Covid-19: What you need to know today
India has reported 287,160 deaths from the coronavirus disease till May 19. Of these, 75,305, or a little over 26%, were recorded in the first 19 days of May. By the end of May, India would have reported at least 100,000 deaths for the month. No country, not the US, not Brazil, has reported more deaths in a month. And anecdotally, the divergence between reported and actual deaths is likely to have been the most in the month. In a previous column, I sought to put an estimate to the extent of underreporting (Dispatch, May 3), arriving at a range of 1.03 to 3.10 times the reported number of deaths for the actual death toll. I surmised at the time that the midpoint of this range was the most likely extent of underreporting (my view hasn’t changed, despite far more sophisticated estimations that have since emerged).
The number of deaths isn’t surprising because India has seen 6,608,317 cases, or a little under 26% of the 25,771,260 cases it has reported to date, in the first 19 days of May. Since deaths lag cases by around two weeks, it is likely that the gap between these two, the proportion of cases reported in May to the overall number of cases, and the proportion of deaths reported in May to the overall deaths, widens, with the latter inching up and the former down.
The 75,305 deaths translate into 56 per million in the first 19 days of May, and if the month sees 100,000 deaths (it will exceed that), it would translate into 74 deaths per million. In comparison, the US saw almost 300 deaths per million in its worst month, January. Based on data for the first 19 days of the month (see table), only Goa and Delhi exceed the US number, but as I have written previously in this column, a death is a death and only statisticians and apologists look for per-million comparisons as if this were a measure of the degree of suffering. And in May, India has suffered. That and the high number of deaths in the month so far are the likely reasons why coverage of India’s handling of the second wave of the pandemic has been sharply critical in both domestic and foreign media. And it’s the reason photographs of hundreds of funeral pyres and bodies buried in shallow graves on the banks of rivers (with a piece of coloured cloth to mark each) have gone viral. In many ways, May has been the cruelest month – for everyone.
May’s death toll can be attributed to three factors, which, in turn, point to three lapses: one, the emergence of variants (and the inadequate surveillance of variants); two, the non-adherence to Covid safety protocols such as social distancing (and the carelessness, complacency, and easing of restrictions that allowed these); and three, the low level of vaccination (and a flawed vaccine drive). Compounding these were other factors, such as inadequate health care infrastructure, the lack of a plan to deal with a rush of cases (few states adopted triaging), and unavailability of crucial medical inputs such as oxygen and medicines when and where they were needed the most. There are learnings all around – provided we are willing to accept that mistakes were made, and that people lost their lives as a result.
PS: There has been a spate of reports comparing deaths this year to deaths in the corresponding month last year, but this approach runs the risk of being inaccurate simply because last year’s 68-day hard lockdown saw few people stepping out of homes, even to obtain death certificates in April and May. A better approach would be to use the longterm average of deaths – as long as this data is available.