Covid-19: What you need to know today
When do you use per capita or per million numbers? And when do you not? This isn’t one of those trick questions about stock and flow — most people, and newsrooms, can’t distinguish between the two and happily compare the wealth of an individual (stock) with the GDP of a nation (flow) — but one of appropriateness. And, in the current context, not just in India but in many other parts of the world, it is a political question.
It is a political question because the government as well as many of its supporters continue to swear by “India’s universally acclaimed approach” in the fight against the pandemic (the quote is from a letter written by the Indian high commission in Australia to The Australian in response to an article headlined “Modi leads India into viral apocalypse”).
The per capita numbers do indicate that India is better off than most other countries. According to worldometers.info, as of Tuesday morning, India had recorded 12,678 cases per million of its population, lower than all but Indonesia in the top 25 countries by total cases. The corresponding number for the US was 98,845, and the UK 64,639. In terms of deaths per million, the number is far lower, 142. The corresponding number for the US is 1,764, and the UK 1,869. Sure, India is most likely undercounting deaths, but even if it were recording only one in every 10 deaths (very unlikely, in my opinion; I have explained in an earlier column that an approach that assumes the infection rate and the infection fatality rate may perhaps be more accurate), the number is still lower than that in the US and the UK. Which brings us to the original question. When do we use per capita (or per million) numbers and when do we not? (Hint: the answer is not what you think — when it is convenient.)
For instance, according to the International Monetary Fund, India is the sixth largest economy in the world in terms of overall GDP, but the 148th (out of 193 countries) in terms of per capita nominal GDP. At a macro level, the fact that it is the sixth largest is important, but at the micro one, especially when dealing with quality and standard of life, affordability, and other such, it is the per capita number (or the per capita number adjusted for purchasing power parity) that is important.
That provides one part of the answer — the context decides whether it makes sense to use per capita (or per million) numbers or not.
Vaccination is another case in point. India has administered 145 million vaccine doses till Monday night — a high number in absolute terms. Of this, it has fully vaccinated 23.8 million people, and another 97.3 million have been partially vaccinated (they have received one dose). That’s around 121 million people that have some form of protection against severe illness and death on account of the coronavirus disease. The number, by itself, means nothing. Some experts believe that when non-pharmaceutical interventions (masking, social distancing, a ban on large public events) are in place, vaccinating around 40% of the population, even partially, will begin to have an impact on infection rates. One expert I spoke to said that the results will start becoming evident even at 25%. That’s 250,000 per million of eligible population. At 121 million, India has vaccinated (many partially) around 200,000 per million of the eligible population. That’s not a bad number, although the country’s aim should be to get it to 400,000 as soon as possible (the results will start showing up once it crosses 250,000).
In the US, the corresponding number currently is around 650,000, one reason why most people expect the fourth wave in that country to be a mild one. The UK number is around the same.
In this case, the context actually helps bestow the number with purpose (a target), but it doesn’t really help answer the original question because a target can be set absolutely, per capita, or per million — it’s just a question of using the right multiplier.
Ultimately, it’s a question of appropriateness, as this piece said at the beginning. Human casualties are always better dealt with as absolutes — reducing the number per capita (or per million of population) may make sense from the actuarial or epidemiological perspective, but seems to somehow devalue human lives. Repeated reference to per capita and per million comparisons can also be interpreted to mean that it’s alright to have a certain level of casualties.
India’s huge population (denominator) means its per capita and per million numbers will always be low, but even one death from Covid-19 is a death too many.