A health worker wearing protective gear takes a nasal swab sample of inbound travellers for Covid-19 coronavirus tests at CSMT railway station, in Mumbai.(Bhushan Koyande / HT file photo)
A health worker wearing protective gear takes a nasal swab sample of inbound travellers for Covid-19 coronavirus tests at CSMT railway station, in Mumbai.(Bhushan Koyande / HT file photo)

Urban areas still more vulnerable to coronavirus but cases now evenly spread

While India seems to have so far escaped a second wave of Covid-19 infections, tracking the geography of the pandemic in the country over the last one year makes for an interesting analysis.
By Abhishek Jha
PUBLISHED ON MAR 01, 2021 04:43 AM IST

March 2 marks a year since India detected its first Covid-19 case which was transmitted locally, and when the cycle of infections in the country began. While India seems to have so far escaped a second wave of Covid-19 infections, tracking the geography of the pandemic in the country over the last one year makes for an interesting analysis. The pandemic initially started in urban areas, proliferated to rural India once lockdown restrictions were eased, and was eventually distributed across urban and rural regions. To be sure, the impact on rural areas was not as devastating as scientists and health care experts had first feared, and urban areas are still more vulnerable to new infections. Here are three charts which explain this in detail.

The pandemic’s urban bias has come down over time

Because the Covid-19 virus came via international travellers, urban areas were the first ones to get affected in India. A district-wise analysis of Covid-19 cases shows this clearly. For the purpose of this analysis India’s 700-plus districts have been classified into five categories on the basis of rural population share: entirely urban (less than 20% rural population), largely urban (20%-40% urban population), mixed (40%-60% rural population), largely rural (60%-80% rural population) and entirely rural (more than 80% rural population). All of Delhi’s eleven revenue districts have been clubbed as one, as Delhi does not provide district-wise Covid-19 data.

To be sure, these districts have different share of India’s population.

As per the 2011 census estimates, the population share of entirely urban, largely urban, mixed, largely rural and entirely rural districts was 6%, 8%, 14%, 34% and 39% respectively.

A distribution of new Covid-19 cases in these groups shows that the entirely urban districts, even though they had just 6% of India’s population, were the biggest source of new infections. This share was 30% in March 2020 and increased to more than 50% in May 2020. This share has fallen steadily and was just 11.3% in February 2020 (data up to February 24). The entirely urban districts show a similar trajectory when it comes to new deaths due to Covid-19, although this share is slightly higher than that for new infections. To be sure, the share of largely urban districts in these numbers has started increasing in 2021.



This does not mean urban population is not vulnerable anymore

The declining share of urban districts in new cases and deaths should not be inferred as evidence of large-scale immunity in urban areas. This is because a simple share in new cases and deaths does not tell us about the infection and deaths rates in these regions. Adjusting new cases and deaths by population of these districts puts things into perspective. While both these numbers have come down sharply since late 2020, urban districts still have much higher infection and death rates than their rural counterparts, which underlines the importance of maintaining caution.


The pandemic has become geographically skewed once again

HT’s Covid-19 dashboard has daily district-wise case numbers from March 14, 2020. In the first week, only five districts – Delhi (all revenue districts combined), Hyderabad, Leh, Jaipur and Bhilwara – accounted for half of the new Covid-19 cases (seven-day average) in India.

The geographical spread of the pandemic was contained until the lockdown restrictions prevented movements of persons across the country. It started spreading once restrictions were eased, and rose at a sharp pace between July-September 2020. By September 19, 2020, 51 districts accounted for half of new Covid-19 cases in the country.

This number started declining since then; displayed a small spike in December last year and has plateaued after falling to just above 10 since January 2021.

The geographical concentration of the pandemic becomes even clearer if one looks at it on a map of India. In September 2020, Covid-19 cases were spread across the country.

Currently, Kerala and Maharashtra seem to be the major clusters of the pandemic.

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