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India second Covid wave - When is the peak
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- Covid-19 deaths in India: The second Covid-19 wave has been more deadly, with over 1.4 lakh deaths happening in the less than two months. Yet there are signs of an approaching peak, including a dipping weekly case fatality ratio.
- Numbers: As on 23-May, the death count had reached 3,03,720. Nearly half of them, close to 1.5 lakh deaths, happened during the second wave, starting from the second week of February. An overwhelming number of these, more than 1.4 lakh deaths, have been reported in the seven weeks after March.
- India already has the world’s third largest death count. Only the United States, which has recorded over 5.84 lakh deaths, and Brazil, which has seen 4.48 lakh deaths, have a higher death count. India now accounts for 16% of the global confirmed cases, and 9% of global deaths.
- Is death count peaking? The daily count of cases in India peaked on May 6. That day, more than 4.14 lakh cases were discovered. There has been a steady decline in the detection of new cases after that. Since the trend in death numbers usually has a two-week lag, it might be the time that the death count begins to decline as well.
- However, the seven-day moving average of daily death counts is still rising, although considerably slower than a few weeks ago, and with dips in between. In the last two weeks, this seven-day average has increased from 4,000 a day, to 4,190 a day.
- A sad month: May was the deadliest month of the epidemic for India so far. It has already seen the deaths of close to 92,000 people so far, almost twice the number for April. The hope is that a lot of deaths being reported now are from past weeks during which they had remained unaccounted for. Almost half of Maharashtra’s daily death count includes the deaths that happened more than two weeks ago. The same thing is happening in Karnataka and Tamil Nadu as well, the two states that are contributing very large number of deaths right now.
- Delayed reporting: This phenomenon of delayed reporting of deaths is not new, however. There has always been a long time lag in reporting of deaths. In fact, Karnataka is still reporting a few deaths from March. And, it is possible that some of the deaths happening now will get counted only two to three weeks later. However, the proportion of older deaths in the daily count being reported these days is significantly higher. What that means is that once the states clear their backlog, there is likely to be a sharp decline in the daily death counts in the coming days.
- Falling CFR: Because the number of deaths are no longer increasing as quickly as they were a few weeks ago, there has been a steady decline in the current (weekly) case fatality ratio (CFR) in the last 10 days. The weekly CFR is calculated by weighing the number of deaths in any seven-day period against the case count in the seven-day period two weeks earlier. It shows the current trends in mortality rates. The weekly CFR had begun to rise around the middle of March, peaked around the end of April, and has been declining ever since. Its peak around end-April coincides with the most chaotic phase of the epidemic in India. Several people had died of Covid-19 caused because of lack of hospital beds, oxygen, or ICUs.
- How it evolved: For the two-week period in the second half of April, the weekly CFR actually surpassed the overall CFR. Overall CFR is calculated by measuring the total number of deaths for the entire pandemic period against the total number of cases as it stood two weeks earlier. But it has gone well below the overall CFR now. As on Sunday, the weekly CFR was 1.07% while the overall CFR, which has been showing a much slower decline, was 1.34%. It means that in the previous one week, 107 persons out of every 10,000 people who got infected succumbed to the disease. However, if we consider the deaths from the beginning of the epidemic, 134 people out of every 10,000 confirmed infections have died. The weekly CFR is low right now because the daily deaths are still being measured against very high case counts that existed two weeks earlier.
- In the subsequent days, however, there has been a rapid decline in the daily case count. Against a daily case count of about 3.9 lakh on an average at that time, only about 2.5 lakh cases are being discovered these days.
- If the death numbers do not decline in the next few days, the weekly CFR would begin to increase once again due to a reduction in the denominator.
- The states: Several states, which were reporting a very high number of deaths until two weeks ago — Chhattisgarh, Delhi, Uttar Pradesh, even Uttarakhand — have seen their death counts go down. That was compensated by the sharp rise in death figures of Tamil Nadu and Karnataka, while Maharashtra has been consistently reporting between 800 and 1,000 deaths every day. Kerala has reported 634 deaths in the last three days, which is close to 10% of its entire death toll.
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