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Covid19 Is Far From Gone, Though Probably Not As Bad In India As Many Believe

Covid19 is far from finished in the world's more economically developed countries. And we – who live in these countries – continue to display a restrained racism towards large culturally different nations such as India and China.

For example, we kept assuming that the main Covid19 risk country was China, long after the main risks had become Italy and Spain and then the rest of the northern hemisphere west.

And we keep assuming that India's recordkeeping on Covid19 is vastly inferior to that of 'the west'. Evidence for a substantially larger undercount of covid cases and deaths in India is in short supply. What if the undercount is comparable to undercounts elsewhere, including the west? Is it really as bad in Uttar Pradesh – India's biggest state – as too many of us assume? If Uttar Pradesh was a country, it would be the world's seventh largest, and comparable in population size to Pakistan (a little larger than Uttar Pradesh) and Bangladesh (a little smaller than Uttar Pradesh). (Uttar Pradesh has 1.7 million notified cases, and 19,000 deaths, for its population of 200 million; most of these cases/deaths are recent. In total, the United States – with just 65% more people – has recorded 604,000 Covid19 deaths.)

Uttar Pradesh is famous for the River Ganges. It also borders New Delhi, it has the longest border with Nepal, and includes the city of Agra which has the Taj Mahal. In India, the places worst affected by Covid19 are Delhi, other richer cities such as Bangalore (and, earlier, Mumbai), the places most renown as tourist destinations, and the cooler Himalaya states. This suggests that, within Uttar Pradesh, there will be larger concentrations of covid close to Delhi (as in the other close state, Haryana), in Agra, and along the Nepalese border (given that Nepal is now suffering worse than India). This means that the areas along the Ganges are most likely below average for Uttar Pradesh, let alone for India. And Uttar Pradesh this last week has recorded incidence of Covid19 at 30% of India's now-waning average, and deaths per capita at half of India's average.

The media fed us all these images of festivals on the banks of the Ganges, with lots of crowds and bathing, and little distancing and masking. "Tut-tut", we thought, these people are sitting ducks for Covid19. In fact, according to the statistical record which we should not dismiss, these people have been surprisingly resilient. Perhaps not really 'surprisingly', given that the villagers of Uttar Pradesh have led crowded lives which will have exposed them to many viruses, and they do not live so much in the covid-lethal indoor environments that characterise Europe and the Americas. India's richer classes, however, do live, work and socialise in these covid-lethal indoor places.

Of course, the statistics in Uttar Pradesh are an understatement of the true extent of contact with the covid virus. But that is true of all polities; European countries had huge undercounts of deaths and cases in 2020, and for most of this year most European countries had covid-test positivity rates higher than India has had in the last month. We should not, by assumption, be more dismissive of Indian statistics than we are of European statistics.

For the record, on reported cases per capita (out of 210 countries):

  • India was ranked 78th on 9-15 April and 28th on 16-22 May, peaking at 19th on 7-13 May.
  • Bangladesh (with living conditions much like Uttar Pradesh) was ranked 110th on 9-15 April and 144th on 16-22 May.
  • Pakistan was ranked 121st on 9-15 April and 127th on 16-22 May.
  • Nepal was ranked 134th on 9-15 April and 17th on 16-22 May, peaking at 15th on 9-15 May.
  • Malaysia was ranked 106th on 9-15 April and 33rd on 16-22 May.
  • United Kingdom was ranked 107th on 9-15 April and 102nd on 16-22 May, troughing at 118th in late April (so it's getting relatively worse in May)
  • United States was ranked 56th on 9-15 April and 72nd on 16-22 May.
  • Chile was ranked 24th on 9-15 April and 12th on 16-22 May (so it's worse in May).
  • Hungary was ranked 8th on 9-15 April and 79th on 16-22 May.

On recorded deaths per capita:

  • India was ranked 85th on 9-15 April and 35th on 16-22 May.
  • Bangladesh was ranked 98th on 9-15 April and 113rd on 16-22 May.
  • Pakistan was also ranked 98th on 9-15 April and 96th on 16-22 May.
  • Nepal was ranked 129th on 9-15 April and 12th on 16-22 May.
  • Malaysia was ranked 123rd on 9-15 April and 61st on 16-22 May.
  • United Kingdom was ranked 98th on 9-15 April and 126th on 16-22 May.
  • United States was ranked 55th on 9-15 April and 54th on 16-22 May.
  • Chile was ranked 25th on 9-15 April and 21st on 16-22 May.
  • Hungary was ranked 1st on 9-15 April and 16th on 16-22 May

In the last week, the eight top-ranking countries for deaths were all in South America or the Caribbean.

India's undercount on deaths is greater than its undercount on cases, unlike South America and East Europe which have almost certainly had comparable case undercounts to India (given their test positivity ratios). While India's death undercount so far will have been somewhat larger than in South America, its actual death rates per capita will still have been much lower than these countries during their prolonged covid peaks.

Malaysia, a country from which New Zealand receives two flights in some days, is currently experiencing an outbreak that could soon be as bad as that in India. Latest case percentages are similar for both countries.

Of considerable concern are the still very high death rates in the United States. The results of the vaccine roll-outs in the United States, and in Chile, are disappointing. Deaths in these two countries, while no longer subject to undercounts, tell us that the Covid problem is far from coming to an end with vaccinations. And, indications in the United Kingdom are now that the lockdown there this year has been more important than the vaccination programme in getting death rates down.

While the March-April wave of Covid19 is waning, for the world as a whole, there are already signs of another wave: already being dubbed the wave of "the India Variant". While the United Kingdom's deaths are still coming down, its cases are increasing. Yesterday, Scotland, with a population the same as New Zealand, reported 340 new cases. That, in New Zealand, would I expect send us into an immediate level 4 lockdown. Meanwhile, the situations in Argentina, Uruguay, Paraguay, Colombia, Brazil and Chile remain critical.

Currently New Zealanders are sitting ducks, and will remain so until fully vaccinated (eg 80% of adults) and we have a programme in place to deliver annual booster vaccines in the autumn of each year. With fewer common colds to give us background immunity, and with vaccination immunity waning, the winter of 2022 could see us getting Covid19 at levels comparable to East Europe in its last winter. Other countries which did very well in one year (2020) had substantial outbreaks in the following year.


Keith Rankin, trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

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