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Covid-19: 4 million milestone paints a grim picture nationally

The number of total Covid-19 cases in India surpassed the 4 million-mark on Friday with little sign of the virus’s pace slowing in the country.

States with a large number of cases, Maharashtra, Andhra Pradesh, Tamil Nadu and Karnataka (Nos 1, 2, 3, 4 by cases), continue to exhibit signs that the contagion is spreading fast with no peak in sight, according to data analysed by HT.

States such as Chhattisgarh, Jharkhand and Punjab face the risk of becoming the new hot spots due to a rapid increase in new cases, rising positivity rates and (in the first two) low testing.

To identify the new hot spots of the outbreak, HT analysed data from India’s 20 most populous regions, looking for three factors — a rising positivity rate, a high growth rate of daily cases, and low tests per million residents — that have marked all hot spots globally.

A similar analysis by HT on July 27 identified Karnataka, Andhra Pradesh, West Bengal and Bihar as possible outbreak states – and all reported a sharp increase in cases through August.

Delhi, the only region in the country that had reported a clear turnaround with performance improving on the three parameters at the beginning of August, saw its performance drop in two of these parameters – it has seen a significant resurgence of daily cases coupled with a rise in positivity rate. To be sure, with improved testing, the Capital has been showing glimpses of improved numbers in the past few days.

Bihar, meanwhile, appears to have set an example of how a state can improve its numbers by aggressively improving testing numbers as both its doubling and positivity rates improved. 

CASE RATE

The rate of increase in cases for a region is generally measured by what is known as doubling rate — the number of days it takes for the total infections in the region to double (the higher the number, the better).

At 13.7 days, Chhattisgarh has the worst doubling rate in India and is one of only three states that have seen this metric worsen in the past month (the other two being Haryana and Delhi). It is followed by Jharkhand (16.5 days), Odisha (22 days), and Punjab (24.1 days).

To be sure, the national doubling rate is 32.4 days, which has improved from 20.7 days at the start of August, but this has come even as the quantum of cases has risen sharply – India had 1.7 million cases at the start of August and was adding around 55,000 cases a day; this has since increased to around 80,000 daily cases in the last week or so.

Among the major hot spots, Karnataka features in the bottom quartile with a doubling rate of 27.2 days. Andhra Pradesh has a doubling rate of 28.6 days. The doubling rate in Maharashtra, the country’s worst-hit state, is only slightly above the national average – 34.6 days. In Tamil Nadu, the plateau of cases is evident in its relatively better doubling rate — 48.3 days.

The resurgence of cases in Delhi, meanwhile, has seen its doubling rate drop from nearly 90 days to 57.7 days – the biggest change among the states analysed. However, it still has the best doubling rate in India.

Bihar’s doubling rate went from one of the worst in the country in August (11.9 days) to 49.4 days on September 3, the third highest.

POSITIVITY RATE AND TESTING

In 12 of the 20 states analysed, the positivity rate – the proportion of people testing positive to those tested – increased in the last month. Positivity rate shows how widespread the virus is in the region, and when coupled with a rise in new cases, indicates that the virus is spreading fast.

Maharashtra continues to have the highest 7-day average positivity rate in the country at 21.7% (up 3.4 percentage points in the last month; the data is for the week ended September 3). Even at the start of August, the state had the highest positivity rate in the country, a statistic that highlights the magnitude of the challenge that faces the western state.

Andhra Pradesh, with the second highest caseload in India, has the second highest positivity rate as well — 17.1% (up 2.3 percentage points). Chhattisgarh has the third-worst positivity rate – 13.8% over the last week (an increase of 8.1 percentage points). Though Karnataka’s positivity rate dropped 3 points to 12.9%, it remains in the worst performing zone. Delhi, meanwhile, saw an increase of positivity rate from 5.9% to 9% — which means the Capital had the fifth worst figure in the country.

In Punjab, the positivity rate increased 1.8 percentage points (from 6.3% for the week ended August 1 to 8.1%) over the last month.

For the week ending September 2, 7.7% of tests came back positive across the country (an improvement of 2.9% from August 1). In total, 8.4% of tests have come back positive across the country till date.

Bihar, meanwhile, witnessed the biggest improvement in positivity rate. For the week ending August 1, 14% of the tests were positive for Covid-19 in the state; this dropped to 1.7% for the week ending September 3. Much of this is because of the increased rate of testing – average daily tests in the state went from 20,000 at the start of August to 113,000 by September.

In terms of testing rate, Madhya Pradesh was at the bottom, with 17,554 tests performed per million of the population, followed by West Bengal (20,853) against the national average of 35,020. Chhattisgarh was again among the worst performers, with the third lowest testing rate – 21,430. It was followed by UP (26,893) and Jharkhand (27,206).

Testing, however, is a parameter that offers hope for residents of Delhi (84,251 tests per million, the highest in India), Andhra Pradesh (74,793), and Karnataka (47,477) — all perform much better than the national average of 35,020 tests per million.

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