Burden of COVID-19 pandemic in India: Perspectives from Health Infrastructure

AbstractThe coronavirus (COVID-19) is spreading rapidly across the country but India’s testing regime is far from the global standards. It is important to identify the states where testing needs expansion and the magnitudes of active COVID cases are higher focusing on current health infrastructure to meet the pandemic. The data on COVID-19 was extracted from the Application Programming Interface. Test positive rate, test per confirmed case, recovery rate, case fatality rate, and percent distribution of active cases were computed. Availability of hospitals, hospital beds, intensive care unit and ventilators per lakh population was also computed by public and private sector. The result revealed that, Maharashtra constitutes more than one-third positive cases in the country. More than a quarter of the active cases in India belonged to the Mumbai district of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra. The increased test positive rate in Maharashtra and Gujarat to almost double in last one month is a concern. In order to bring the states and the country in right track, the test positive rate need to be brought down to below 2 percent. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour. Only few states have adequate health infrastructure. The priority should be the laid on expansion of more laboratories and hospitals, storage of PPE kit, testing kit, and indigenously developed vaccines.HighlightsMaharashtra is having the highest number of positive cases followed by Gujarat and Tamil Nadu. Maharashtra constitutes more than one-third positive cases in the country, but the test per confirmed cases (8) is much lower than the other states.More than a quarter of the active cases in India belonged to the Mumbai district (26.1%) of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra.The test positive rate is higher in Maharashtra, Gujarat and Delhi is a concern.The recovery rate in India increased substantially by 26.5 percent point from 11.9 percent on April 14 to 38.4 percent on May 17, 2020.The case fatality rate of Covid-19 in India declined by 0.2 percent from 3.4 percent on April 14 to 3.2 percent on May 17 in India.The number of Dedicated Covid Hospitals is not sufficient in India.The available ventilators in the country will deficit in near future to cater to a growing number of active Covid-19 patients and the burden of other communicable and non-communicable diseases.India has only 569 testing laboratories (396 govt. and 173 private) against its 1.35 billion population. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour.

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Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

10.1101/2020.04.06.20054890 ◽

2020 ◽

Cited By ~ 7

Author(s):

Meizhu Chen ◽

Changli Tu ◽

Cuiyan Tan ◽

Xiaobin Zheng ◽

Xiaohua Wang ◽

...

Keyword(s):

Mechanical Ventilation ◽

Early Intervention ◽

Disease Progression ◽

Case Fatality Rate ◽

Severe Disease ◽

Invasive Mechanical Ventilation ◽

Case Fatality ◽

List Type ◽

Fatality Rate ◽

Medical Burden

AbstractBackgroundCOVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference.MethodsWe analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020, included laboratory examination results, imaging findings, treatment effect, prognosis, etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients.ResultsHypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients. The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression.Characteristic images of lung CT had a clear change in COVID-19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2.According to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients.ConclusionsAccurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2. Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

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COVID-19 (NOVEL CORONA VIRUS-2019)- TRENDS OF CORONA PANDEMIC OVER A PERIOD OF ONE YEAR IN HIMALAYAN REGION IN INDIA.

10.36106/2909673 ◽

2021 ◽

pp. 12-14

Author(s):

Kamlesh Sharma ◽

Ram Lal Sharma

Keyword(s):

Public Health ◽

Recovery Rate ◽

Case Fatality Rate ◽

Preventive Measures ◽

Case Fatality ◽

Himalayan Region ◽

Fatality Rate ◽

Public Health Threat ◽

One Year ◽

Authentic Data

COVID-19 is a emerging disease and is of public health importance.This study was done to analyse the trends of corona pandemic over a period of one year in Himalayan region in India. Data regarding state statistics from January 2020 to January 2021,was gathered from various sources. Since objective and authentic data was released by different agencies daily and reported to WHO, so the state prole of new cases, cumulative cases, recoveries, cumulative deaths, samples tested, positive samples was taken based on availability of information from National Health Mission site, other state websites and news papers and analysed for various parameters. The current study conducted in Himachal Pradesh showed Case fatality rate as 1.7%, recovery rate 99% and positivity rate 6.1% with Shimla having highest CFR 2.5%. Population wise most affected district was Lahul & Spiti with affected population 4.0%.It may be considered as a severe public health threat of this decade. COVID-19 trends, pattern and its analysis will be very important for control and preventive measures.

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Assessment of Epidemiological Determinants of COVID-19 Pandemic Related to Social and Economic Factors Globally

10.20944/preprints202006.0346.v1 ◽

2020 ◽

Author(s):

Mohammad Mahmudul Hassan ◽

Abul Kalam ◽

Shahanaj Shano ◽

Md. Raihan Khan Nayem ◽

Md. Kaisar Rahman ◽

...

Keyword(s):

Recovery Rate ◽

Attack Rate ◽

Case Fatality Rate ◽

Multinomial Logistic Regression ◽

Case Fatality ◽

Economic Factors ◽

Fatality Rate ◽

Middle Income ◽

Multinomial Logistic Regression Analysis ◽

Middle Income Countries

The COVID-19 outbreak has severely affected the social and economic conditions across this globe. Little is known about the relationship of COVID-19 with countries’ economic and socio-demographic status. Publicly available data on COVID-19 test rate, attack rate, case fatality rate, and recovery rate were analyzed in relation to country’s economic status, population density, median age, and urban population ratio. We also conducted multinomial logistic regression analysis to predict the influence of countries’ social and economic factors on COVID-19. The results revealed that the median age had significant positive correlation with attack rate (r=0.2389, p=0.003), case fatality rate (r=0.3207, p=0.000) and recovery rate (r=0.4847, p=0.000). The urbanization has positive significant correlation with recovery rate (r=0.1957, p= 0.016). The multinomial logistic regression analysis revealed low-income countries are less likely to have an increased recovery rate (p=0.000) and attack rate (p=0.016) compare to high-income countries. The lower-middle-income and upper-middle-income countries are less likely to have an increased recovery rate (p=0.000 and p=0.001, respectively) compared to high-income countries. Based on the result of this study, these economic and socio-demographic factors should consider in designing appropriate preventive measures as a next step. The low and lower-middle-income countries should invest more in health care services to lower the case fatality rate and increase test and recovery rates as part of pandemic preparation like COVID-19. As the number of COVID-19 attacks, death and recovery rates are constantly changing; however, the intensive study is required to obtain a clear picture.

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The importance of COVID-19 testing to assess socioeconomic fatality drivers and true case fatality rate. Facing the pandemic or walking in the dark?

10.21203/rs.3.rs-30743/v2 ◽

2020 ◽

Author(s):

Cristina Isabel Ibarra-Armenta ◽

Moises Alejandro Alarcon-Osuna

Keyword(s):

Cross Section ◽

Case Fatality Rate ◽

Case Fatality ◽

Health Indicators ◽

Developed Countries ◽

Population Characteristics ◽

Panel Data Models ◽

Fatality Rate ◽

Health Infrastructure ◽

Developed Nations

Abstract Up to date, European and other developed countries became the centre of the pandemic. While the COVID-19 spread to developing countries and less developed regions, seems to be still very low. The Case Fatality Rate (CFR) differs a lot among countries, genetics, health systems, population characteristics as well as public health and social measures (lockdown measures) are believed to be the determinants of such diversity. Through an Ordinal Probit, Cross Section and Panel data models for 71 countries, it is shown that the nations applying more tests per million inhabitants are also those reporting more cases and deaths, yet greater testing helped to reduce CFR; while, health infrastructure and population health indicators could not be confirmed as drivers for CFR. The Stringency Index showed a negative correlation with the number of deaths. Our main finding is that, the pandemic concentration on developed nations is highly related with their ability and resources for tracking the pandemic. Three additional conclusions are drawn: first, the true CFR and its drivers at national levels cannot be estimated without increasing the number of tests per million inhabitants; second, there is an under-identification of cases and/or deaths and the countries applying more tests, are most clearly identifying the reality of the pandemic, while countries with less cases, are actually still walking in the dark; third lockdown measures have been effective at reducing the number of deaths.

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Epidemic Trend and Effect of COVID-19 Transmission in India during Lockdown Phase

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i3931027 ◽

2021 ◽

pp. 78-86

Author(s):

Ranjit Prasad Swain ◽

Pratap Kumar Sahu

Keyword(s):

Mortality Rate ◽

State Government ◽

Recovery Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

Present Situation ◽

Fatality Rate ◽

And Control ◽

Control Initiative

To evaluate the present situation concerning the epidemic trend associated with the COVID-19 in Indian demography, the dynamics of the case rise has been analyzed from the perspective of the different index. The index for the analysis has been chosen in terms of the Case Recovery Rate (CRR), CASE Fatality Rate (CFR), as well as Mortality rate (MR). The study includes the rise of the case related to the pandemic in the different demographic regions of India as well as deep analysis and calculation of the indexes considered for the study. The analysis of the rising cases has also been investigated to relax the imposed rule so that economy of the country will not get affected adversely. Several preventive and control initiative has been taken by the central and state government in collaboration. The result of this paper can be taken as an input to decide further policy in the fight against the COVID- 19.

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A Study on the Global Scenario of COVID-19 Related Case Fatality Rate, Recovery Rate and Prevalence Rate and Its Implications for India—A Record Based Retrospective Cohort Study

Advances in Infectious Diseases ◽

10.4236/aid.2020.103023 ◽

2020 ◽

Vol 10 (03) ◽

pp. 233-248

Author(s):

Vinod K. Ramani ◽

R. Shinduja ◽

K. P. Suresh ◽

Radheshyam Naik

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Prevalence Rate ◽

Recovery Rate ◽

Retrospective Cohort ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Related Case

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Prevalence and cross states comparison of case fatality rate and recovery rate of COVID 19/SARS-COV-2 in India

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_1088_20 ◽

2021 ◽

Vol 10 (1) ◽

pp. 475

Author(s):

AjazAhmed Z. Ansari ◽

HardikD Desai ◽

Kamal Sharma ◽

DhigishabaM Jadeja ◽

Rahul Patel ◽

...

Keyword(s):

Recovery Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate

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Assessment of Epidemiological Determinants of COVID-19 Pandemic Related to Social and Economic Factors Globally

Journal of Risk and Financial Management ◽

10.3390/jrfm13090194 ◽

2020 ◽

Vol 13 (9) ◽

pp. 194

Author(s):

Mohammad Mahmudul Hassan ◽

Md. Abul Kalam ◽

Shahanaj Shano ◽

Md. Raihan Khan Nayem ◽

Md. Kaisar Rahman ◽

...

Keyword(s):

Regression Analysis ◽

Population Density ◽

Recovery Rate ◽

Attack Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Middle Income ◽

Middle Income Countries ◽

The Impact

The COVID-19 pandemic has manifested more than a health crisis and has severely impacted on social, economic, and development crises in the world. The relationship of COVID-19 with countries’ economic and other demographic statuses is an important criterion with which to assess the impact of this current outbreak. Based on available data from the online platform, we tested the hypotheses of a country’s economic status, population density, the median age of the population, and urbanization pattern influence on the test, attack, case fatality, and recovery rates of COVID-19. We performed correlation and multivariate multinomial regression analysis with relative risk ratio (RRR) to test the hypotheses. The correlation analysis showed that population density and test rate had a significantly negative association (r = −0.2384, p = 0.00). In contrast, the median age had a significant positive correlation with recovery rate (r = 0.4654, p = 0.00) and case fatality rate (r = 0.2847, p = 0.00). The urban population rate had a positive significant correlation with recovery rate (r = 0.1610, p = 0.04). Lower-middle-income countries had a negative significant correlation with case fatality rate (r= −0.3310, p = 0.04). The multivariate multinomial logistic regression analysis revealed that low-income countries are more likely to have an increased risk of case fatality rate (RRR = 0.986, 95% Confidence Interval; CI = 0.97−1.00, p < 0.05) and recovery rate (RRR = 0.967, 95% CI = 0.95–0.98, p = 0.00). The lower-income countries are more likely to have a higher risk in case of attack rate (RRR = 0.981, 95% CI = 0.97–0.99, p = 0.00) and recovery rate (RRR = 0.971, 95% CI = 0.96–0.98, p = 0.00). Similarly, upper middle-income countries are more likely to have higher risk in case of attack rate (RRR = 0.988, 95% CI = 0.98–1.0, p = 0.01) and recovery rate (RRR = 0.978, 95% CI = 0.97–0.99, p = 0.00). The low- and lower-middle-income countries should invest more in health care services and implement adequate COVID-19 preventive measures to reduce the risk burden. We recommend a participatory, whole-of-government and whole-of-society approach for responding to the socio-economic challenges of COVID-19 and ensuring more resilient and robust health systems to safeguard against preventable deaths and poverty by improving public health outcomes.

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Global, Regional and National Incidence and Case-fatality rates of Novel Coronavirus (COVID-19) across 154 countries and territories: A systematic assessment of cases reported from January to March 16, 2020

10.1101/2020.03.26.20044743 ◽

2020 ◽

Cited By ~ 3

Author(s):

Akshaya Srikanth Bhagavathula ◽

Jamal Rahmani ◽

Wafa Ali Aldhaleei ◽

Pavan Kumar ◽

Alessandro Rovetta

Keyword(s):

Incidence Rate ◽

Recovery Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

The United States ◽

Systems Science ◽

Fatality Rate ◽

Systematic Assessment ◽

Cumulative Change ◽

Novel Coronavirus

AbstractBackgroundThe 2019 novel coronavirus disease (COVID-19) outbreak turned into a pandemic, with hundreds of thousands of cases reported globally. The number of cases dramatically increased beginning in early March 2020.AimWe assessed the cumulative change in the incidence and case-fatality rates of COVID-19 at the global, regional, and national levels from January to March 16, 2020, in 154 affected countries and territories globally.MethodsWe collected data of COVID-19 cases using the GitHub repository, which provided real-time surveillance information developed by the Center for Systems Science and Engineering (CSSE), Johns Hopkins University (USA). Information such as confirmed COVID-19 cases, deaths, and recoveries reported across all affected countries was collected from January 22 to March 16, 2020. We estimated the change in the incidence rate, case-fatality rate, and recovery rate from January 22 to February 29 and from March 1 to March 16, 2020.ResultsFrom January 22 to March 16, 2020, globally, the number of incident COVID-19 cases increased by 276.2%, and Europe recorded 65,281 new cases from March 1 to 16, 2020. Overall, the case-fatality rate was 3.92%, with a high COVID-19 fatality rate in Italy (7.7%), Iran (5.7%), China (4.2%) and the United Kingdom (3.6%). The estimated percentage change in COVID-19 cases from March 1 to 16, 2020, was highest in Belgium (105.8/100,000 population), followed by Qatar (439/100,000 population) and Portugal (331/100,000 population). The overall recovery rate of COVID-19 was 43%; China (35.5%) had the highest recovery rate, while the United States of America recorded a recovery rate of 0.3%.ConclusionOverall, all the COVID-19-affected countries showed an upward trend in incidence, with little change in the incidence rate of -0.20% from January to Mid-March. The case-fatality rate was found to be 3.92%, and the recovery rate was observed to be less than half (43%) among COVID-19 patients. Italy, Iran, and Spain had the largest numbers of new cases of COVID-19 from March 1 to 16, 2020.

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