India’s Covid-19 deaths cross 5,000, but rate lower than elsewhere
The number of deaths due to the coronavirus disease (Covid-19) in India crossed the 5,000 mark on Saturday, reaching a grim milestone, but with a fatality rate, which at 2.8% is much lower than the global 6%, there is hope that the outbreak in the country may not be as deadly as it has been in many countries, perhaps highlighting some of the gains from the nationwide lockdown. Meanwhile, the recovery rate in India improved to 47% on Saturday, up 5 percentage points from just a week ago.
The country’s top experts said keeping fatalities down by focussing on health care facilities will now be the most crucial strategy to deal with the pandemic across the country, where the outbreak has largely taken hold and a rise in the number of infections is inevitable.
According to a compilation of data reported by state governments, there have been 181,791 infections and 5,106 fatalities in the country as of Saturday. India took 79 days to record these many deaths, while some of the major Covid-19 hotspot – such United States, United Kingdom, Spain and Italy – took less than a third of this duration to rack up similar counts.
“My concern is more about mortality than the cases. Our population is such that we will have more cases than other countries, but if our hospitals don’t get completely overrun and mortality remains low, as is happening in Tamil Nadu, then we’re in a good place,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences.
The mortality ratio in Tamil Nadu is less than 1% due to what experts say is an aggressive containment strategy by the state which has always had high quality public health care.
“The number of cases will definitely increase, given our large population, and high mobility. Even if we touch a large number, if we are able to save the health system and isolate the majority of people with mild symptoms at home or in Covid Care Facilities, and the mortality is not high, we are fine,” added Dr Guleria.
According to the Union health ministry on Saturday, the doubling time of coronavirus cases in India over the last fortnight has improved to 15.4 days from 13.3 days.
“During the last 24 hours, a total of 11,264 Covid-19 patients have been cured. This is the highest number of recoveries recorded in a day,” the Union health ministry said in a statement.
The move comes after the government changed its discharge policy. “When we realised that our patients are recovering sooner, then after looking at the data we decided that we can discharge the mild cases sooner. Our discharges have accelerated after the new discharge policy,” said Dr VK Paul, member of NITI Aayog, in a press briefing on Thursday.
Cumulatively, 3,612,242 tests have been done so far for Covid-19 and 126,842 samples were tested on Friday, the ministry said.
There are now 942 dedicated Covid hospitals with 158,908 isolation beds, 20,608 ICU beds and 69,384 oxygen supported beds are available, it added.
Fatalities recorded a sharp increase in countries like Spain and Italy, and New York city, where hospitals were overwhelmed after a sudden spike in infections. Most of these regions enforced varying degrees of lockdowns after cases began to spike, compared to India that adopted such restrictions early on.
“Two things worked in our favour: the young demographic and early implementation of lockdown before cases exploded, helping flatten the curve and prevent deaths,” said Dr Ambarish Dutta, associate professor of epidemiology and public health, Indian Institute of Public Health-Bhubaneswar.
India went under a sweeping, unprecedented lockdown on March 25 when people were banned from stepping out of their homes for any purpose except for a handful of essential or emergency reasons. At the time, the number of cases in the country was 602, and deaths, 12. The curbs have slowly been relaxed in the months since, with the government announcing on Saturday a phased unlock plan from June.
“Around 9% of India’s population is over the age of 60, compared to 28% in Italy, which recorded a high number of deaths. In most countries, 40% deaths happened in care homes, which have a concentration of older persons, who are most vulnerable. Young people get less severe disease and are also less likely to get infected but when coronavirus spreads to a cluster of older people living together, it’s dangerous,” Dr Dutta added.
But India’s population patterns are also what add to risks in the country, he added. “What is working against us is unimaginably high urban density, which has led to clusters in Mumbai, Delhi, Ahmedabad, and Chennai. In urban slums and transport, social distancing is not possible and cases will go up, but most of the migrant population in slums is young and able to fight the virus,” he said.
In other countries where infections have peaked, deaths could have come down because of the “harvesting effect”, which is an epidemiological term used to describe the vulnerable dying very quickly and making the death rate peak, after which it goes down, Dutta added.
The health ministry reiterated on Saturday that all precautions must be taken while “living with the new normal” of Covid-19.
These include physical distancing at public places and workplaces, frequent hand washing and use of masks or face covers.