New Delhi: With 57,542 deaths as on 24 August, India ranks fourth in the world with regard to the Covid-19 toll, accounting for 7 per cent of total global deaths. The country’s Covid-19 cases tally has also risen to 30.1 lakh.
The US continues to head the death toll with 1.75 lakh deaths as of 24 August.
India has, however, been able to keep the deaths relatively low, with a death rate of 1.85 per cent, but there are large-scale state-wise variations and also concerns about undercounting deaths in certain states. Moreover, unlike many countries that have seen a dip in new cases and deaths, there has been no such drop in India.
To analyse the death rate and for uniformity, ThePrint has calculated the deaths per million. For one, large states cannot be compared with smaller states and Union territories.
Our analysis also shows that the states with the highest deaths do not necessarily have the highest death rate. So, while Maharashtra, Tamil Nadu, Delhi, Karnataka and Andhra Pradesh have the highest number of deaths, it is Delhi, Maharashtra, Puducherry, Goa and Tamil Nadu that have the highest deaths per million.
A high death rate also doesn’t necessarily indicate a poor Covid-19 response.
According to Tanmay Mahapatra, an epidemiologist working for the non-profit, CARE India, and part of Bihar’s Covid-19 response, there are various factors that influence the death rate in the states — age distribution, prevalence of comorbidities as well as the stage of the epidemic.
In absolute terms, Maharashtra has the highest number of deaths in the country. With 22,253 deaths, Maharashtra alone is responsible for 38 per cent of all deaths reported in India.
The death toll, however, can be attributed to the timing of infection spread.
“All around the world, the places that reported the infection early on during the pandemic have recorded the most number of deaths,” said Giridhar R. Babu, Professor and Head Lifecourse Epidemiology, Public Health Foundation of India.
“With time, other states learned about measures that can prevent deaths, including early oxygen therapy, and allocated extra resources for Covid-care that helped them reduce deaths.”
Mumbai saw the earliest outbreak among cities in India and has reported the highest deaths among all districts in Maharashtra. The infection then spread from Mumbai to surrounding suburbs, other cities and towns as movement of people continued. The state is currently reporting about 12,000 cases each day. The city is also among the most transparent when it comes to Covid-19 data.
In terms of deaths per million, Maharashtra reports 180 deaths per million, compared to the national average of 42 and is the second highest in the country behind Delhi.
With 6,517 deaths, Tamil Nadu ranks second highest in deaths reported in the country. Even here, the infection began spreading from the state capital Chennai when a coronavirus cluster emerged in Koyambedu, a 65-acre wholesale market in the city. Cases spread to even nearby Andhra Pradesh from here.
As of 23 August, the state has been reporting 5,904 cases every day and it has maintained a testing rate of 54,000 per million. Tamil Nadu’s infection rate has remained at 1.03, lower than India’s average of 1.06 according to the website Covidtoday.in. With a death rate of 83 per million, it ranks fifth in terms of deaths per million.
With 4,683 deaths, Karnataka ranks third in the number of deaths.
Initially, the state was seen as managing the Covid-19 crisis well as the cases remained below 5,000 until June. The number of cases, however, rose sharply after that, especially in Bengaluru.
The state is now reporting 7,264 cases every day at an infection rate of 1.10, which is higher than India’s average (1.06). Karnataka is testing 35,729 tests per million. It reported 83 deaths per million, almost double of national average (42).
With 4,300 deaths, Delhi ranks fourth in the number of deaths reported.
The national capital struggled to bring the number of deaths under control in the initial months of the pandemic.
It was only after Home Minister Amit Shah’s intervention that testing was ramped up and more cases were diagnosed and treated. While the number of deaths reported daily have gone below 20, hospital beds are running empty in the city state and most people are now seeking treatment at home.
However owing to the high number of cumulative deaths, the mortality rate has remained high. With 229 deaths per million, Delhi reports the highest death rate in the country.
The high deaths and death rate can be attributed to the fact that Delhi was among the first cities for the virus to spread.
“During the early part of the epidemic, there is a theory that the body’s immune response is aggressive leading to excessive inflammation, cytokine storm, multiple clots in the body leading to hypoxia, which causes death,” Mahapatra said, adding that health systems were also not prepared in the early part of the epidemic.
With 3,282 deaths, Andhra Pradesh ranks fifth in the number of deaths reported in the country. As the state ramped up testing, it showed a sharp rise in the number of cases in July. Compared to its sister state Telangana, Andhra Pradesh has been more upfront about its testing and confirmed cases.
The state has been reporting 9,040 cases daily with an infection rate of 1.01. The death rate in Andhra Pradesh is 60.9 per million, which is higher than the national average.
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