Coronavirus: India's low death rate in sharp focus amid record rise in cases

Factors could include younger demographic, but experts worry about under-reporting

Testing for Covid-19 taking place at a bus terminal in Ahmedabad, India, yesterday. The country's mortality rate, at 1.7 per cent, is among the world's lowest, with the death toll as at yesterday at 76,271. India has more than 4.5 million cases, with
Testing for Covid-19 taking place at a bus terminal in Ahmedabad, India, yesterday. The country's mortality rate, at 1.7 per cent, is among the world's lowest, with the death toll as at yesterday at 76,271. India has more than 4.5 million cases, with more than 940,000 active ones and spiking infections. PHOTO: REUTERS

India continued to set daily record rises in coronavirus cases as official mortality rates stayed suppressed.

The country saw an increase of 96,551 new cases in the last 24 hours, according to the Ministry of Health and Family Welfare yesterday.

With new daily caseloads far surpassing other countries', these figures come even as a sero-prevalence survey by the Indian Council of Medical Research found that India had an estimated 6.4 million infections in May, when official figures for the middle of that month put the number of positive cases at 85,940. This means that potentially millions went undetected.

At the time, testing was averaging 100,000 tests a day. That has now been ramped up to one million tests a day on average.

For the sero survey, which tracks antibodies to assess exposure to the virus, 28,000 people were tested.

Experts said India's numbers would continue going up, likely surpassing the US, which currently has the highest number of cases. India has more than 4.5 million cases. The US has 6.59 million cases.

"It will keep going up. Virus transmission is taking place more or less freely. There is no great mystery about it... We have a large population," said leading Indian epidemiologist Jayaprakash Muliyil.

"Fortunately, the future is not bleak... People who get the disease and get out of it seem to have good immunity."

India implemented a complete lockdown on March 25 which brought all economic activity to a halt. It has since gradually loosened restrictions as worries have grown about the health of the economy.

Still, the government has taken India's low mortality rate and high recovery rate (77.65 per cent) as a good sign and a result of efforts to improve medical infrastructure and hasten detection of cases.

India's mortality rate at 1.7 per cent, calculated by Johns Hopkins University of Medicine, is among the world's lowest.

The death rate in Mexico, the highest worldwide, is 10.7 per cent. The US, which has the world's highest caseload, has a death rate of 3 per cent.

 
 
 

Experts believe India's low mortality rate could be due to a combination of factors, including a younger demographic, with 65 per cent below the age of 35, as well as the elderly staying at home instead of at old-age homes like in the West.

But another key factor is seen to be potential under-reporting of cases. The death toll as at yesterday was 76,271.

Due to co-morbidities - other pre-existing medical conditions - cases are also reportedly being written off as non-Covid-19. Several states such as Assam have faced criticism of under-reporting cases.

"Covid-19 cannot be eliminated as a cause of death (in cases) even if there are co-morbidities," said Dr Rajib Dasgupta, chairman of the Centre of Social Medicine and Community Health at Jawaharlal Nehru University. He noted that many states are reviewing and verifying Covid-19 deaths.

With more than 940,000 active cases and spiking infections, India's health infrastructure will now face its biggest test.

As numbers rise, Kerala Health Minister K. K. Shailaja, according to a government press release, has warned that the Covid-19 death toll in the state may go up further, with the lifting of restrictions.

The federal health ministry on Thursday asked states not to put restrictions on the cross-border movement of oxygen.

Said Dr Muliyil: "Now, some states are showing signs of strain on health services. I believe mortality issues will come into much more focus."

 
A version of this article appeared in the print edition of The Straits Times on September 12, 2020, with the headline 'India's low death rate in sharp focus amid record rise in cases'. Print Edition | Subscribe