Reports in late April claimed that over 40% of COVID-19 deaths in India were in those younger than 60 years. Ashutosh Gupta, a 26-year-old swimming coach at a Delhi government facility in Central Delhi’s Jhandewalan died after testing positive for coronavirus on Wednesday, two days before his birthday and four months into his marriage.
According to Indian Express Report his family on Sunday alleged negligence on the part of Lady Hardinge Medical College (LHMC), claiming he was not given timely treatment and the family was asked to help wrap his body in protective covering after he died.
His brother Ankit (20) said Ashutosh had won medals in many swimming competitions over the past five years and supported the family financially. “He was admitted in the ‘orange zone’ of the hospital and died a few hours after the test results came out. I was with him in the ward throughout, along with my mother and cousin. After he died, the hospital sent one of their attendants to wrap the body, who took my help to lift and move it,” said Ankit.
He added that the body should have been put in a bag inside the ward as per protocol, and the hospital is finding out how the body was handled after death.
Ashutosh’s father Rajendra Prasad Gupta worked as a security guard at a school for the blind near Connaught Place before the lockdown but is presently out of work. Ankit is preparing for an exam to enter the Delhi Police. “He used to support us all at home, now we don’t know what will happen,” said Ankit.
Ankit said he watched his brother die at the hospital on Wednesday afternoon after he began foaming at the mouth. The family hoped they would be provided with some compensation as Ashutosh was the main earning member of the family.
Age-specific COVID-19 case fatality rate (CFR)
Reports in late April claimed that over 40% of COVID-19 deaths in India were in those younger than 60 years. Comparisons of COVID-19 age-wise deaths are available in the US, the UK and Italy. A cursory look tells us that 10-15% of those who died are younger than 65 years. Why then is this figure closer to 50% in India?
Statements about COVID-19, like ‘new cases, are reducing’, ‘recoveries surpass active cases’ and ‘doubling time has increased’, only add to the confusion. And before we know it, people believe there are three types of lies, à la Mark Twain: simple lies, damned lies and statistics.
The true interpretation of these numbers lies in the accuracy of two components: numerator and denominator. An accurate figure of the number of people infected or cured depends on the diagnostic tests performed or even the definition of ‘cured’, which in turn would affect all the above statements.
A Chinese study of 1,023 Covid-19 deaths had noted 6.3 per cent deaths among patients 49 years or younger, around twice lower than India’s figure of 14.4 per cent among patients below 45 years.
A New York City analysis updated on May 13 of 15,230 deaths had recorded 0.06 per cent deaths among patients 17 years or younger, or 50-fold lower than India’s 3 per cent deaths in children below 15 years.
But experts say the age-distribution of cases, the presence of any underlying health disorders, or even nutrition might help explain such differences.
Gender-specific COVID-19 case fatality rate (CFR)
According to global data, out of the 56 countries (including India) around 48 of them show that more men are getting infected with the virus. It further disclosed that more men are dying from Covid-19 than women around the world.
Sabra Klein, a scientist who studies sex differences in viral infections at Johns Hopkins Bloomberg School of Public Health, says “being male is as much a risk factor for the coronavirus as being old”.
However, a recent report published by the BBC claimed otherwise for India.
New research by a group of scientists in India and the US shows that although men make up the majority of infections, women face a higher risk of dying from the coronavirus than men.
The study, based on Covid-19 deaths in India until May 20, shows early estimates that 3.3 per cent of all women contracting the infection were dying compared to 2.9 per cent of all men. India had a fatality rate of 3.1 per cent when the study was conducted, reported by the BBC.
In the 40-49 age group, 3.2 per cent of the infected women have died, compared to 2.1 per cent of men. Only females have died in the 5-19 age group.
Prof Subramanian says for the large part, the statistics have looked at the latter – men having a greater share of total deaths (63% in India, hewing to international data) – but “inferred the former risk”.
“Our overall conclusion is that, when infected, women do not seem to have any specific survival advantage [in India],” says Prof Subramanian.
“How much of this can be attributable to biological factors and how much of this is associated with social factors is unclear. Gender can be a critical factor in Indian settings,” he says.
Women outlive men in India and there are more older women than men. Is this leading to more deaths among women, as elderly people are vulnerable to the infection?
Also, women in India are more likely to delay going to doctors and often self-medicate at home. And a woman’s health is more likely to be ignored in a household. So are women arriving late for testing and treatment?
Homemaker caregivers are more prone to contracting the infection – during the 1918 Spanish flu more women in India – relatively undernourished, cooped up in unhygienic and ill-ventilated dwellings, and nursing the sick – died than men.
However, men are more likely to suffer from co-morbidities, including cardiovascular disease, and hypertension, says Kunihiro Matsushita, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.
Men also smoke more than women in many countries, and some studies have shown that men wash their hands less frequently than women.
Scientists also believe that women have a lower mortality risk because of sturdier immune defences. And have hormones like estrogen which has “beneficial effects on upper and lower airways and is associated with stimulation of the immune response to upper airway infections”.