This document discusses coronavirus (Covid-19) mortality rates in India by comparing Covid-19 deaths to other causes of death in India. Some key points:
1) As of April 9th, 2020, there were approximately 6,000 confirmed Covid-19 cases and 200 deaths in India, compared to over 1.5 million global cases and 84,000 deaths.
2) In India in 2017, communicable diseases caused over 6,900 deaths per day, while non-communicable diseases caused over 4,500 deaths per day.
3) The author argues that given India's high mortality rates from other causes like suicide, drowning, and snake bites, Covid-19 should
GHME 2013 Conference
Session: Global and national Burden of Disease II
Date: June 17 2013
Presenter: Kyle Heuton
Institute:
Institute for Health Metrics and Evaluation (IHME), University of Washington
Dr Yousef Elshrek is One co-authors in this study >>>> Global, regional, and...Univ. of Tripoli
Global, regional, and national age–sex specifi c all-cause and cause-specifi c mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
GBD 2013 Mortality and Causes of Death Collaborators*
Dr. Yousef Elshrek is Coauthors in this study
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
GHME 2013 Conference
Session: Global and national Burden of Disease II
Date: June 17 2013
Presenter: Kyle Heuton
Institute:
Institute for Health Metrics and Evaluation (IHME), University of Washington
Dr Yousef Elshrek is One co-authors in this study >>>> Global, regional, and...Univ. of Tripoli
Global, regional, and national age–sex specifi c all-cause and cause-specifi c mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
GBD 2013 Mortality and Causes of Death Collaborators*
Dr. Yousef Elshrek is Coauthors in this study
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
Food security in India and States: key challenges and policy option Premier Publishers
Condition of food security in India is gloomy and is similar to African countries. Both the supply side and demand side factors have their roles in the present condition of food security and undernourishment in India. This study supports that if agriculture production grows; increasing food prices has less bearing on low food security. Problem of food security in India is very much related to low demand. If demand of people can be improved, food security can be achieved. Disaggregated trend of food security shows that problem of food insecurity is high in poor states. Considering disaggregated level of food security, government has passed Food Security Bill in India. Our analysis points out that food security cannot be achieved in India without improving the level of overall agriculture production. Improving agricultural production is essential for ensuring long term food security and promoting poverty reduction. State level condition of storage capacity of food grains also points out that how a state like Bihar with low storage facility will manage to implement this Bill. Without identifying role of market, success of Food Security Bill and reduction of poverty is distant dream.
GHME 2013 Conference
Session: Global Burden of Diseases, Injuries, and Risk Factors Study 2010: workshop on methods and key findings
Date: June 18 2013
Presenter: Rafael Lozano
Institute:
Institute for Health Metrics and Evaluation (IHME), University of Washington
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
India has around 2.5 million people suffering from Cancer. Around 1 million cases get added every year. Annually, nearly 5 lakh people die of cancer in India. The WHO said the number is expected to rise to 7lakh, by 2015. Are you adequately prepared?
The great british singing group, the bee gees, have the answerdrstevenquay
This is the data for annual death rates by age for COVID-19 (left column), Influenza (center column), and what is called by the Actuaries, All-Cause Mortality (right column). That third column is, death for any reason for a particular age group. All of these data are annual deaths per 100,000 people of the particular age group or gender (the All-Cause data is separated by gender to show how much harder it is for a guy to stay alive for a year compared to a women).
Tracking the Birth Pains- 9 Deadly Diseases in 2015Beth Frisby
As Messiah's return draws near, deadly diseases will continue to wreak havoc on our world. Take a look at 9 deadly diseases that affected our world in 2015.
The SARS-CoV 2 pandemic, since its origin in China as a cluster of pneumonia cases, had reached almost every part of the world and had killed more than one million people
worldwide [1]. The case fatality differs substantially between countries along with the number of symptomatic patients, sequelae of the disease and those who require intensive lifecare
support. Such a perceived difference can be attributed to macroecological dissimilarities like the general well-being of the population and a more extent, its demographic structure.
The demographic characteristics, most notably the age structure and population density, has important implications in the spread of infectious diseases [2,3]. Like most of the infectious
diseases we have known so far, COVID-19 is seen more severely in groups like the elderly and those with comorbidities [4,5]. Robustness of the health system and abundance of resources might have helped the western countries to report proportionately a greater number of cases. However huge proportion of elderly population in these countries might have contributed to higher reporting of severe illness and deaths in these countries [6].
The misunderstood epidemiological determinants of covid 19, problems and solu...Bhoj Raj Singh
COVID-19, a viral disease, fought with political means for socio-economic gains, will keep on haunting humanity for long. Without doing any epidemiological study on COVID-19 we have determined its modulators and determinants not to win over COVID-19 but to create misunderstanding to persist for long in inquisitive minds to blur the vision for novel inventions. This presentation deals with COVID-19 in general and misunderstood disease determinants in particular to suggest possible means to win over the disease. As the tip of COVID-19 iceberg is illusion and reality unknown, thus the struggle is endless.
Food security in India and States: key challenges and policy option Premier Publishers
Condition of food security in India is gloomy and is similar to African countries. Both the supply side and demand side factors have their roles in the present condition of food security and undernourishment in India. This study supports that if agriculture production grows; increasing food prices has less bearing on low food security. Problem of food security in India is very much related to low demand. If demand of people can be improved, food security can be achieved. Disaggregated trend of food security shows that problem of food insecurity is high in poor states. Considering disaggregated level of food security, government has passed Food Security Bill in India. Our analysis points out that food security cannot be achieved in India without improving the level of overall agriculture production. Improving agricultural production is essential for ensuring long term food security and promoting poverty reduction. State level condition of storage capacity of food grains also points out that how a state like Bihar with low storage facility will manage to implement this Bill. Without identifying role of market, success of Food Security Bill and reduction of poverty is distant dream.
GHME 2013 Conference
Session: Global Burden of Diseases, Injuries, and Risk Factors Study 2010: workshop on methods and key findings
Date: June 18 2013
Presenter: Rafael Lozano
Institute:
Institute for Health Metrics and Evaluation (IHME), University of Washington
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
India has around 2.5 million people suffering from Cancer. Around 1 million cases get added every year. Annually, nearly 5 lakh people die of cancer in India. The WHO said the number is expected to rise to 7lakh, by 2015. Are you adequately prepared?
The great british singing group, the bee gees, have the answerdrstevenquay
This is the data for annual death rates by age for COVID-19 (left column), Influenza (center column), and what is called by the Actuaries, All-Cause Mortality (right column). That third column is, death for any reason for a particular age group. All of these data are annual deaths per 100,000 people of the particular age group or gender (the All-Cause data is separated by gender to show how much harder it is for a guy to stay alive for a year compared to a women).
Tracking the Birth Pains- 9 Deadly Diseases in 2015Beth Frisby
As Messiah's return draws near, deadly diseases will continue to wreak havoc on our world. Take a look at 9 deadly diseases that affected our world in 2015.
The SARS-CoV 2 pandemic, since its origin in China as a cluster of pneumonia cases, had reached almost every part of the world and had killed more than one million people
worldwide [1]. The case fatality differs substantially between countries along with the number of symptomatic patients, sequelae of the disease and those who require intensive lifecare
support. Such a perceived difference can be attributed to macroecological dissimilarities like the general well-being of the population and a more extent, its demographic structure.
The demographic characteristics, most notably the age structure and population density, has important implications in the spread of infectious diseases [2,3]. Like most of the infectious
diseases we have known so far, COVID-19 is seen more severely in groups like the elderly and those with comorbidities [4,5]. Robustness of the health system and abundance of resources might have helped the western countries to report proportionately a greater number of cases. However huge proportion of elderly population in these countries might have contributed to higher reporting of severe illness and deaths in these countries [6].
The misunderstood epidemiological determinants of covid 19, problems and solu...Bhoj Raj Singh
COVID-19, a viral disease, fought with political means for socio-economic gains, will keep on haunting humanity for long. Without doing any epidemiological study on COVID-19 we have determined its modulators and determinants not to win over COVID-19 but to create misunderstanding to persist for long in inquisitive minds to blur the vision for novel inventions. This presentation deals with COVID-19 in general and misunderstood disease determinants in particular to suggest possible means to win over the disease. As the tip of COVID-19 iceberg is illusion and reality unknown, thus the struggle is endless.
Article Type: Editorial
Title: Changing and Challenging Scenario of Burden of Disease
Year: 2022; Volume: 2; Issue: 1; Page No: 3 – 4
Author: Dr. P.K. Govindarajan
10.55349/ijmsnr.20222134
Affiliation: Professor, Department of Community Medicine, Vinayaka Missions Medical College and Hospital, Karaikal, Puducherry (UT), India.
Email ID: drpkgr@gmail.com
Article Summary:
Submitted : 15-February-2022
Revised : 27-February-2022
Accepted : 15-March-2022
Published : 31-March-2022
Coronavirus effects heighten fears of recession in the world economy. Stock exchanges have had a difficult week around the world and, in Europe, the recession seems inevitable. The paralysis in China weighs on domestic growth because the supply chains of multinationals need components made in Chinese factories to guarantee their production. Consumption in western countries will be strongly affected. Tourism, air transport, leisure are already suffering the consequences.
Similar to India Must Learn to Live with Coronavirus (20)
Anil Chawla Law Associates LLP is a law firm based in India. We add value to business. We help startups and MSMEs grow and prosper.
We help through every life-cycle-stage of a small / medium enterprise.
Supporting promoters with creativity, vision, empathy and wisdom is our speciality.
We help Indian entrepreneurs form entities abroad. We also assist foreign companies to enter India.
We help design global structure for visionary Indians with dreams.
We help you with wealth management, family settlement and succession planning.
We combine entrepreneur's perspective with legal expertise and engineer's analytical approach.
Our clients are spread across the globe. We are always near you wherever in the world you may be.
We strive to be your friend, mentor and guide - with trust, confidence and care.
Seeing your business grow and prosper is our passion.
Senior Partner - Advocate Anil Chawla, Bachelor of Technology (Mech. Eng.) from Indian Institute of Technology Bombay; Master of Laws (Corporate & Commercial Law);
Bachelor of Laws, Insolvency Professional;
Author of many articles and books. Public Speaker.
Partner - Advocate Yogita Pant, Bachelor of Arts (Management); Master of Personnel Management; Master of Laws (Corporate & Commercial Law);
Bachelor of Laws, Insolvency Professional
Liabilities of Directors under the Companies Act of IndiaAnil Chawla
This Presentation gives the liabilities (punishments, penalties etc) that a Director of an Indian company faces when the company defaults under the Companies Act 2013 (As amended by The Companies Amendment Act, 2020).
This Guide is intended to help every Hindu whether living in India or outside India to prepare a Will. While the primary focus is on Indian law, it also takes into account essentials of international private law. Written in simple language free of legalese, it gives an overview of Wills for an educated Hindu without any legal knowledge.
A chapter gives legal aspects of executing Advance Medical Directives (Living Will) as per March 2018 judgment of Supreme Court of India. A Sample of Advance Medical Directives is also included.
Decriminalization of Doing Business in India – Cheque BouncingAnil Chawla
This long article is a representation to Government of India pleading for decriminalization of the offence of dishonour of cheques. It pleads that the law relating to cheque bouncing is being used by money lenders and as a result entrepreneurship is being killed in India.
Unfolding of the Great War - World War IIIAnil Chawla
This mini-book is an attempt to understand the key players, the dynamics, the tools and the goals in the Great War (World War 3) which is unfolding across the globe. People's Republic of China seems to be following in the footsteps of Nazi Germany. Annexation of Tibet can be compared to Hitler's invasion of Poland.
Guide for Creating a Global Structure Using Holding CompanyAnil Chawla
Indian entrepreneurs are looking at the whole world as
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Coronavirus (COVID-19) - Prevention with AyurvedAnil Chawla
This long article discusses Covid-19 from the viewpoint of ayurved. It provides practical tips to avoid getting hit by the disease and also to reduce the impact if the initial symptoms appear. It also talks about Spanish flu of 1918.
Guide to Place of Effective Management Rules for Foreign Companies Owned by I...Anil Chawla
This presentation is intended to help Indian entrepreneurs owning and managing companies in foreign
countries. Under POEM rules of Indian Income Tax foreign companies are liable to tax in India if their place of effective management is in India. This Guide is intended to help Indian entrepreneurs deal with POEM Rules.
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This mini-book throws light on the options available to foreign companies when entering into joint ventures in India. It examines the various options with reference to different needs of foreign companies. It also gives in brief the sector-wise restrictions imposed by Government of India in relation to foreign direct investment. The Fourth edition has a special section about formation of joint ventures for participating in government tenders.
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Guide for Indians Wanting to Seek Relief under India's Investment Treaty with...Anil Chawla
This comprehensive Guide is useful for Indians (including Non-Resident Indians) who have invested either in a foreign company or in a foreign venture and are facing trouble due to some action by either Government of that country or by any provincial government or by any other government body. The Guide includes Frequently Asked Questions, Selected Sample Cases and details of key persons involved in international investment arbitration.
Guide for Foreign Investors Wanting to Seek Relief under Their Country's Inve...Anil Chawla
This comprehensive Guide is useful for foreign companies who have invested either in an Indian company or in an Indian venture and are facing trouble due to some action by either Government of India or by any state government or by any other government body. The Guide includes Frequently Asked Questions, Selected Sample Cases and details of key persons involved in international investment arbitration.
Guide for Arbitration Clause in International Agreements in IndiaAnil Chawla
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This presentation discusses the legal provisions related to Liabilities of Directors under Labour Laws. It is of interest to entrepreneurs, business men, directors of companies and corporate houses.
This presentation discusses the legal provisions related to prosecution of directors in cases involving bouncing of cheques. It is of interest to entrepreneurs, directors of companies and corporate houses.
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01062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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An astonishing, first-of-its-kind, report by the NYT assessing damage in Ukraine. Even if the war ends tomorrow, in many places there will be nothing to go back to.
In a May 9, 2024 paper, Juri Opitz from the University of Zurich, along with Shira Wein and Nathan Schneider form Georgetown University, discussed the importance of linguistic expertise in natural language processing (NLP) in an era dominated by large language models (LLMs).
The authors explained that while machine translation (MT) previously relied heavily on linguists, the landscape has shifted. “Linguistics is no longer front and center in the way we build NLP systems,” they said. With the emergence of LLMs, which can generate fluent text without the need for specialized modules to handle grammar or semantic coherence, the need for linguistic expertise in NLP is being questioned.
हम आग्रह करते हैं कि जो भी सत्ता में आए, वह संविधान का पालन करे, उसकी रक्षा करे और उसे बनाए रखे।" प्रस्ताव में कुल तीन प्रमुख हस्तक्षेप और उनके तंत्र भी प्रस्तुत किए गए। पहला हस्तक्षेप स्वतंत्र मीडिया को प्रोत्साहित करके, वास्तविकता पर आधारित काउंटर नैरेटिव का निर्माण करके और सत्तारूढ़ सरकार द्वारा नियोजित मनोवैज्ञानिक हेरफेर की रणनीति का मुकाबला करके लोगों द्वारा निर्धारित कथा को बनाए रखना और उस पर कार्यकरना था।
03062024_First India Newspaper Jaipur.pdfFIRST INDIA
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‘वोटर्स विल मस्ट प्रीवेल’ (मतदाताओं को जीतना होगा) अभियान द्वारा जारी हेल्पलाइन नंबर, 4 जून को सुबह 7 बजे से दोपहर 12 बजे तक मतगणना प्रक्रिया में कहीं भी किसी भी तरह के उल्लंघन की रिपोर्ट करने के लिए खुला रहेगा।
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1. समथ भारत
Copyright – All Rights Free Page No. 1 www.samarthbharat.com
India Must Learn to Live with Coronavirus
Author – Anil Chawla
A. Coronavirus (Covid-19) Present Situation
A fear psychosis seems to have gripped everyone in India. Coronavirus (Covid-19)
has been painted as such a deadly malaise that the country is ready to sacrifice
anything and everything in the war against the disease. The sentiment seems to be
that unless we make all the sacrifices, the world will come to an end and we shall all
be dead sooner or later.
While there is no denying that Coronovirus is a deadly virus which can leave a
percentage of those affected by it dead, it seems to me that we need to step back a
little and put Covid-19 mortality in the perspective of deaths caused by various
reasons in India.
Before we begin, let us look at the facts related to Covid-19 as on the date of writing
this article (9 April 2020):
• Cases of Covid-19 across the world – approx. 1.5 million
• Deaths caused by Covid-19 globally – approx. 84,000
• Covid-19 positive cases in India – approx. 6,000
• Covid-19 deaths in India – approx. 200
The above figures are unquestionable. However, interpreting the figures needs some
context. Presently, the world is seeing parabolic projections based on the above
figures. There is no way that anyone can contest projections which are based on
impeccable mathematical models. However, the fact remains that nature most often
does not follow mathematical models and has a mind of her own. And also there is
the fact that in the present world, there are vested interests who want to profit from
the hype about the virus. Of course, there are also global games of putting one
country or the other down and profiting from it. Let us not get mixed up with either
the mathematical models or the interests / games that are behind them.
2. Coronavirus (covid-19) mortality समथ भारत
Copyright – All Rights Free Page No. 2 Author – Anil Chawla
www.samarthbharat.com
B. Deaths per Year in India
Thousands Per Cent
All Causes 9,652 100.00%
Diarrhoea 519 5.38%
Perinatal conditions 445 4.61%
Tuberculosis 375 3.89%
Respiratory infections 342 3.54%
Fever of unknown origin 339 3.51%
Malaria 185 1.92%
Other infectious and parasitic 123 1.27%
Hepatitis 75 0.78%
Nutritional deficiencies 73 0.76%
Meningitis and encephalitis 49 0.51%
Sub-Total 2,525 26.16%
Ischaemic heart disease 1,554 16.10%
Chronic respiratory diseases 833 8.63%
Stroke 656 6.80%
Cancers 544 5.64%
Liver and alcohol related conditions 270 2.80%
Diabetes and other endocrine 228 2.36%
Renal failure 190 1.97%
Digestive 145 1.50%
Neuropsychatric conditions 66 0.68%
Congenital anomalies 44 0.46%
Genitourinary diseases 28 0.29%
Musculoskeletal disorders 27 0.28%
Vision and other sensory loss 9 0.09%
Sub-Total 4,594 47.60%
Road traffic injuries 275 2.85%
Suicide 199 2.06%
Falls 190 1.97%
All other injuries 149 1.54%
Drowning 62 0.64%
Venomous deaths 46 0.48%
Sub-Total 921 9.54%
Ill defined or cause unknown (age
less than 70 years)
238 2.47%
Injuries
Source: National Burden Estimates of healthy life lost in India, 2017; Indian Council of Medical Research;
Lancet Glob Health 2019; 7: e1675–84; December 2019
Cause of Death
Deaths in 2017
Communicable,perinatal,
maternalandnutritional
Non-communicable
3. Coronavirus (covid-19) mortality समथ भारत
Copyright – All Rights Free Page No. 3 Author – Anil Chawla
www.samarthbharat.com
C. Deaths per Day in India
We live in a country where every day 6,918 persons die due to communicable
diseases, perinatal, maternal and nutritional causes. It might interest some to know
that of the above figure, there are 929 persons dying every day due to fevers of
unknown origin.
Let us look at charts showing deaths per day due to various causes.
0
200
400
600
800
1,000
1,200
1,400
1,600
Deaths/day
Communicable Diseases, Perinatal, maternal and nutritional
Data relates to year 2017. Source for data: ICMR study published in The Lancet
4. Coronavirus (covid-19) mortality समथ भारत
Copyright – All Rights Free Page No. 4 Author – Anil Chawla
www.samarthbharat.com
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
Deaths/day
Non-Communicable Diseases
Data relates to year 2017. Source for data: ICMR study published in The Lancet
0
100
200
300
400
500
600
700
800
Road traffic
injuries
Suicide Falls All other
injuries
Drowning Venomous
deaths
Deaths/day
Injuries
Data relates to year 2017. Source for data: ICMR study published in The Lancet
5. Coronavirus (covid-19) mortality समथ भारत
Copyright – All Rights Free Page No. 5 Author – Anil Chawla
www.samarthbharat.com
D. Comparing Covid-19 Deaths with Other Deaths
In a country where 545 persons commit suicide every day, where 170 persons die
due to drowning every day and where 126 persons die due to snake / scorpion bites
every day, one may be excused for thinking that a disease that has killed about 200
persons over four weeks is likely to be treated as a minor ailment.
It may be relevant to mention here that snake / scorpion bites can be completely
prevented if every villager is provided with some basic footwear. Do you know the
cost of providing footwear (costing say USD 10 per pair per annum) to all poor
villagers (assume 60% of the population, about 780 million persons) of the country?
Simple back of the envelope calculations will tell you that the cost is about USD 7.8
billion or about Rs. 58,500 Crores per year (1 Crore = 10 million). That figure seems
small when one compares it to the Rs. 170,000 Crores package announced by the
Finance Minister of India on 26th
March 2020 to help the poor of the country face the
lockdowns in wake of Coronavirus. We are a poor country with lack of resources
when it comes to preventing deaths of poor landless farm workers, but no resource
is to be spared for a disease that affects international travelers.
Earlier we talked about 929 deaths every day due to fevers of unknown origin. Given
the poor state of medical research in India, it should surprise no one that many of
these deaths are caused by viruses that have not yet been mapped. If you live in
India you would surely know that around February-March and also during
September-October across the country every third house has someone or the other
suffering from cold, cough and fever. Doctors will tell the patients that it is viral
infection without bothering to identify the virus. Indian doctors routinely prescribe
antibiotics to such patients while admitting that antibiotics have no effect on the virus.
Nevertheless, most patients get cured and the few who are not cured end up to
make the statistics of 929 deaths per day. Indian Council of Medical research and
various medical colleges of India have made no efforts to map the virus / viruses that
cause 3.4 Lakhs (340,000) deaths every year.
Knowing the above facts, one is shocked when one hears the leaders of India shout
from TV, radio and every other media that every life is precious or “jaan hai to jahan
hai” (if there is life there is world) and so on. One wonders whether the agenda is
indeed what is made out to be or there is something else at play.
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E. Years of Life Lost (YLLs)
An important parameter for measuring the burden of a disease is YLLs. The YLLs for
2017 are as follows:
Millions Per Cent
All Causes 346 100.00%
Perinatal conditions 41 11.85%
Respiratory infections 20 5.78%
Diarrhoea 20 5.78%
Tuberculosis 14 4.05%
Fever of unknown origin 11 3.18%
Malaria 8 2.31%
Other infectious and parasitic 7 2.02%
Hepatitis 4 1.16%
Nutritional deficiencies 4 1.16%
Meningitis and encephalitis 3 0.87%
Sub-Total 132 38.15%
Ischaemic heart disease 45 13.01%
Cancers 19 5.49%
Chronic respiratory diseases 19 5.49%
Stroke 17 4.91%
Liver and alcohol related conditions 12 3.47%
Digestive 6 1.73%
Renal failure 6 1.73%
Diabetes and other endocrine 6 1.73%
Congenital anomalies 4 1.16%
Neuropsychatric conditions 3 0.87%
Genitourinary diseases 1 0.29%
Musculoskeletal disorders 1 0.29%
Vision and other sensory loss 0.5 0.14%
Sub-Total 140 40.32%
Road traffic injuries 14 4.05%
Suicide 11 3.18%
All other injuries 7 2.02%
Falls 6 1.73%
Drowning 4 1.16%
Venomous deaths 3 0.87%
Sub-Total 45 13.01%
Ill defined or cause unknown (age
less than 70 years)
8 2.31%
Injuries
Source: National Burden Estimates of healthy life lost in India, 2017; Indian Council of Medical Research;
Lancet Glob Health 2019; 7: e1675–84; December 2019
Cause of Death
YLLs in 2017
Communicable,perinatal,
maternalandnutritional
Non-communicable
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When a young person dies, more years of life are lost as compared to when an old
man dies. The above table takes this into account. Hence, perinatal conditions
account for 11.85% of YLLs but account for only 4.61% of deaths.
F. Age Profile & Other Diseases for Covid-19 Morbidity
The following profile of Covid-19 morbidity shows that the Coronavirus hits elderly
more than the young. In other words, the disease causes low loss of Years of Life
(YLLs).
From a public health perspective another noticeable fact is that “86% death cases
have exhibited comorbidity related to diabetes, chronic kidney issues, hypertension
and heart related problems” (Source: Ministry of Health & Family Welfare, GOI;
Press Note dated 6th
April 2020). In other words, 86% of deaths are due to a
combination of Covid-19 and non-communicable diseases. So, from a statistical
point of view 86% of deaths cannot be added to the head of communicable diseases
and must at least partly be assigned to non-communicable diseases.
G. Coronavirus & Immunity to Other Viral Infections
Modern science does not know whether a person afflicted by one virus becomes
immune to other viruses. There are instances of a person afflicted by rhinovirus
(which causes the common cold) to be afflicted by another virus that also causes
7%
30%
63%
0% 20% 40% 60% 80%
Below 40 years
40-60 years
60 and above
Covid-19 Deaths
Source: Ministry of Health, GOI
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similar symptoms. But by and large it is felt that as the body builds immunity fighting
one virus the chances of another virus being able to attack are low. I must
emphasize that in health matters there are no absolutes; one can only state
something that has a high probability.
It is likely that while the country is fighting Coronavirus, either other viruses lie low or
the population develops higher immunity to communicable diseases. This possibility,
surely, needs to be verified based on actual data from hospitals and doctors across
the country. However, based on my personal experience and also based on what I
have heard from a few doctors, I can say that this year (February-April 2020) the
instances of viral infections (fevers of unknown origin) as well as malaria etc. are
very low as compared to previous years. It seems that nature has a way of taking
care of her children.
Before I am accused of being unscientific, let me propose something which is the
correct scientific method. Government of India should issue daily bulletins about all
communicable diseases on a daily or weekly basis (just the way it is doing now for
Covid-19). Let the people know at the end of each week or day, the number of
persons who have died due to respiratory infections (excluding Covid-19), Diarrhea,
Tuberculosis, Fevers of unknown origin, Malaria, Other infectious and parasitic
diseases, Meningitis and Encephalitis besides Covid-19. Let this morbidity be given
along with the annual average for each respective disease.
Detailed data for all communicable diseases along with the data for Covid-19 will put
Covid-19 in perspective and stop the panic reactions that the country is currently
experiencing based on reporting of each death. More importantly, if the daily tally for
deaths by communicable diseases, perinatal conditions and nutritional deficiencies
(including Covid-19) is lower than the average of 6,918 deaths per day observed
during 2017, the nation may conclude that probably Covid-19 has been beneficial
and not as much of a killer as it has been made out to be.
If this sounds preposterous, let me back it up with anecdotal evidence. I have a habit
of looking in the obituary columns of local newspaper every day. For the past three
weeks, I have been noticing that the columns are almost empty. It seems that not
many people are dying. The observation has been confirmed by many friends across
the country. The joke going around on Whatsapp is that the doctors are busy with
Coronavirus and hence they have no time for carrying out unnecessary surgeries
leading to drop in deaths. I do not agree with the joke. But the fact that someone
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thought of making a joke on the lower number of deaths confirms that this is a widely
observed fact.
H. Spread of Coronavirus Infection & Living with it
Much has been made of the deadly nature of Coronavirus and its fast spreading
nature. The reports that are quoted in support of these claims are based on very
thorough studies carried out by laboratories across the world. However, there is no
denying that laboratory and real world are different. In real world, while spread does
take place by contact the spread is controlled by factors that we know little about.
The word immunity is often thrown around, but again no one really knows what
immunity is all about.
Let me explain with an example. We in India live with mosquitoes. More than 600
persons die every day in India due to diseases that are caused by mosquito bites.
There is no home in the country which has no mosquitoes and some have swarms of
them. If a mosquito bites an Indian, he rubs the spot for a few seconds and forgets
about it. My American friends often go hysterical the moment a mosquito bites them.
But no Indian will even mention it to his / her family. Yes, we know that mosquito
bites cause a number of diseases. But we also know that every mosquito bite does
not cause malaria or dengue or encephalitis. There is a chance that a particular
mosquito bite may be fatal. But, we Indians do not let that chance disturb our day-to-
day life.
Imagine if Indians or Government of India decide to make sure that all contact
between humans and mosquitoes should be eliminated completely to save precious
lives. There will be no farming or horticulture or aquaculture or pisciculture in the
country. Each of us will be living in glass, steel and concrete houses with controlled
environment. Actually, the country will just perish in the absence of all types of food.
And then people will not die of diseases caused by mosquito bites but will die from
starvation.
We Indians have learnt to live with mosquitoes and many other bacteria and viruses.
It is high time that we learn to live with Coronavirus too. We have to surely contain it
and limit the damage that it may cause. But we cannot aim for eliminating
Coronavirus. Let us admit that Coronavirus is here to stay with us for a long time to
come. Anyone who thinks that the virus will go away in a matter of weeks or months
is either too optimist or does not understand the nature of virus. It has been about
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four decades since HIV appeared and we still have not been able to get rid of it.
There is no reason to believe that Coronavirus will be any different.
I. Expenditure on Health
Before we discuss about preventing and containing Coronavirus, we should look at
the expenditure on health by Government of India and by the state governments.
National Health Policy, 2017 lays down the following objective:
It is not unreasonable to make a guess-estimate and say that the total expenditure
by central and state governments is less than 2% of the GDP.
Budget of Government of India for 2020-21 provides for a total sum of Rs. 68,168
Crores for revenue expenditure and Rs. 3,188 Crores of capital expenditure for
AYUSH Ministry, Department of Health & Family Welfare and Department of Health
Research. The total expenditure by Government of India in financial year 2020-21 as
per budget is supposed to be about Rs. 71,356 Crores or about 0.35% of the
country’s GDP.
The above figures of total health budget of Government of India are mentioned to
provide a perspective on the sort of money that the country can afford to spend on
fighting just one disease (Covid-19).
J. Economic Cost of Lockdown
Many observers have commented that the 21-day lockdown (24th
March to 14th
April
2020) is expected to cost the country about USD 100 billion or about Rs. 750,000
Crores, which is more than ten times the Government of India’s budget for health
during 2020-21. Of course, if the lockdown is extended the losses are likely to
increase more than proportionately.
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The above estimate of economic loss does not take into account loss of opportunity
due to slow-down in various sectors. GDP growth during 2020-21 may well be close
to zero and may even go negative.
One should also not forget the collapse of economic cycle for agriculture which can
lead to widespread human distress and may lead to a famine-like situation with large
farmer suicides and starvation deaths.
K. Lockdown / Curfew & Prevention of Covid-19
The key question is whether a general curfew with complete lockdown of all
economic activity (the type that has been implemented in India) does prevent spread
of the disease. The answer is probably No.
If the general curfew could have prevented spread of the disease, in the more than
two weeks that have passed since the janata curfew of 22 March the number of new
cases should have come down. Undeniable fact is that the number of cases, as well
as deaths, has been rising throughout the period of the curfew.
Many of the new cases are from government officers, government staff, police,
hospital staff, doctors etc. The strategy of total elimination of Coronavirus has put the
complete machinery of government, police and hospitals under extreme strain
making them extremely tired and thus more susceptible to virus attack.
An unfocussed approach of stopping all movements of men, materials and vehicles
puts demands on the enforcing machinery that are impossible. Most policemen and
officers are working for sixteen hours per day. This is clearly unsustainable in the
long run.
The enforcement machinery is part of the same society that is suffering due to
unavailability of food or water or medicine or job or money. On one hand, the
machinery starts permitting leakages. On the other hand, the machinery starts
seeing itself as above the law that they are involved in implementing; they start
breaking the law in their own personal lives. More than two dozen of health
department officials of Government of Madhya Pradesh have tested positive
because a couple of senior officers did not take the self-isolation instructions
seriously.
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Among large countries, India has the lowest ratio of police officers or doctors or
health workers for 100,000 population. In such a situation, a general curfew is
neither sustainable nor effective.
The need of the country is clearly a focused approach (not unlike the one followed in
the case of malaria, HIV and other communicable diseases) with resources targeted
at the high-risk sections of society and at the affected persons.
L. Recommendations
Let me quote, Mr. Rajiv Bajaj, Managing Director, Bajaj Auto Limited.
To the best of my knowledge, virtually no country has imposed such a
sweeping lockdown as India has; I continue to believe this makes India
weak rather than stronger in combating the epidemic.
We should have kept only the vulnerable at home, closed all public
spaces, and allowed the young and healthy to keep turning wheels of
the economy — with due precautions, with respect to hygiene, masks,
distancing, etc.
I don’t buy the condescending argument that all Indians are a bunch of
illiterate, ignorant, indisciplined morons who need cattle-like
shepherding.
The current approach is obviously totally unsustainable in the future;
every now and then when a virus returns, are we to fear that the
lockdown will also be back?
I’m dismayed that despite having a full-fledged Ayush ministry and
being the world’s centre of excellence in homoeopathy, India has
barred homoeopaths and naturopaths from offering affordable, scalable
solutions, especially given that homoeopathy is universally
acknowledged to have no inimical side effects.
https://economictimes.indiatimes.com/news/politics-and-nation/view-must-sell-
ourselves-out-of-this-crisis/articleshow/75038503.cms
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Mr. Bajaj’s concern “to keep turning wheels of the economy” must be appreciated
and shared by all those who care for India. While agreeing with the line taken by Mr.
Bajaj, let me elaborate and suggest the steps for containing (not eliminating)
Coronavirus (Covid-19):
Strictly ban all large gatherings whether in religious places (temples,
mosques, churches, gurudwaras, synagogues etc.) or for business or social
(weddings, parties etc.) or political purposes or entertainment (cinema, sports
etc.).
Order strict curfew (no stepping out of house or other abodes) for all high-risk
individuals which will include the following:
a) All persons above 70 years of age
b) All those who have had tested positive in the past two weeks
c) All those who have interacted during past two weeks with persons
mentioned at (b).
All workplaces and educational institutions to strictly enforce hand-washing
and use of masks.
Hygiene levels at workplaces and public places (railway stations, airports, bus
stations etc.) to be improved.
International travel to be restricted to only countries with low level of spread of
Coronavirus.
All international travelers coming to India to be compulsorily tested for
Coronavirus. Pending receipt of test report, all inwards travelers to be
compulsorily put under self-isolation or quarantine.
Medication of positive cases with no or mild symptoms to be assigned to
AYUSH (Ayurved, Homeopathy, Unani) hospitals. (It may be mentioned here
that China has been able to control the malaise quickly due to extensive use
of Chinese traditional medicine, which broadly follows the same principles as
ayurved).
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Allopathic doctors and hospitals to get involved with Covid-19 patients only in
case of severe symptoms.
Strictly enforcing the maximum period (eight hours) that any human being can
be put to work in a day. This is most important for doctors (allopathic as well
as Ayush), nurses, police officers, government officers, software
professionals, call centre employees, hospitality industry employees etc. A
tired person has lower immunity and is most susceptible to falling prey to the
virus.
Personal protective equipment to be provided to all those who may be
vulnerable.
The approach is clearly to ensure that the productive sections of society are not
restricted while the vulnerable are protected to the maximum. The above
recommendations, if implemented, should be reviewed after three months.
Indian industry should be encouraged to increase capacities and take advantage of
the emerging opportunities as the world moves to develop alternative source for
various goods and products. The past few weeks have put the industry in ICU. It
needs help to come out of the sad state that it has got into. But the situation is not
impossible.
India must get out of the fear psychosis and regain its confidence and enthusiasm. A
booming economy can better take care of sick and weak.
India has faced worse in the past and has come out with flying colors. There is no
reason that we cannot do it now with determination and vision.
Let me conclude this long article with the objectives that National Health Policy 2017
has set up for two diseases – HIV and TB:
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Let our objectives for Covid-19 be on the lines that we have for HIV and for TB. Let
us not aim to eliminate Covid-19 in a matter of weeks or months. Let us be realistic.
Let us not be panicky.
Anil Chawla
9 April 2020
(With editorial support from Yogita Pant)
ANIL CHAWLA is an engineer and a lawyer by qualification but a philosopher by vocation and an
advocate, insolvency professional & strategic consultant by profession. His works can be seen at
www.samarthbharat.com To know about his professional work, please visit www.indialegalhelp.com
and www.hindustanstudies.com