t surprising — the same trend has been seen around the world. Older people who contract the coronavirus disease are more likely to die. How much more likely? According to data from the US Centers for Disease Control and Prevention (CDC), those between the ages of 50 and 64 are 30 times more likely to die from the disease than those between the ages of 18 and 29; those between the ages of 65 and 74, 90 times; those between the ages of 75 and 84, 220 times; and those over the age of 85, 630 times more likely.
Similar data for India isn’t available, but there is a very significant difference between the US and India in terms of the mortality of younger people infected with the Sars-CoV-2 virus which causes Covid-19. Only 8.2% of the people who succumbed to the disease in the US (till August 26) were under the age of 54 (data wasn’t immediately available for those under the age of 50, although mathematics indicates that it should be lower, making the difference with India even more significant).
The Indian data is till August 22.
It isn’t clear why almost one in four of the dead in India (23.4%) were under the age of 50. And almost 10% were under the age of 40. The prevalence of comorbidities such as diabetes in younger people could be one reason. As could access to health care. This is clearly an area that merits further investigation, although a survey of scientific literature on Covid suggests that the trend seen in India is no different from that in other developing countries. On the flip side, some experts believe that India’s younger population can explain its low case fatality rate.
There is also a difference between India and the US in terms of the gender of those who died from Covid-19. In the US, till August 26, data from CDC shows that 54% of those who died from the disease were men. The corresponding proportion in India (till August 22), was 69%. A 15 percentage point difference is significant by any measure. Again, there is no obvious reason for this — except that men in India may have had more chance of being exposed to the virus than women. This, too, is an area that merits more research. As an aside, the health ministry’s coronavirus dashboard should be updated in real-time with the ages and the gender of the dead.
Recent studies in the UK, Spain, Italy, and Geneva in Switzerland, reported in Nature, claim that the Infection Fatality Rate (or proportion of those dead to those presumably infected) is near-zero for those under the age of 50. The numbers cited in this column with reference to India are all case fatality rates — only a nationwide sero survey (blood test for antibodies) can shed light on the number of those infected, although similar surveys, across a few states, do show that a significant proportion of the population has been infected (see back flap).
While on the matter of fatality rates, all countries have managed to progressively reduce them as health care workers figure out more therapies that work.
On Wednesday, an analysis of seven studies that was published in JAMA, the Journal of the American Medical Association, confirmed that steroids help reduce fatalities by a third when administered to severely ill Covid-19 patients. The analysis covered steroids such as dexamethasone, hydrocortisone, and methylprednisolone. A previous installment of this column reported one of the studies covered by a June analysis (a UK one that showed dexamethasone to be effective in the treatment of Covid-19). As that column pointed out, steroids are inexpensive and widely available in India.