Letters

Letters to the Editor — June 8, 2020

India’s CFR

The Editorial (The Hindu, June 4), “Curves and recoveries”, cited “2.79%” as India’s “case-fatality rate” (CFR). The graphic (“How India fares in COVID-19 deaths”) accompanying a report, “Maharashtra reports highest fatality surge with 139 deaths” (June 6), said India’s CFR is 2.8% (“hovering around the 3% mark”) as against the world average of 5.9%. These have resulted from erroneous calculations, taking cumulative total deaths on a particular day as numerator and cumulative total infections on the same day as denominator. On June 4, total deaths were 6,363 and the total infected were 2,26,713, for the ratio of 2.8%. This ratio is not CFR.

The total number, 226,713, are not all “cases” (COVID-19) but “coronavirus infections” (lab-confirmed); hence the derived rate will be Infection-fatality rate (IFR), not CFR. IFR is a fraction of CFR, since cases are a fraction of infections. Moreover, COVID-19 patients do not die the day they are diagnosed, but two to three weeks later, after completion of incubation period and after the disease becomes severe and fatal. Therefore, the denominator for cumulative deaths on June 4 ought to be total infected 2-3 weeks earlier — during May 14 to 21. The total during those eight days was 791,184, for a daily average of 98,898. So the current IFR is 6,363/98,898 = 6.43%.

True, our infections include some COVID-19 patients tested de novo, but we do not have those numbers. The majority tested prior to mid-May were for infection control through contact tracing. Therefore, the 6.43% is predominantly IFR, but also CFR in a minority of the total. Globally, IFR is about 1-3%; our death rate is higher than the global average. India’s CFR is certainly much higher than 6.43%, but how much higher cannot be stated with accuracy and confidence.

Dr. T. Jacob John,

Vellore, Tamil Nadu

Virus count

India was way down in the world tally during the first lockdown and it is distressing to note the report, “India’s COVID-19 tally fifth highest in the world” (Page 1, June 7) Despite long lockdowns and enforcement of stipulated norms such as distancing and wearing masks, it should be analysed how and what is going wrong with the adopted strategies. In the midst of the disease count, I wonder whether it is wise to unlock places of worship as going by the present situation, it appears that COVID-19 will be with us for quite a while.

D. Sethuraman,

Chennai

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Printable version | Jul 13, 2020 7:16:41 AM | https://www.thehindu.com/opinion/letters/letters-to-the-editor-june-8-2020/article31774340.ece

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