Early data shows why coronavirus death rates differ across Indian states

Experts underlined that some states could be testing more and treating better, showing a marked difference in disease pattern.
For representational purposes (Photo | PTI)
For representational purposes (Photo | PTI)

NEW DELHI: This could just be initial days of COVID-19 outbreak in India but an analysis of cases in various states so far has thrown an interesting trend: the infection is not killing people uniformly across the country and there is a dramatic difference in the rate at which states are losing people to coronavirus.

At 16.6, the percentage of people who have lost their life due to deadly coronavirus is highest in Himachal Pradesh followed by Gujarat which has seen nearly 9.5 per cent of all who got infected, dying.

In contrast, in Rajasthan, which now has 200 confirmed cases, no death has been reported yet and in Tamil Nadu and Kerala—two states with one of the highest identified cases—the death rate due to COVID-19 is under 1.

In Maharashtra, the state with the highest confirmed cases in the country—the death rate due to COVID-19 is nearly 5 per cent. In Madhya Pradesh with 104 confirmed cases and 6 deaths the percentage of death too is well above 5.

Globally, the death rate due to the infection has been estimated between 3 and 4 and it has been estimated that those above 60 and with co-morbidities like hypertension, diabetes, cancer and respiratory issues among others are much more susceptible to the infection. Males, it has been seen, are also slightly more likely to die of the infection, than females.

States with highest death rate (based on Union Ministry of Health data)

StatesTotal casesDeath percentage
Himachal Pradesh616.6
Gujarat1059.5
Punjab578.7
Madhya Pradesh1045.7
Maharashtra4904.89

Nationally, of total 3,374 confirmed coronavirus cases as of Sunday morning, 77 have died --- which marks a death rate of 2.2 per cent.  

Experts, while pointing out that more data is required to make sense of the fatality rate emerging so far—underlined that some states could be testing more and treating better, showing a marked difference in the disease pattern.

“While heterogeneity in disease pattern across states is expected given the public health infrastructure in some states vis a vis others it can be fully analysed only if the government releases line-listed data which shows the age and health profile of patients,” said Dr Anupam Singh, a public health researcher and infectious disease expert at Santosh Institute of Medical Sciences in Ghaziabad.

Dr Anant Bhan, a researcher in bioethics and global health policy says that higher deaths in some states could be explained by the fact that they are only testing the symptomatic ones which report to hospitals with complications.good to look at the age distribution of the tests in these states and see if there is a larger number.'

States with lowest Death Rate (based on Union Ministry of Health data)

StatesTotal casesDeath percentage
Rajasthan2000
Tamil Nadu4850.61
Andhra Pradesh1610.62
Kerala3060.65
Delhi4451.34

'The other states might be testing more widely where you would pick up positives even among asymptomatic, or those with mild illnesses. Maharashtra is interestingly a bit of an outlier as a big state with comparatively better testing capacity,' he said.

Dr Oommen John, a researcher with the George Institute of Global Health echoed the views. “Possibly very sick ones are the ones getting tested or at very serious stages, while those states who started testing liberally early have more people being tested,” he said.

'It would be good to look at the age distribution of the tests in these states and see if there is a larger number.'

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