Since July 14, Pune has been recording the highest number of new cases each day in the country, surpassing Thane, which until recently was the worst affected district. Pune now has almost twice as many new cases each day as Mumbai, even though its population is less than half that of Mumbai.

New Delhi, July 21:

Just last week, the health ministry had said that India’s recovery rate from coronavirus was 63 per cent, and recoveries were double the number of active cases. However, since then, India has been consistently recording a massive growth in daily new cases.

India Today Data Intelligence Unit (DIU) analysed daily new cases and recoveries and found that more people are being added to the Covid-19 tally each day than the number of people being discharged, and the gap is widening steadily. In such a situation, is the recovery rate in India a mere statistical placebo?

The seven-day rolling average shows that India added more than 34,000 new cases each day on an average over the last one week. On the contrary, the seven-day rolling average of recoveries is less than 21,000. This means daily new additions of Covid-19 cases were 63 per cent more than discharged/recovered patients.

Trends show this gap has been widening. By the end of May, daily new cases were twice as much as daily recoveries. The situation improved till June 21 when daily new cases were 37 per cent more than recoveries. Since then, the gap has been widening and as of July 20, daily new cases were 63 per cent more than daily recoveries.

 

Regional heterogeneity

The gap between daily new cases and recoveries has been widening in almost all the bigger states, with Kerala being the most impacted.

The average number of new cases in Kerala was at least three times more than the average number of recoveries. Coronavirus cases in the state are doubling every 10 days, while recoveries are taking 17 days to double. Kerala health minister KK Shailaja had said there was 50 per cent community spread inside the state’s Covid-19 clusters.

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The state was one of the first to flatten the curve, but with the return of nearly half a million residents to the state, it had to deal with a second wave of Covid-19 cases.

Kerala’s northern neighbour Karnataka faces the same problem. As of July 19, Karnataka’s average daily new cases of over 3,500 is more than thrice its average daily recovery of a little less than 1,100. Nearly half the cases and deaths have been reported in the state capital of Bengaluru.

Other states where daily cases are at least twice the recoveries are Andhra Pradesh, Madhya Pradesh, West Bengal, Uttar Pradesh and Bihar.

Daily additions are 13 per cent higher than recoveries in Tamil Nadu, 17 per cent in Odisha, 20 per cent in Gujarat, 23 per cent in Assam, 27 per cent in Haryana and 45 per cent in Rajasthan. Maharashtra, the worst affected state, witnessed 60 per cent more cases than recoveries every day.

Outlier Delhi

Of the bigger states, Delhi is the only one where daily recoveries have been higher than daily new additions. However, Delhi’s numbers are to be taken with a pinch of salt.

The state government is mostly conducting rapid antigen tests which have a high degree of providing false negatives. In a statement before the Delhi high court, it had said that among the 1,365 retested negative antigen samples, nearly one in five tested positive.

Expert speak

Experts believe India’s overall recovery rate might not provide us with useful insights.

“There is a lag between the lifting of a lockdown and an increase in the numbers of new cases, because increased contacts between people will only result in symptomatic infections 5-7 days later. There is another lag between cases and deaths, since deaths today must have come from infections 2-3 weeks prior,” said Professor Gautam Menon, who teaches physics and biology at Ashoka University.

 

“Given that lockdowns have been imposed and withdrawn or partially relaxed at different times at different places means establishing a direct link between the rates of growth of cases, recoveries and fatalities while the epidemic is spreading is not very meaningful,” Professor Menon, also an infectious disease modeler at IMSc Chennai, said.

He added that the recent spike in daily cases will impact recoveries and fatalities in the coming weeks. “The sharp increase in the number of cases over the past few days will certainly reflect in increased fatalities in the coming weeks. One might then expect the recovery rate to plateau or even dip for a while, since it will take time for most of these new cases to recover,” Professor Menon said.

Professor Giridhar R Babu, Professor and Head Lifecourse Epidemiology at Public Health Foundation of India, says, “Recovery rate doesn’t actually mean much, since most cases are actually going to recover. It is important to track active cases rather than the recovery rate.”

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“More than 98 per cent of those who are infected at any point will be expected to recover both infections and deaths are under-recorded and labeling cases as recovered alone ignores long-term morbidities,” Professor Menon added.