Why are deaths from corona virus increasing in India?

 Coronavirus has killed about 100,000 people in India. Only the United States and Brazil have more deaths than India. September was the worst month for India in this regard. An average of 1,100 Indian citizens dies every day. The situation is very different regionally as the death toll in some states is very high which experts believe is a reflection of the fact that the virus is still spreading in the country. Maharashtra is one of the largest and richest states in India and has the highest number of confirmed patients and deaths. There have been 1.3 million cases in the state and 36,000 people have fallen victim to the disease. The epidemic spread quickly in Maharashtra and did not abate. The daily death toll in September ranged from 300 to 500, far more than many other worst-affected states. And now it's not just about the densely populated city of Mumbai, the state capital. Mumbai is still the deadliest district, but the quiet district of Pune also has 5,800 deaths. Five of the country's ten worst districts are in Maharashtra. Dr. Arnab Ghosh, who is testing for the coronavirus in Pune, says the virus entered the state from Mumbai. According to government research, antibodies to the disease were found in about half of the people in some areas of the city. Dr. Ghosh said that although the virus was mostly in the city in Mumbai, it was more prevalent in the state due to the movement between rural and urban areas of Pune district. The death toll has also risen in the face of such a heavy burden on hospitals. The media had accused the staff of irresponsible behavior in connection with the deaths of some people at the Jumbo Code Center in Pune. The death rate in Punjab has been 3% which is double the national rate. The state ranks ninth in terms of total deaths. And in some districts of the state, the death rate is more than 4%.

Dr. Shamika Ravi of the Brookings Institution says Punjab is a source of trouble. The death toll here is not only high but also rising. He says the rise is the opposite of what is happening around the world. In India as a whole, the rate is falling.

Dr. Ravi says that the only problem in Maharashtra and Punjab is that testing is being reduced due to which the confirmed cases and death rates are high. He says low testing could lead to an increase in deaths because people do not know the disease in time. Punjab has a positive test rate of 6.2 percent, much lower than Maharashtra's 24 percent. But still, the rate of Punjab is much higher than the rate of states like Bihar and Jharkhand. These states are also doing almost as many tests per million as Punjab is doing. But still, the rate of coming here is much lower.

Dr. Ravi says that if you reduce the number of tests and still have a high positive rate, it means that the epidemic has gone far beyond you. "You are arriving late in the case." His analysis fits the situation in Maharashtra. The incidence and mortality rates of people here are both consistently high, but testing has not been increased. But not everyone agrees with him. "I don't see a connection between the two," said Dr. Gautam Memon, an epidemiologist. You are reducing the tests, which means you are not catching cases. But it is difficult to estimate how many of them turn into deaths. ”Dr. Ghosh says it could be a direct link. If testing is low, the patient will arrive late at the hospital, which can lead to increased mortality. According to an analysis conducted in Andhra Pradesh and Tamil Nadu, the average number of hospital visits and deaths is 13 per day, which is why many experts in the states say the diagnosis is being delayed. But still, Tamil Nadu has been doing more testing and the death rate here is lower. The total death toll has risen to 9,000, the second-highest in the country, but the number of daily cases has been declining since July. But epidemiologist Dr. Jacob John says early detection of infection doesn't make much difference to a patient's treatment, as in many cases doctors are following the same path without testing for the disease. Have to do later Dr. John says that more deaths than less testing mean that you are believing that testing makes a difference in the treatment of patients.

Instead, he says, more deaths mean the public health system is not working properly. The worst ten districts in the country have all urban areas and the same is true for the highest mortality rate. Urban areas have accounted for 80% of India's deaths so far, and many of them have above-average deaths This is not surprising since the virus is most prevalent in densely populated areas. And that is why richer states like Punjab and Maharashtra are so bad. These states have large urban areas and are densely populated outside the cities.

Experts say the death rate in urban areas is also high because people from the surrounding rural areas come here for treatment. Dr. Memon says Pune's data is inaccurate because a large number of people from the surrounding areas come here. He says the lack of other diseases in rural areas also leads to a reduction in deaths. Deaths are declining in poor states

India's poor states have fewer deaths, but more reporting problems. And people thought that the poorer states would be destroyed, but that hasn't happened yet.

Dr. Ghosh says that we have not yet reached the end of this epidemic. "Probably the best time has passed in areas like Maharashtra and Delhi. But in some cases, this is yet to happen. ”Each state is at a different point in terms of the epidemic. Thankfully, it started in the rich state of Maharashtra. If it was spring, there would be destruction.