NEW DELHI: An analysis of COVID-19 cases in the country shows that five cities with less than 5 per cent of the country's population have more than 50 per cent of the cases and deaths suggesting that the epidemic is largely concentrated in congested cities.
These cities include Mumbai, Delhi, Ahmedabad, Chennai and Thane where just about 4.4 % of India’s 135 crore people reside.
In India, COVID-19 deaths per million is 3.4, which places the country in a good position compared to several others, noted the researchers. However, deaths per million in ten of the top 20 districts is higher than the national average and maximum in mega cities like Ahmedabad (87 DPM) and Mumbai (85 DPM), which is more than 25 times the national average
The report by researchers at the Public Health Foundation of India, published in the British Medical Journal, noted that 67.2 % of cases and 77.2% of deaths related to the disease are concentrated in only 20 of the 739 districts in India.
“All cities having the highest burden of COVID-19 either have an international airport or are major financial/tourist hubs, with a population density of 1,036-28,220 persons per square km in urban areas,” the report said.
“All the major COVID-19 hotspot districts are urban and 15 out of 20 districts have more than 50 % urban population,” it said.
Mumbai, where more than 31 % households have over four people sleeping in a single room, is the worst-hit city in India.
“It may reflect that a few cities have a COVID-19 burden completely different from the rest of the country,” said the researchers.
Without any vaccine or treatment for the infectious disease, non-pharmaceutical interventions are the only measures to control the epidemic, the report underlined. However, in crowded cities, it is challenging to maintain one-metre physical distance due to lack of proper space within and outside the home.
“Declaring an entire district as a red or orange zone and locking down the whole district may risk other health services while closing all social and economic activities will also have a major financial burden,” said the report.
The researchers stressed that the availability of more granular data at the ward level in cities and sub-district level in rural areas, together with local policy flexibility at a lower administrative level, might help achieve better control.
“It is the right time to focus on a robust public health system to manage COVID-19 and prepare for any future pandemic as well as to achieve sustainable development goals,” the report said.