We had an interesting discussion on Zoom about Covid 19 Progress in India and a possible scenario. I would appreciate your views and feedback.

1. Covid 19 Stats in India
Review of key data and presentation of a projection model
Data updated till 23.05.20
Data Sources: https://www.covid19india.org/; https://www.worldometers.info/

2. Agenda
• Presentation of key data for All India 10 Mins
• Presentation of key data for Hot Spots 5 Mins
• Q&A 5 Mins
• Presentation of projection model 15 Mins
• Q&A 15 Mins

3. All India Data

4. • Testing has been ramped
up to over 100,000 tests
per day.
• However, the percentage of
positive cases is increasing.
This is counter intuitive.
• If the centre of the target is
the Covid + patient the
chances of his testing
positive are 100%. If you
test his contacts the ratio
should go down and the 2nd
level contacts lower still.
• The fact that this is not
happening in India implies
that the virus has already
spread in the population.
Most cases may be
asymptomatic or mild.

5. • We are crossing 6000 new
infections/day. The
doubling rate is 10 days
currently and is decreasing.
• However, new infections
being discovered are a
function of how many tests
are being done. The real no
of infections is probably far
higher than what is being
discovered.
• IMPORTANT – New
Infections are therefore
not a reliable indicator for
forecasting future trends.

6. • Deaths are touching
140/day. The 3 day Moving
Average is ahead of the 7
day Moving Average
indicating a rising trend
currently.
• The polynomial line of best
fit is showing an upward
trend.
• Deaths are a more reliable
indicator for forecasting
than infections. Even here
there may be some
misreporting, but the level
is not likely to be
significant.
• Days for doubling are 13 as
of now but the trend
indicates that this figure
will come down.

7. • Recoveries have been steadily
going up as a percentage of the
total cases.
• Partly this may be due to a
change in the definition. Earlier
a patient was deemed
recovered if two consecutive
tests came out negative. This
definition has been diluted and
now (from May 8th) a patient
can de discharged if he has no
fever without a test
https://www.indiatoday.in/diu/s
tory/india-coronavirus-cases-
recovery-rate-1680694-2020-
05-22

8. • The death rate has been steadily
declining. However there are two
points to be considered.
• Deaths may occur afterwards from the
same group. This will push up the rate
a little.
• As discussed earlier the real level of
infections in the population may be
very much higher. In that case this rate
will come down considerably.

9. Hot Spots Data

11. • The Western Region has
been most severely
impacted by Covid 19.
• Ahmedabad is the worst
affected followed by
Mumbai on a per capita
basis.
• Chennai and Delhi are
reporting a large number of
infections, but death rates
are relatively low.
• The disease has hardly
penetrated into the
hinterland as yet.

12. • Most of India’s testing has
been in the Metros and major
cities. Small towns and rural
areas have hardly been tested.
• Delhi and Tamil Nadu have
seen aggressive testing. West
Bengal is clearly deficient.
• The low level of testing in
Western India where most of
the hot spots are concentrated
is alarming.

13. Projection Model for India

14. Basis for Projection
• Most countries have seen a fall in new infections and deaths per day
after some time. Some countries like India have yet to experience
this.
• The response of various counties is different in terms of when this
decline started.
• Our model will use per capita deaths and infections on the day the
decline started in each country to model a possible scenario for India.
As stated earlier, deaths are a more reliable indicator than infections
for projection.

15. Herd Immunity and R0
• There is some speculation on why the virus has declined in so many countries.
• ‘Herd Immunity’ comes when approximately 60% of the population is immune
either by a vaccine or because they have had the disease already. This has not
happened anywhere.
• Social distancing, hand washing, and masking can help to reduce the R0 value
even if Herd Immunity has not been achieved. Perhaps this is the reason why
infections and deaths have declined.
• This presentation and projection model does not seek to answer this question. It
is merely based on the empirical evidence of declines having taken place in most
countries.

16. Infections Deaths Infections Deaths
Malaysia 3.04.20 29.03.20 103 1
Thailand 29.04.20 NA 42 -
Indonesia 13.05.20 NA 57 -
Bangladesh NA NA - -
Pakistan NA NA - -
Turkey 11.04.20 19.04.20 619 24
Iran 30.03.20 4.04.20 495 41
Italy 26.03.20 27.03.20 1,333 151
Spain 1.04.20 2.04.20 2,227 221
France 3.04.20 15.04.20 1,171 263
Germany 2.04.20 15.04.20 1,012 45
Russia 11.05.20 NA 1,517 -
UK 6.05.20 21.04.20 2,962 298
USA 24.04.20 21.04.20 2,797 138
Brazil NA NA - -
Date of Decline Start Per Million on that date

17. Daily Deaths and Infections - Spain

18. Daily Deaths and Infections - Turkey

19. Country Wise Variations
• The disease has impacted various countries differently. Broadly, the following clusters
emerge:
• UK/USA are the worst hit. While deaths/day have started declining in both countries they will have
a slow recovery.
• Spain/France/Italy have had a very sharp increase followed by a steep fall.
• Germany is the outlier in Europe as they have managed to contain the infection better than other
neighbouring countries.
• Turkey and Iran in West Asia have fared better than their European counterparts. There is a
‘second wave’ of infections happening in Iran but it may be due to enhanced testing as deaths/day
continue to decline.
• South East Asia, Africa and ANZ have largely escaped the brunt of the disease.
• It is outside the scope of this discussion to assign reasons for this differential behaviour.
Speculation about natural immunity, BCG vaccination, endemic malaria, hot weather etc
are continuing.
• Based on the differential response, India looks set to behave more like its West Asian
counterparts. The rest of South Asia may also follow suit.

20. Projection
Population Per Mn Deaths on Day Decline Starts Projected Deaths on Day Decline Starts
Low Medium High Low Medium High
India 1,37,843,247 25 40 50 34,461 55,137 68,922
Cumulative Deaths as of 23.05.20 3,867
Doubling
Rate
5.06.20 18.06.20 1.07.20 14.07.20 27.07.20
13 (Current) 7,734 15,468 30,936 61,872 123,744
Doubling
Rate
2.06.20 13.06.20 24.06.20 5.07.20 16.07.20
11

21. Directions
• Cumulative deaths will reach the level by when the decline in daily deaths should start in
the first half of July 2020.
• At that time, the no of infections would be between 11 – 23 Lakhs based on the current
death rate percentage. However, this is a highly speculative figure.
• The first lockdown was likely more effective in reducing infections and deaths. After that
with progressive opening up the virus has most probably spread through the entire
population especially after the migrant workers have gone back to their villages. This is
not a bad thing. Social distancing is probably better achieved in a village rather than in an
urban slum. The other point is that there is little more that the govt or anybody can do to
slow down/halt the spread.
• The increase in infections and deaths will happen. Hopefully, self limiting as has
happened in other countries will happen in India too.

22. Thank You!
Please mail me at debubhatnagar@gmail.com
with any comments.
Disclaimer: These projections and analysis is not official and are the work of an
amateur. They should not be the basis of any decision making.