Covid-19 in perspective

Indians have long seen deadlier diseases. We need to take all precautions and get on with our lives

In a large country like ours, there are contradictions galore. While one section of society is either ignorant or careless about following basic precautions such as wearing masks, maintaining social distance, and so on, others are afraid to venture out for the past two months and imagine every person to be a carrier of the disease. This is okay for seniors, but when the young population gets paralysed, it is time to put the problem in perspective.
 
First, let us see India from a global perspective. Worldwide data showed that India, with 1.3 billion people, stood at 40th place when we became serious about the lockdown. Yet, due to our large size, we have now entered the list of top 10 countries in total Covid deaths. However, our mortality rate is 4 deaths per million population, compared to Belgium’s 820, Sweden’s 436, Italy’s 554, UK’s 575, and US’ 323. The number of deaths per thousand positive cases is 28 in India, compared to 152 in France, 144 in Italy, 141 in UK, and 95 in Spain.
 
Our slow start — we took 2.5 months to reach 5,600 fatalities, due to multiple lockdowns — has helped us so far in keeping the disease under some control. These months taught us about wearing masks, physical distancing and other precautions. Another hopeful statistic is that 48 per cent of cases have recovered now, compared to only 25 per cent just a few weeks ago. By and large, when that reaches 75 per cent, the urgency reduces and relaxation starts, as we have seen in China and Italy.

Yes, there has been a rise in the number of cases from 2,000 per day on May 1 to 8,000-plus on June 2. But this can be partially attributed to substantially increased testing, from 1.06 million to 3.73 million, which also includes asymptomatic cases.  
 
Second, Covid deaths should be seen in the perspective of the overall death rate in India, which is seven per 1,000, which translates into 9.1 million deaths a year, or approximately 750,000 deaths per month, or 25,000 per day. Covid fatalities of 6,643 (as of June 5) over a period of 2.5 months may seem a very small fraction of total deaths. But we have to keep in mind that there may be under-reporting of deaths, and the total number of cases does not make the Covid risk acceptable. There have been reports about reduced deaths from traffic and air pollution, and even a reduction in net death rates. But it does raise a question about how deaths due to Covid and its consequences should be viewed.
 
Third, we need to view them from the perspective of what other threats of death we are already living with. The accompanying table shows the burden of deaths for the year 2017. We see that it covers communicable and non-communicable diseases, and accidental deaths such as traffic accidents and drowning. Here, cardiovascular diseases are at the top with 2.36 million, in which air pollution is one of several factors. Respiratory diseases, at 1.27 million, are second.
 
If we insert Covid deaths of 6,643 over the 2.5-month period of 2020, it will be only at 29th place. This chart also includes deaths from road accidents (218,876) and drowning (60,199), at 11th and 16th place, respectively. Temperature stress (14,728), natural disasters (1,979) and terrorism (465) are at 27th, 31st, and 33rd place, respectively. Of course, that does not make them any less important. The fact that we have a new additional cause of death in the list is in itself a major concern. One avoidable death is always too many, and should not be tolerated, from any source.
 
How many of the other deaths could have been avoided if they had received similar focused attention, time, manpower and a Rs 20-trillion package? How many deaths from diabetes, cancers, HIV and tuberculosis could have been avoided with even a small fraction of this effort? On a personal fear front, do we think of the 218,876 deaths caused by road accidents, before we embark on a journey every day?
 
Yet another perspective is a socio-economic one. Images of migrants, food distribution and deprivation may have a much longer-lasting impact on our society. The worst-case scenario of further escalation, and the attendant health risks of Covid-19, needs to be weighed against the risk of the poor suffering due to the closing of economic activities. We have realised that stopping economic activities will bring more misery than the disease itself. Therefore, it is imperative to address community fears, as we are in the third month.
 
Unfortunately, the danger is far from over. Doubling time, which was rapidly improving, has started stagnating. New epicentres and containment zones are making an appearance. The early gains may vanish unless we strengthen precautions and our health systems.
 
Let us get on with our lives, taking precautions and managing several new normals — our health, lifestyles, the way we work and our economy. We need to walk on a tight rope, with no place for complacency.      
 
The writer is executive director of the think tank, Integrated Research and Action for Development (IRADe), New Delhi