While the higher numbers over two years may give the impression that these states have been the worst hit by Covid, their better reporting systems are likely to have actually saved more lives, a leading expert said.
Maharashtra, where 9.3% of India’s population resides, has so far accounted for 18.8% of cases reported in the country and 28.9% of all Covid deaths. Kerala, with just 2.8% of India’s population, has reported 14.3% of all cases and 10.6% of deaths.
In stark contrast, the country’s most populous state of Uttar Pradesh, home to 16.5% of Indians, has recorded just 4.9% of all cases and 4.7% of deaths. Likewise, barely 2% of Covid cases in India and 2.5% of fatalities so far have been logged in Bihar, which accounts for 8.6% of the country’s population.
“People in all parts of India are equally susceptible to the coronavirus. While there can be some differences in infection rates over short periods, such a gap over a period of two years has only one explanation — Maharashtra and the southern states are doing a far better job of detecting and reporting cases than others,” said Dr Shahid Jameel, virologist and former head of the scientific advisory group to the Indian SARS-CoV-2 Genomics Consortia (INSACOG).
“If you don’t test, and test properly, you wouldn’t find cases and provide institutional care,” he added.
The disproportionately low detection of Covid cases and reporting of deaths aren’t restricted to UP and Bihar. The trend is spread across north and central India, with exceptions such as Delhi. For instance, Bengal (7.5% of India’s population) has reported 4.9% of cases and 4.2% of Covid deaths in the country.
Madhya Pradesh’s numbers are more skewed. With a 6% share in population, the state has accounted for 2.3% of all cases in the country and 2.1% of all deaths. Gujarat is home to 5% of India’s population but has recorded 2.8% of cases and 2.1% of all deaths. Similarly, Rajasthan (5.7% of population) accounts for 2.9% of cases and 1.9% of deaths.
Delhi, with a predominantly urban population, is an exception to this trend. Accounting for 1.4% of the country’s population, the capital has reported 4.5% of cases and 5.2% of Covid deaths in India. Punjab’s case is interesting. The state, with 2.3% of India’s population, has a higher proportion of deaths (3.5%) while infections detected are low (2.3%).
While fewer cases and deaths look good on paper, are states paying a price for low detections? “Yes”, says Dr Jameel. “Consistently recording a low number of cases is not a batch of good governance. The better reporting systems in Maharashtra and the south have prevented deaths through early detections. In many northern states, a much higher proportion of Covid deaths have likely gone unreported.”