Looking at it on a standalone basis, India’s second wave of COVID-19 has been very severe, but it is not as severe as several other countries have already experienced
-Amit Bagaria
Ever since April 6, 2021, when India’s COVID-19 cases crossed one lakh for the first time since the pandemic started in India in 2020, people started blaming Prime Minister Narendra Modi for India’s ‘second wave’.When the daily case count crossed 1.5 lakh cases just four days later, the voices became a little louder. These were not just voices on TV screens but also posts on social media (especially Twitter), and articles in Indian and foreign newspapers and news websites.
Fast forward to just five days later and the anti-Modi voices gained additional momentum, as India crossed the unfortunate milestone of two lakh daily cases. The daily case count had peaked at 97,859 during the ‘first wave’, on September 16, 2020.
India crossed three lakh cases on April 21, or 2.74 times the cases of just 15 days earlier. By that time, India already had severe shortages of hospital beds, oxygen, and Remdesivir. The anti-Modi brigade got a huge supply of additional arsenal to aim at India’s PM. The same PM who had been credited across the world just a year earlier for handling the pandemic very well, and who had been applauded just a couple of months earlier by more than 50 world leaders for helping them combat the disease in their countries, as India had exported (or even donated) vaccines to more than 90 countries.
The attack did not come from China or Pakistan. It came from within—from political opponents of Modi and the BJP and their voters, from journalists and media houses that have always been against Modi/BJP/RSS, from hundreds of armchair ‘experts’ who took on Modi and the BJP/RSS on TV debates and thousands more through social media, especially Twitter.
Yes, India reported 414,182 cases on May 6 and crossed four lakh cases on three out of seven days during the week. But how do India’s COVID-19 cases compare with other relatively large countries which have reported a very high number of cases in any given week?
The comparison has to be in the number of cases per million people, as there is no other way to compare data since you can’t expect cases in a huge country like India to be the same as Italy with 4.34 per cent of India’s population, Brazil with 15.37 per cent or even the USA with 23.9 per cent.
The daily circulation of The Times of India is more than double the UK’s Metro and almost 1.78 times higher than USA Today not because more Indians read English newspapers, but because India has far so many people. Indian Railways has 10.1 times more passenger-kilometres of traffic than Russian Railways as India’s population is 9.53 times higher than Russia’s. Therefore, it is but natural that India will see many more people get sick from a pandemic than much smaller countries.
If China disclosed data honestly, we would have ‘real’ comparisons, but China hasn’t done so—not that anyone with an average IQ expects them to.
Despite India reporting more than 2.73 million (27.3 lakh) cases from April 30 to May 6 (including both days), we were much lower than seven of 15 other countries with a minimum population of 40 million (four crores) and comfortably lower than three others. The average for the 15 countries excluding India is 491 compared to India’s 280.3.
The logic for using countries with a minimum of 40 million population is simple. There are only 14 countries with over 100 million people, and eight (China, Indonesia, Pakistan, Nigeria, Bangladesh, Japan, Ethiopia, and Egypt) are under-reporting numbers, mismanaging, or have miraculous immunity from COVID-19. That leaves six, which is too small a sample. If I pick another 15 countries with over 50 million people, seven have the same issues. By picking countries with a minimum of 40 million people, I could get 15 countries to compare with.
Even if India’s actual case (and death) count is larger than ‘official’ figures, how do we know the same is not the case with other countries? Going by the nature of governments in Turkey, Ukraine, Colombia, Iran, and Russia, it is very likely they have fudged data.
How does India compare with other countries in cumulative cases? In this chart, all the 15 other countries have higher cumulative cases than India as of May 6, 2021. And the differences with India (except in the case of Mexico) are huge. India’s number is just 24.9 per cent of the average.
The population of 48 European countries (including Russia), the USA, Brazil, and Mexico, is roughly equal to 1.024 times India’s population, and they have 2.39 times India’s cases. It is important to look at the case count in the context of tests done. The fewer the tests, the fewer will be the cases (for any disease), and vice-versa.
The numbers (as on 4 May) for total tests per 100 million in 20 large countries with a minimum population of 50 million (five crore) are given in the next chart. If you multiply by 100, you get the number of tests per million people.
While India has fared much better in its testing numbers than far richer countries such as Japan, South Korea, Iran, Mexico, Thailand, South Africa, and Indonesia, we could have still done better, as I said in over 230 blog posts on COVID-19 between March and November 2020, which you can find at www.bagariaamit.com.
Govt did a Phenomenal Job: Devi Shetty
“The number of patients what we have, if they are presented to US Government, there is no way they could manage, forget about any other country. These are astronomical numbers; no other country has the infrastructure to manage. In terms of oxygen, I can tell you, I have gone through the details. Our Government has done a phenomenal job: they have moved heaven and earth to get oxygen to the hospitals. Of course, lots of people have suffered. But then if the whole country is falling sick, no infrastructure in the world can manage.”
On May 4, the world (excluding China) had conducted ~2.053 billion (~205.28 crore) tests, and India’s share was 14.37 per cent compared to its population share of 21.67 per cent (excluding China). If we had conducted 1.5 times the number of tests, we would have been at par with our population share.
Anyways, 2120 is not bad, considering that India’s per capita GDP (PCGDP) of $2,191 is much lower than the nine other countries that have done more testing per million (Source: IMF’s April 2021 World Economic Outlook Database).
In the US, official deaths reported were 574,043 but IHME put the actual deaths at a shocking 905,289 (2,722 per million). In India, official numbers were 221,181 but IHME puts the number at 654,395 (470 per million, or just 17.3 per cent of the US)
Except for Russia, and to a smaller degree Turkey and the UK, all the other countries have done far lesser testing than India, when we compare their economies. Also, the fact that India has done more testing per 100 million people than Japan (~5.87x higher per capita income than India based on PPP), South Korea (~5.42x), Iran (~2.91x), Mexico (~2.6x), Thailand (~2.5x), South Africa (~1.89x), and Indonesia (~1.72x), is a feat in itself, notwithstanding that we could have done more testing.
Let us look at the deaths per million as of May 6, 2021.
Yes, Covid-related deaths in India are low, at only 26.66 per cent of the average of these 19 countries. There could be two explanations. India has a much younger population compared to Western countries. India’s median age is 28.7 years, compared with Italy’s 46.5, the UK’s 40.6, the USA’s 38.5, France’s 41.7, Germany’s 47.8, Russia’s 40.3, and Turkey’s 32.2 years. Indonesia at 31.1, and Philippines and Egypt at 24. They have a similar death rate as that of India. The outliers are Brazil (33.2 years), Mexico (29.3), Colombia (31.2); and South Africa (28); but these two regions/continents are the worst affected by COVID-19.
I am surprised that Japan (median age 48.6) has such low death numbers despite high urbanisation and population density. But a large percentage of their population wears face masks even in the normal course, and professionals such as taxi drivers, bus drivers, porters, etc., also wear gloves. The less said the better about Pakistan and Bangladesh.
The second reason could be that deaths have been underreported across India, and if this is the case, it could be either because the Governments (Central and States) want to suppress numbers or sheer mismanagement. Even if actual deaths are 3x the ‘official’ figures, we would be at 80 per cent of the world average. That is without factoring in the very real possibility that deaths have been quite possibly underreported by Iran, Turkey, Indonesia, Philippines, Egypt, Pakistan, and Bangladesh, and quite possibly by Japan also.
And I may just be right. As per a new analysis published by the Institute of Health Metrics and Evaluation (IHME) at the University of Washington on May 6, COVID-19 has caused ~6.9 million deaths, more than double what official numbers show. IHME found that Covid deaths are significantly underreported in almost every country, including the USA. Latin America, Central Europe, Eastern Europe, and Central Asia were the hardest hit. This figure only includes deaths caused directly by the ‘Coronavirus’, not deaths caused by disruption to health care systems and communities.
In the US, official deaths reported were 574,043 but IHME put the actual deaths at a shocking 905,289 (2,722 per million). In India, official numbers were 221,181 but IHME puts the number at 654,395 (470 per million, or just 17.3 per cent of the US). Here is the IHME data for the top 20 countries affected by COVID-19.
Yes, apart from the USA, other developed countries such as Japan, Russia, Germany, Spain, Italy, the UK, and France have all underreported deaths.
Interestingly, the IHME report does not feature the origin of the COVID-19 pandemic—China. That’s because there is no report anywhere on the actual deaths in China, which officially claims only 4,636 deaths, or only 3.22 per million, compared to the 416.8, global average, which goes up to ~917 as per the IHME study. China’s ‘official’ deaths are just 0.77 per cent of the world’s official death figures.
If we were to assume that India’s actual number is 2.96 times the official number and the world’s actual number is 2.15 times the reported deaths (as per IHME), it means India’s cumulative deaths per million was ~497 on May 6, and the global average was ~896—therefore, India’s death rate is ~55.5per cent of the world’s death rate, despite our poor healthcare infrastructure. Let’s also look at the Case Fatality Rate (CFR), or the percentage of positive cases which resulted in deaths. This is perhaps more important, as the death rate by itself (without factoring in total cases) means very little.
Seva Bharati’s Healing Touch
When Delhi has been reeling under severe second wave of the pandemic, Seva Bharati swung into action by setting up a chain of well-equipped isolation centres in association with various other social organisations for the benefit of patients who could not manage to get hospital beds.
Initially, six isolation centres have been set up by Seva Bharati in Delhi. These centres are being operated in Ashok Vihar, Udaseen Ashram, Narela, Dwarka, Harinagar, Amar Colony, and Lajpat Nagar district. Later, nine more centres were added. All the preparations have been completed, and they will also be operated as soon as they get administrative permission. Arrangement of about 450 beds has been made through these isolation centres. If the administration supports and oxygen facility is made available to Seva Bharati, then there is a plan to expand it to one thousand beds in the next few days. Medical oxygen is being provided in all isolation centres. The availability of medical oxygen is being provided through cylinders and oxygen concentrators in these centres. In the centre at Saraswati Bal Mandir, Lajpat Nagar, has 35 beds, which will be expanded to 50 beds. The former Additional Secretary of the Medical Council of India, Dr. P Prasanna Raj and Dr. Kalpana Nagpal (a robotics surgeon), provide their services free of cost to the patients. Seva Bharti has 21 oxygen concentrators to provide oxygen to the patients in the isolation centre. There is a provision to provide food, lemonade, decoction, medicines and all medical facilities to the patients.
A 100-bed facility is being run by Seva Bharati at Laxmibai College, Ashok Vihar. The isolation centre is for non-serious patients. College classes have been converted into Covid wards.
If we exclude Mexico (which is a very odd outlier), the average of 17 countries falls to 1.96 per cent. Even then, India’s 1.09 per cent seems to be very low, despite the fact that we have a lower median age. Therefore, it can be safely concluded that death rates in India are not being underreported.
If we estimate that the actual deaths in India are 2.96x the official figures, our CFR goes up to 3.23 per cent, which is believable, considering that India’s health infrastructure is not as good as most other countries in the above chart and that the IHME report says almost all countries have underreported deaths. Given below is what the CFR chart looks like after factoring in IHME’s study. It has only 13 countries as the IHME report does not cover Colombia, Pakistan, Philippines, Bangladesh, and Turkey, whose underreporting must be even beyond IHME’s imagination. India has done very well.
I don’t believe even for a second that more than one in four COVID-positive cases are dying in Mexico, or more than one in six in Japan. Therefore, if deaths have been underreported by almost all countries, so have the number of cases.
But propaganda articles (especially in foreign media) and tweets have suggested India’s death tolls at 5x and even 10x the official figures. Are people suggesting India has lost 2.341 million (23.41 lakh) lives to COVID-19? As per official figures, 59,736 people died due to COVID from April 15 to May 6, 2021. Are these morons trying to say that 537,624 bodies were secretly cremated or buried? Over five lakh bodies? An NRI doctor even put it at 100x. C’mon, be realistic! Criticise the Government for all its mistakes, but stop playing games with death, as what goes around, comes around. It’s called Karma.
India’s second wave of COVID-19 has been very severe when you look at the numbers on a standalone basis but not as severe as several other countries have already experienced. India’s cumulative cases per million (from February 2020 to May 6, 2021) are only 15.4 per cent of the US, 17.6 per cent of France, 20.3 per cent of Spain, 22 per cent of Brazil, and much lower than 10 other relatively large countries. India’s rank is 110 out of 220 countries, with cases being 80 per cent of the world average as on May 12, 2021.
‘IISc COVID Vax Superior’
The COVID-19 vaccine being developed by the Indian Institute of Science (IISc) is promising as the results show a better neutralising effect than the existing vaccines, according to Karnataka Health Minister K Sudhakar. The Minister has sought IISc’s help in tiding over the current surge in COVID cases in the State. The Minister also held discussions with IISc Director Professor Govindan Rangarajan.
According to a Press release, the vaccine being developed by IISc is promising as the results show a better neutralising effect than the existing vaccines. This vaccine, which is yet to begin human trials, could be a big breakthrough in the nation’s battle against the pandemic, it said, adding that from a public health point of view this is a huge advantage as it enables the Government scale up distribution of vaccine faster and easier.
The Director told the minister that an oxygen concentrator of 10 LPM (litre per minute) capacity developed by IISc is being tested for its clinical validation at Bangalore Medical College. Professor Rangarajan said the oxygen output is about 90 per cent and hence more efficient that the Chinese products whose efficiency is measly 45 per cent.
In cumulative deaths per million, India’s tally is 8.6 per cent of Brazil, 9 per cent of the UK, 9.4 per cent of the US, and so on. India’s rank is 111 and the deaths are 42.8 per cent of the world average as on May 12. Most countries in the world, including the US, are under-reporting data.
(The writer is a former serial entrepreneur who became an author in mid-2018. He has published 12 books)
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