When infections were growing at a relatively slower pace, most of India’s COVID-19 cases were confined to urban districts. In subsequent stages, not only have the cases grown at a relatively quicker pace but the locus too has shifted to rural areas where the health infrastructure is fragile.
How have the cases in rural districts grown?
The infographic depicts the total number and % share of India’s new cases recorded during three stages: between O and 1 million cases (P1), between 1 million and 2 million cases (P2) and between 2 million and 3.3 million cases (P3) across urban, mostly urban, mostly rural and rural districts.*.
The % share of cases in rural districts increased from 15% of total cases in P1 to 24% in P3; in mostly rural districts from 25% to 43%. Whereas, the % share of cases in urban districts decreased from 32% of total cases in PT to 11% in P3; in mostly urban areas from 28% to 22%.
Only 18 States which had consistent district-wise data were considered, so the number of cases depicted will be fewer than India's cases in all periods.
The districts were classified based on the 2011 Census, Districts with <20% rural population were classified urban; >20% but <50% rural population were classified "mostly urban"; >50% but <80% rural population were classified "mostly rural" and >80% rural population were classified as rural districts.
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Where is the rural spread most intense?
The tables depict new cases recorded in rural districts as a % share of all cases in the State, in P1, P2, and P3. For instance, in Assam, 41% of the State’s cases in P1 were recorded in rural districts; 71% in P2; 70% in P3.
In Assam, West Bengal, Odisha, Uttar Pradesh and Madhya Pradesh, the % share of cases in rural districts increased the most between P1 (0 to 1 million cases) and P3 (2 million to 3.3 million). In States such as Jharkhand, Uttarakhand and Chhattisgarh, rural cases decreased.
What is the impact of the spread?
The health infrastructure is not equally spread between rural and urban India. While more than 65% of India’s population resides in the rural areas (World Bank estimate), about 65% of all government hospital beds are in urban India. The clear rural-urban divide is visible in many such indicators.
Graphics: Kannan Sundar
Sources: State Health Ministries, KPMG, World Bank, NSS Report No. 586 (Health in India)
