Curves and recoveries: On India’s coronavirus numbers

As cases mount, India must focus on keeping mortality low

Updated - June 04, 2020 03:13 am IST

Published - June 04, 2020 12:02 am IST

The silver lining equivalent of science in this COVID-19 pandemic for India is the relatively low case fatality rate , and the high recovery rate . Case fatality rate — the number of deaths among the cases detected — has been dropping over the months, and is at 2.79% (as of 5 p.m. on June 3). Experts have advanced several hypotheses, but without a precise understanding, health-care managers are just hoping the good run would continue. Recovery rate, which is the rate of transition from a state of infection to recovery from the disease, here measured as a percentage of the total cases, has been on an upward trajectory. This figure, inclusive of people who tested positive being discharged from hospitals, is now over 48%, according to Health Ministry officials. As the total numbers keep climbing daily, well over 2,00,000 cases so far, the ideal of flattening the case curve with what is currently known about the disease, and with available resources, is perhaps difficult. However, reducing the number of deaths by protecting the old and the infirm from exposure, and improving the recovery rate — flattening the first curve, and ensuring the latter rises — seem well within reach.

It is important to ensure that the same urgency and eagerness that goes into counting those who have recovered is reflected when counting the dead. As per WHO definitions, the death of every COVID-19 patient is to be counted as a COVID death “unless there is a clear alternative cause of death that cannot be related” (e.g. trauma). Guidelines in India require States to record these COVID-19 deaths with notes on complications resulting from pre-existing co-morbidities, and every State needs to follow this model. With States also monitoring Severe Acute Respiratory Infections and influenza-like illnesses in hospitals, the entire gamut of severe respiratory diseases is being monitored, and deaths will not pass unnoticed. Assuring people with known exposure (not necessarily only with symptoms) to SARS-CoV-2 that they will have access to COVID-19 tests, ensuring that they reach care facilities before becoming extremely breathless, protecting vulnerable populations are sure-fire ways of delivering a double whammy against the disease — reducing case fatality rate further, and bumping up the recovery rate. Even if efforts to control transmission are being frustrated, the sober way of dealing with COVID-19 is to focus on the really sick patients, while ensuring that others who test positive but remain asymptomatic also have access to care when they develop symptoms. The Centre and States must specifically attempt to destigmatise COVID-19 infection and ramp up awareness activities informing people about symptoms in order to encourage people to come forward early. This will amount to seizing the silver lining and battering it into a whole cloud, besides keeping the country’s focus on the right curves.

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