Though Tamil Nadu is yet to see the peak of the second wave of COVID-19, a comparison of the cases and deaths reported so far with those in the first wave shows noticeable changes in the age and gender distribution of deaths. The proportion of women and people of younger age among the deceased have increased in the second wave.
However, the comparison shows no significant differences in the age and gender distribution of cases. (Please read the note in the infographic for the number of deaths and cases taken for analysis.)
While women accounted for 27% of all the deaths in the first wave, they have accounted for nearly 33.5% of all the deaths thus far in the second wave. But the gender distribution of cases remains the same, with women accounting for 40% and men 60%. Similarly, while those aged 21-60 accounted for 38.7% of the deaths in the first wave, they have accounted for 43.6% in the second wave. In comparison, the percentage of those aged 60 and above among the deceased has declined from 61% in the first wave to 56.3% in the second wave. However, there has been no shift in the reported cases. In fact, the percentage of the elderly among the cases has increased from 13.1% in the first wave to 14.4% in the second wave.
The number of deaths reported daily during the second wave has been on a steep increase, with more than 1,200 deaths occurring in the past one week alone. In comparison, during the 12-week period from July to September, there were a total of nearly 7,900 deaths. However, the case fatality rate appears lower, at least for now, than in the first wave. While the case fatality rate was around 1.62% at the peak of the first wave from July to September, it is around 1.03% as of now. While the decline in the case fatality rate is seen among all age groups and gender, it is more pronounced among the elderly. They, however, remain the most vulnerable with a case fatality rate of 3.91%, compared with the the overall rate of 1.03%.
V. Ramasubramanian, senior consultant, infectious diseases, Apollo Hospitals, pointed to the stark difference in the restrictions during the first wave and since this year. “People are not staying indoors, and therefore there is more exposure for people of all age groups, including children, leading to more infections,” he said. Asked why more people of younger age were among the deceased, he said a possible factor was the delay in getting medical attention, with the perception that the disease would not affect them severely. However, he said, this required further study. K. Kolandaisamy, former Director of Public Health, Tamil Nadu, said a clearer picture would emerge only after the second wave played out fully. “A higher volume of cases will mean that more from the younger age group with detected and undetected vulnerabilities or co-morbidities will be among the infected, and they will account for more fatalities,” he said.
Prithvi Mohandas, managing doctor, MIOT International Hospital, recently co-authored a paper published in Clinical Epidemiology and Global Health on the hospital’s experience in treating COVID-19 patients in the first wave. He said the relaxed curbs and disregard for precautions led to more exposure for all age groups. Many of the relatively younger age, who require hospitalisation, resorted to home care and went to hospitals only when the illness became severe. “If you have pneumonia on CT, coupled with raised disease activity in the blood tests, do not sit at home measuring your oxygen level,” he said.
He, however, said an encouraging thing was that the hospital had not seen any case of COVID-19 pneumonia among those vaccinated.
