Even as India is poised for the next round of unlocking the economy on September 1, a new modelling study projects that the country could prevent more than two lakh Covid-19-linked deaths by December 1, if it enforced measures like wearing a mask in public and targeted lockdowns.

Without these stringent measures, India can expect approximately 492,380 deaths by December, says the study by United States-based Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Pointing out that India was at “a tipping point”, IHME Director Dr Christopher Murray told BusinessLine , that in terms of sheer numbers India might top the number of deaths globally. However, he added, in terms of infection fatality rate, it would be “much much lower” than the US or Brazil, for example.

The infection is spreading to large-population Indian States, Murray said speaking from Seattle, pointing to a concern being raised by local studies as well, as the country continues with easing-up on lockdown measures. Cautioning that India’s epidemic was far from over and a large proportion of the population was still susceptible, he added, mask-wearing and social distancing were crucial to mitigate the spread.

Currently, India is behind the US and Brazil in terms of total Covid-19 cases, and behind the US, Brazil and Mexico in the total number of deaths, according to data from the World Health Organisation (WHO) and the Johns Hopkins University, respectively. In terms of deaths per million population, India records 41 deaths, compared to US at 526, Brazil at 533, and Mexico at 462, according to WHO data.

Best & worst cases

The latest IHME projection puts India’s best-case scenario at, “approximately 291,145 total Covid-19 deaths by December 1, up from 60,000 in late August. This scenario assumes that face mask usage increases to near-universal (95 per cent) levels and that six-week, state-level lockdowns are re-imposed if the daily death rate exceeds 8 per million in the state. This threshold is based on when governments worldwide have typically imposed lockdowns to stop Covid-19 transmission.”

In contrast, if lockdown restrictions continue to ease up and face mask usage remains at current levels, “India can expect approximately 492,380 total deaths by December 1. In this scenario, 13 states would have more than 10,000 total Covid-19 deaths by that time. Currently, only Maharashtra has crossed this threshold,” a note on the study pointed out.

“If hospitals in those states are unable to accommodate everyone needing Covid-19 care, the result will be more deaths and greater long-term harm to state and local economies,” he points out.

Virus and projections

The IHME study started in March, Murray said, and covered 160 countries, with India being the last major country to be looked at. Modelling studies done by other institutions in the past had projected inflated numbers and had been called out by public health experts, who said the “virus knew no maths” and that the studies had not accounted for the many variables. Responding to this, Murray agreed that earlier studies done by some institutions did project “exaggerated” numbers. However, months into assessing the virus spread, he said, IHME’s forecast had proved to be the “best” of the modelling studies, with the “smallest” error of 20 percent in 10 week average. If anything, he said, the criticism is that they tend to “underestimate”.

India’s response to Covid-19 have produced some significant successes that highlight the opportunity to limit the pandemic’s toll in the country, a note from the IHME said.

Until there is a widely available vaccine against Covid-19, much of India’s population remains susceptible to the disease, the note said. “Monitoring trends state-by-state, encouraging mask use, continuing social distancing and hygiene precautions, and using state-level or district-level lockdowns, if needed, can help save lives and minimise the impact of the pandemic on India’s health and economy,” it added.

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