For a nation obsessed with cricket, the frequent question used to be: What is the score? That was till the virus took over our lives. Every hour, Indians rush to their phones to check the “score”. The virus is a threat that we want to be aware of. And the method to be aware of anything is the numbers, isn’t it?
There is one big difference between cricket scores and the virus numbers; the former represent unquestionable facts while the latter are statistical data. Such data are meaningful only in the context of definitions, the method of collection, the size of the sample population and so on. The misinformation generated by the lay use of statistics prompted some to rank statistics higher than lies and damned lies in the order of falsehood.
The figures reported to us many times in the day are the latest numbers of confirmed cases, deaths, and recoveries. Many countries report the number of serious and critical cases also, although some smaller countries do it infrequently.
The number of confirmed cases worldwide on 26th May was 5.60 million, a very large figure. Out of this number, if one were to subtract deaths and recovered cases it would leave more than 2.88 million active cases, still a number too large for comfort. Look closely and you find that less than 54,000 or less than 2% of these are serious or critical in the whole world. We can add pro rata numbers for the countries not reporting this figure, and it will rise to 2%. The remaining 98% are mild cases. Isn’t that very comforting?
Across India, on 15th May, 185 Covid19 patients were on ventilators, 1425 were in ICUs, and 1282 required oxygen support. For a comparison, the total number of ICU beds is India is about 95000 and these are, in normal times, fully occupied by the critically ill. Thus, the virus-related ICU use in India is 1.5% of the total.
The virus has so far killed about 4200 persons in India over a period of three months. We have about 12,000 road deaths in addition to more than 40,000 injured persons every month. During the lockdown, very little movement on the roads resulted in marginal deaths. Thus, in these three months at least 20,000 persons have escaped death and 80,000 have escaped injuries. Road accidents predominantly kill and injure the working-age population while the virus is killing predominantly older persons with pre-existing comorbidities. This is not to minimise the economic hit caused by the lockdown that may lead to widespread malnutrition and even premature deaths among the poor. The psychological impact will also impose a huge cost on the nation.
The seemingly large number of confirmed cases in the world and particularly in the USA raises its own questions. A case is confirmed either through a test or when symptoms are reported. The USA has conducted 15 million tests, the highest in the world and has confirmed more than 1.7 million cases, again the highest. But of this huge number, only about 17,000 are serious or critical, which is not a very large number for a country of that size.
India ramped up its testing rate during the last two weeks and has seen an upsurge in confirmed cases in this period. Yet, the number of critically ill virus-infected persons was less than 9000. Against this small number, we had reserved in dedicated coronavirus hospitals and health centres, more than 39,000 ICU beds for virus patients. Even against the remaining 73,000 active cases, 300,000 beds are reserved in these dedicated health facilities. Clearly, the numbers did not overwhelm us.
The numbers of confirmed cases being reported by various countries also have different underlying bases. China changed the criteria eight times, avoiding the huge number of confirmed asymptomatic infections, thereby depressing numbers to below 83,000. The death figures are even more debatable, the major issue being whether an infected person died because of this virus or because of an existing terminal condition or whether the virus only hastened the death. China did not include those confirmed infections that had other existing health issues and reported only 4634 deaths, which no one believes to be factual. The USA includes all those who died of any cause but had this infection and reported 99,000 deaths. In Colorado, an infected, drunk road-accident victim with an alcohol level of 0.55 against the legal limit of 0.08 (0.3 is lethal) was counted as a virus death!
All this does not mean that the virus is not an extraordinary threat to humankind and should not be taken seriously. It is known to spread and kill faster than other known infections. But for the measures taken, the toll might have surpassed that of the 1918 Spanish flue, which infected 500 million and killed an estimated 50 million in a world population of about 1500 million, (India today has 1300 million). The world is more mobile today and that also facilitates spread. Shared knowledge has saved mankind from a disaster of that magnitude.
The diverse approaches adopted for reporting virus data do indicate a failure on the part of World Health Organisation. As the premier international organisation concerned with human health, it should have laid down criteria for counting the infected, the dead, and the critically ill. Mankind has seen several international outbreaks during the last two decades and this confusion was seen even in those times. It is hoped that now such definitions will be laid down by international consensus.