Covid-19: What you need to know today
Delays and lapses in recognising coronavirus related deaths, and outright exclusions that are now coming to light, mean that states once feted for their response to the pandemic may not have done all that well.Updated: Jun 12, 2020 06:18 IST
The first 10 days of June have been torrid for India in terms of deaths from the coronavirus disease (Covid-19). India recorded 205 deaths on June 1, then 221, 252, 270, 300, 298, 261, 342, 271, on subsequent days and finally 359 on June 10. That’s a total of 2,779 deaths in 10 days, out of a total of 8,107 deaths in the country thus far from the pandemic. The math says it best: India has seen a third of its Covid-19 deaths in the first 10 days of June.
The data on deaths from Covid-19 in India has been plagued by two problems: delayed or complete lack of reporting. For instance, Delhi was recognising some deaths that took place in April only in May. According to HT’s database, Delhi’s dashboard listed only 73 deaths till May 11. On June 10, the number stood at 984 — and several of these deaths were old ones that had not been recognised. In some cases hospitals hasn’t reported them; in others they had not reported them in the format prescribed by the Indian Council of Medical Research (ICMR). Earlier this week, The Times of India reported, citing the Chennai corporation’s own data that Tamil Nadu’s count had left out around 236 deaths in the city (from Covid-19) from the state total. Another report in The Indian Express cited an unnamed corporation employee attributing the exclusion to procedural issues arising from inadequate staffing during the lockdown.
On Thursday, Delhi’s municipal corporations claimed the actual number of deaths in the state was a little more than double (2,098) of what was being claimed by the AAP government, but at this stage, this is just a claim, albeit one that merits careful investigation and deserves some honest answers from all sides.
This column has often argued that, because caseload data is meaningless, the only number that really matters is the daily death toll. Not to spot patterns — the delay in recognising deaths scotches any such effort — but to get a broad understanding of whether things are getting better or worse. The daily deaths since May 1 show that they aren’t getting better for sure — as does the trailing five-day average (both are shown in the accompanying chart). India’s case fatality rate is still less than half the global case fatality rate, but 100 days into its run in the country, the pandemic is clearly yet to peak here.
Delays and lapses in recognising deaths, and outright exclusions that are now coming to light, also mean that states once feted for their response to the pandemic may not have done all that well. My reference isn’t as much to Kerala — this column has time and again pointed out that no matter how good the health care system in that state may be, its testing rate is pathetic — as it is to Tamil Nadu and Delhi. For instance, Tamil Nadu’s case fatality rate will increase from 0.88 to 1.52% if the excluded deaths are taken into account. There’s also the question of whether more deaths have been similarly excluded in the state. Delhi’s case fatality rate was just around 1% on May 11, when the national rate was 3.13%. On June 10, Delhi’s death rate was 3%, and the national rate, 2.82%.
The ebb and flow of numbers suggests that while there may some outliers, most states eventually veer towards the national average. Another way of looking at it would be that in the large urban centres, the performance of governments in terms of managing Covid-19 is pretty much the same. All their health care systems (not to mention their brave health care and front line workers who have been at it since March) are under strain and nothing, from testing to hospitalisation, is proving to be easy.
Delhi, Mumbai and Chennai have to prepare for a coming surge — and they are — but their experience should also be a lesson to other states, especially those that are just beginning to witness a spike. They need to test widely and indiscriminately, trace aggressively, and create dedicated treatment and quarantine facilities that are at least double what their worst-case scenarios project.