Hindustan Times ST (Jaipur)

In the second wave, is India’s CFR rising?

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On Sunday, 2,808 people lost their lives to Covid-19 across India, the highest ever in a single day. On Monday, this figure was 2,764. For the week ending Monday, 2,476 people lost their lives every day on average. A week ago, this number was 1,348 deaths a day – meaning average deaths in the country are increasing at 84% a week right now. To put this number in perspectiv­e, even during the brutal third wave in the United States, daily deaths never grew at a rate that exceeded 50%. India’s daily deaths have been increasing above that 50% threshold for nearly four straight weeks now.

Does this mean that India is squanderin­g its advantage of having the best case fatality rate, or CFR, among the world’s worst-hit nations? A close look at numbers presents a disturbing answer.

For an accurate understand­ing of the relationsh­ip between Covid-19 cases and deaths, one must keep in account a 14-day lag. This is because studies have showed that the median time between someone testing positive for Covid-19 and dying from it (if things go South) is around 13.8 days. So, people who are dying because of Covid-19 today will most likely have tested positive around two weeks ago.

In the past week, 17,330 people died across the country. If we look at the correspond­ing period 14 days ago, there were 1,001,558 new infections in the country. This would imply that around 1.7% of all Covid-19 patients are currently dying – the highest proportion since at least early August. A week before that, CFR was 1.6%; two weeks before, it was 1.3%. When we look at the same figures in the number of deaths reported in early February, the CFR drops to as low as 0.7%. So, it is clear that the CFR, which was dropping steadily for the past several months, has again started rising.

This rising mortality rate is not because the disease has become more fatal all of a sudden, but because the massive caseload (there were nearly 2.9 million active cases in the country on Monday) has completely overwhelme­d India’s health care system. People are dying not just because of the fatality of the disease, but also due to the lack of treatment, hospital beds, medicines, oxygen, even ambulances. With active cases continuing to rise at a record level, the burden on the country’s health care system is only increasing, which means the crisis will only worsen in the near future.

On Sunday, with 354,709 new cases, India broke the record for most daily cases reported in a country for the fifth day in a row. If 1.7% of these cases end up dying, India will likely be reporting daily deaths in excess of 6,000 a day in as little as two weeks.

This is a frightenin­g figure, even without taking into account reports of massive undercount­ing of deaths or the impact of a further rising active caseload on CFR.

Most models expect India’s second wave to peak by the third week of May. By then, if fatality numbers don’t turn around, confirmed daily deaths may be in excess of 7,000 a day. This highlights the urgency of arresting the second wave — the lives of hundreds of thousands of people are at stake.

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