COVID-19: India’s case fatality ratio up marginally in last 5 weeks

India’s CFR has remained steady at 1.34% since July 20, 2021; It increased to 1.38% as of December 

By Taran Deol
Published: Thursday 23 December 2021

The new Variant of Concern (VOC) of the novel coronavirus, omicron, is now present in over 100 countries. COVID-19 cases have skyrocketed in several parts of the world, including in the United Kingdom and the United States, where omicron is now the dominant variant.

Cases so far have increased only marginally in India. But there is a cause of concern: The country’s case fatality rate (CFR) — the ratio of confirmed deaths to confirmed cases — has risen.

India’s CFR has remained steady at 1.34 per cent since July 20, 2021, according to Our World in Data. However, a slight upward trend has been observed since November 12: CFR steadily increased to 1.38 per cent, as of December 21, 2021.

CFR dipped to 1-1.1 per cent in May and mid-June 2021. It touched 1.31 per cent by June-end. It was the highest in April 2020, at 3.6 per cent, came down to around 2.8 per cent by June 2020, spiked again to 3.36 per cent the following month and declined rapidly thereafter.

CFR is an important measure of disease severity. It is the number of confirmed deaths out of the total confirmed cases.

We must, however, exercise caution using the measure to gauge how deadly COVID-19 can be: The number of actual cases and deaths remain unknown even till now. 

Excess COVID-19 deaths in India were six times more than the reported figure, according to projections by the Institute for Health Metrics and Evaluation (IHME), an independent population health research centre, University of Washington Medicine.

This, in absolute figures, translates into 300 daily deaths by March 2022. India was ranked seventh in a list of “20 countries with the highest numbers of excess COVID-19 deaths, March 2020-May 2021.”

Several other measures are used to understand where the COVID-19 pandemic is headed. One is the test positivity rate (TPR), which at present for India is 0.5 per cent. The TPR must remain below 5 per cent to control an outbreak, according to the World Health Organization (WHO). 

Other measures include infection fatality rate — total deaths per total number of cases, and crude mortality rate — the occurrence of death in a defined population.

The CFR has often been the go-to figure for many countries to gauge how severe a disease is. “It is the ratio between the number of confirmed deaths from the disease and the number of confirmed cases, not total cases. That means that it is not the same as – and, in fast-moving situations like COVID-19, probably not even very close to – the true risk for an infected person,” the portal noted.

It is for this reason that the CFR is not an accurate indicator of how likely a person is to die of COVID-19. A majority of cases, across the globe, continue to go undetected. Therefore, the CFR calculated cannot paint an accurate picture.

In India, much like across the world, the CFR was very high at the beginning of the pandemic and has since come down considerably despite a rise in cases. This is because our healthcare systems have improved and “the standard of care has evolved over the course of the outbreak,” according to the World Health Organization. 

India added 6,317 COVID-19 cases and 318 new deaths in the last 24 hours, as of December 23. The total active caseload is now 78,190, the lowest in 573 days.

Omicron continues to spread rapidly, having marked its presence in all but 17 Indian states. India has 269 omicron cases so far, with 33 new cases reported from Tamil Nadu December 23.

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