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“Poor record-keeping”, “lack of widespread testing” and “India grossly understating the true state of the pandemic” are some of the damning observations on the second wave of the COVID-19 pandemic in India made in a New York Times article.
In the absence of transparency, the NYT spoke to over a dozen experts to analyse the number of cases and deaths to arrive at several estimates for the real extent of devastation on ground zero.
The detailed report also relies on large-scale antibody tests to arrive at estimates. Despite its limitations, the tests provide a fresh way to arrive at more realistic figures. “It gives us a starting point. I think that an exercise like this can put some bounds on the estimates,” Dan Weinberger, an associate professor of epidemiology at the Yale School of Public Health, told the NYT.
The conservative estimate suggests that the pandemic’s actual toll and infections are, in reality, several times higher than reports suggest. This, the NYT report calls, the best-case scenario.
The report used data from three nationwide antibody tests, called serosurveys. Each survey had about 30,000 people examined for COVID-19 antibodies. They also used a conservative infection-fatality rate in this scenario at 0.15 percent.
These estimates reveal:
The report uses the latest seroprevalence in India, which happened in January 2021, and estimated roughly 26 infections per reported case.
In this “more likely scenario”, the report uses a slightly lower figure (than 26 infections per reported case) to calculate infections and the infection fatality rate at 0.3 percent.
These estimates reveal:
This scenario uses a slightly higher estimate to account for the current wave of infections per reported case. The infection-fatality rate has also increased to double the previous one at 0.6 per cent.
This scenario takes into account the stress of India’s healthcare system. Over the last few weeks, there has been a severe lack of oxygen, beds, and medicines among other things.
This means that a greater share of those who contracted the virus but are not getting access to medical infrastructure, are dying.
The estimates reveal:
Relying on three national serosurveys, the report states how all three found that the actual number of infections was drastically more than the official figures.
Even this, doctors said, could be an underestimation.
“Those who had been infected a while ago may have not been captured in this survey. So this is probably an underestimation of the true proportion of the infected population,” said, Dr Shioda, an epidemiologist at Emory University.
The report says that infection-fatality rates published were calculated before the second wave in India, meaning that the rate could be much higher.
At the same time, these rates vary greatly by age. A paper that examined infection rates using serosurvey data from three locations in India found huge variations, depending upon the population being sampled.
“We found that age-specific infection-fatality rate among returning lockdown migrants was much higher than in richer countries. In contrast, we found a much lower first-wave infection-fatality rate than richer countries in the southern states of Karnataka and Tamil Nadu,” Dr Paul Novosad, an associate professor at Dartmouth College, said.
While estimates may vary, one thing that can be said “clearly beyond all doubt” is that the pandemic is much larger than official figures portray.
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