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Relevance of Rising Recoveries - COVID-19

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June 12, 2020

What is the issue?

  • The number of people who have recovered from COVID-19 in India, from the time the first ever case was recorded, has exceeded the number of active cases (as of 11 June 2020).
  • The rise in the recovery rate is cause for cheer, but it gives no room for complacency seen in the light of the nature of the disease and the cases.

Why does this have little relevance now?

  • The figures on recovered cases neither mark the beginning of the end of the epidemic, nor the arrival of the “peak”.
  • It does not mean either that the number of cases would be declining from now on.
  • In fact, seen along with number of deaths, it is learnt that less than 50% of the total infected people (2.86 lakh) have recovered so far.
  • The total recoveries, in fact, work out to 49% of all cases.
  • More importantly, total recoveries and the number of active cases are not comparable metrics.
  • Total recoveries account for everyone who has recovered from the disease since the start of the outbreak.
  • It is an accumulated number.
  • The active cases, on the other hand, are only those that have been infected in the last 14 days.
  • This is again only if it is assumed that every infected person, apart from those who die, is recovering in 14 days.
  • It must also be remembered that the Indian government revised its discharge policy.
  • No longer does a patient have to test negative twice over an interval of 24 hours.
  • Any patient who does not show any symptom over 3 days is allowed to go home now.
  • Likewise, patients who were on critical care require only one negative test to be discharged.
  • [Discharge is likely to be followed up with home isolation for a period of 7 days or 2 weeks, with restrictions on movement outside the home.]

How does recovery rate work?

  • It is no surprise that with the passage of time the number of recoveries will progressively rise.
  • Even when seen as a percentage of total infections in the country, the recovery rate will rise.
  • Right now, the fatality rate in India is about 2.8%.
  • But that is only because India is measuring the number of dead against the infections that have been confirmed through testing.
  • Most likely, there are many more people who are also carrying the infection, but are unknown because they have not been tested.
  • In large population groups, like that in India, the exact number of people infected during an epidemic may in fact never be known.
  • Theoretically, when those untested and unconfirmed infections are also accounted for, the overall fatality may certainly remain below 1%.
  • Scientists thus expect the overall fatality to be below 1%.
  • So, if this remains the case, then, by the end of the pandemic, eventually, more than 99% of the infected would be expected to have recovered.

What then is a safe metric?

  • The ratio of the number of daily recoveries to the number of new cases detected every day is perhaps a better metric.
  • If the number of people recovering on any given day is more than the new cases being detected on the day, it would suggest a favourable trend.
  • If this trend holds for more than two weeks, then it can be an indication of the disease having ‘peaked’ and a decline having started.
  • In India, that stage is yet to be reached.
  • As and when recoveries begin to exceed new cases, the trend would become evident in some states even before getting visible at the national level.
  • So, meanwhile, the focus on health care must not be lost at this point in the continuum of fighting this epidemic.

 

Source: Indian Express, The Hindu

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