INTRODUCTION
It’s been almost six weeks since the beginning of the lockdown in India, which began on 24 March 2019. As governments in India, both Central and States, begin the process of re-opening the
country, it is time to evaluate whether the primary objective of the lockdown –
slowing down of the number of confirmed COVID cases and COVID deaths – has been
achieved. This is, of course, the so-called flattening of the curve that has
been much spoken of during the last few months. In order to get a sense of how
well or badly India has done, I will compare India with three countries, which
have also experienced lockdowns of their own, more or less at the same time
that India had its lockdown. These three countries are Italy, Spain and the United Kingdom (UK). The start dates of lockdowns in these countries are as follows:
Italy: 10 March 2020
Spain: 15 March 2020
UK: 23 March
In order to carry out a
comparison, I label the date of the commencement of lockdown in each country as Day 0 and each day subsequently as Day 1, Day2 and so on. The time period considered for India is from 24 March till 5 May 2020. This yields 41 days of data for India and, for the other countries, I use six weeks of data from the beginning of their respective lockdowns.
TOTAL CASES AND TOTAL
DEATHS
The countries with which India is being compared have been
ravaged to a far greater level than India has been. Figures 1 and 2 show these
details. The problem with Figures 1 and 2 is that the difference in levels of cases
and deaths in India and in the other three countries flattens the Indian curve relative to the other curves. This is especially so in Figure 2.
Despite the Indian curves being flattened excessively, we can draw some comparisons. On Day 0, Indian cases
were just 5.8% of those in Italy, 6.2% of those in Spain and 7.6% of those in
the UK. As far as deaths are concerned, the corresponding numbers were 2.4%,
3.8% and 2.9% of those in Italy, Spain and the UK respectively. By Day 41, the figures
for cases were 25.6%, 22.6% and 24.9% of those in Italy, Spain and the UK while
the figures for deaths were 6.5%, 6.8% and 5.5% of those in Italy, Spain and
the UK. Clearly, the ratio of India’s cases and deaths to those of the other
three countries has been growing over the last weeks. However, neither these
numbers nor Figures 1 and 2 give any indication of whether the pace of the spread
of COVID 19 is slowing down in India as compared to the three countries.
It has been suggested that taking
logarithmic transformations of the number of cases and deaths helps clarify the trends better than do
actual values. Figures 3 and 4 report the same data as in Figures 1 and 2 but
using log values.
Taking logs does lift the Indian
lines above the horizontal axis and shows that there is still a large gap
between the situation of COVID 19 cases and deaths in India as compared to the
other countries. But we already knew that. What we wish to see is whether the pattern of the progress of the disease in India is similar to the patterns in Italy, Spain and
the UK.
In order to eliminate the effect
of these huge differences in numbers between India and other countries, I
transformed all the data to z-scores. A z-score is defined as the value of
cases on a given day minus the average number of cases for the period divided
by the standard deviation and likewise for deaths. “For a standardized
variable, each case’s value of the standardized variable indicates its
difference from the mean of the original variable in number of standard
deviations (of the original variable). For example, a value of 0.5 indicates
that the value for that case is half a standard deviation above the mean, while
a value of -2 indicates that a case has a value two standard deviations lower
than the mean”.[i]
Having done this, I report Figures 5 and 6.
For both, cases and deaths, the
Indian line shows a worrying trend. While the other countries clearly show a
flattening of their respective curves, Indian cases and deaths continue to show an upward trend. It is
disconcerting that despite having suffered massive pain and incurred huge economic costs, India has not yet managed to exert control over the disease. It
is true that the number of cases and deaths in India are substantially lower
than in other countries but it is important to remember that India’s health
services will be stretched to breaking point at far lower numbers than in other
countries.
GROWTH RATES AND DOUBLING RATES
As a final basis of comparison, I
look at the rates of growth of cases and deaths (Figures 7 and 8) and their doubling
rates (in number of days) (Figures 9 and 10). It may be noted that for Week 6, the Indian growth rate has been averaged over only 6 days since data for the 42nd day of lockdown is not yet available.
The average daily growth rates
have been computed based on weekly totals. The rate of growth for Week 1 is
computed over the total for Week 0 which was taken to be the week that ended on
the day lockdown was announced. For India, the average daily rate of growth of cases has
fallen from 16.7% in Week 1 to less than one-fourth that level in Week 6.
However, the fall has been much steeper in the other countries. A similar
pattern is visible in the average daily growth rate of deaths.
Even in terms of doubling rates
of cases and deaths, India has shown good progress but the other countries have
shown a much greater increase in the doubling rates. See Figures 9 and 10.
CONCLUSION
In conclusion, we can see that
India has managed to control the spread of the disease as measured by the
number of confirmed cases and the number of deaths. However, concerns with
respect to testing remain. Given India’s huge population, the number of tests
performed remains very low. The ICMR has announced that it has performed over a
million tests.[ii]
However, there needs to be clarity about exactly what is being measured when
ICMR reports a million tests: is it the number of tests performed or the number of
persons tested? This is important because a COVID positive person is tested
numerous times as his or her treatment progresses before he or she is finally declared free of the disease. Naturally, the number of
tests performed will be greater than the number of persons tested.[iii]
Table 1 below gives the number of tests performed per million.
Table 1: COVID
Testing
|
Country
|
Number of Tests per million Population
|
|
India
|
758
|
|
Italy
|
36244
|
|
Spain
|
28898
|
|
UK
|
13925
|
Clearly, the rate of testing in
India is very low and it is quite possible that the results shown above may
undergo a change for the worse in the weeks to come.
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