New Delhi: The high elderly population in Tamil Nadu, Punjab, Jammu and Kashmir, Maharashtra and West Bengal explains the high Covid-19 fatality rate in these states, the State Bank of India claimed Thursday in a report on the state of the pandemic after the lockdown.

These states have reported a fatality rate of 1.7 per cent, 2.6 per cent, 1.9 per cent, 3.2 per cent, and 2.0 per cent, respectively, said the report titled Three Months After Unlock. India’s fatality rate is currently at 1.74 per cent.

The SBI also predicted that the peak is still at least a month away.

“Daily Covid cases rose from around 50,000 daily in Aug beginning to around 80,000 cases by Aug-end. If the states increase their test capacity to match their test positivity, the total number of cases could hypothetically even increase by upto 50,000 over current levels on a daily basis! This implies the peak is still at least a month away if not more!” said the report.

On Thursday, India reported around 83,000 Covid cases, taking the tally to over 38 lakh cases and 67,000 deaths.

The report also said that out of the 50 worst Covid affected districts in August, 26 were rural. “Rural areas in Andhra Pradesh are the worst hit. Maharashtra, Karnataka and Uttar Pradesh are showing increasing rural spread,” it said.

Moreover, it asserted that since states have resumed partial lockdowns in July and August, it has “perversely” resulted in “increase in cases as short lockdowns have undesired impact of large conglomerations before designated lockdown date”.

The report added that Maharashtra was “significantly lagging” in tests and must ramp up tests significantly in order to contain the infection.

Public health experts disagree

While the report correlated high elderly population to the fatality rate in some states, public health experts didn’t agree.

Giridhar R. Babu, professor and head, lifecourse epidemiology, at the Public Health Foundation of India (PHFI), said the assertions in the SBI report “aren’t in accordance with evidence from the states”.

“The states that are finding cases well by enhanced testing are the ones that are reporting well too. These are the states which report death well and reduce it over a period of time,” he said.

Even the SBI report noted that states like Kerala, Himachal Pradesh, Odisha and Andhra Pradesh have a high elderly population, but have been “successful” in preventing Covid related deaths and have low fatality rate.

“The number of cases increasing are a function of progressive unlocks, people movement and increased testing,” said Babu, adding that one can’t be sure about whether this can imply that the peak is a month away.

“Covid-19 infection has been reported to carry higher risk of death in the elderly than in those who are younger. This has been reported from all parts of the world. This is usually due to lowered immunity status as well as higher prevalence of co-morbidities like cardiovascular disease, diabetes, chronic lung and kidney disease in the elderly,” PFHI president K. Srinath Reddy said.

“However, even the elderly can do well and recover if they have a good nutritional status and have avoided co-morbidities through good living habits,” he added.

He also said increased testing will “reveal more cases”. “However, in a declining epidemic, test positivity rates will steadily decrease, followed by daily case counts, followed by daily death counts. We have to track all of these indicators, though the last of these three will be the most reliable trend indicator,” he said.

Talking about the peak, he said the report mentions this “hypothetically”. “Also, there will be multiple regional peaks as different areas have different calendars as the spread is happening to different areas at different time periods,” he added.

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