ROMANO: India’s COVID outbreak is bad, could be much worse

India is experiencing a massive outbreak of COVID-19 with a probable more than 12 million new cases a day as the virus peaks, according to projected data compiled by the Institutes for Health Metrics and Evaluation (IHME).

The IHME projects that peak fatalities will come in 0.098 percent, or about 12,000 deaths on the worst day of pandemic there, projected to be May 23. But as bad as that is, it is actually a lower death rate than the U.S., which is currently 0.36 percent.

The reason is largely age demographics. COVID fatalities primarily the impact the elderly — 80 percent of COVID deaths in the U.S. for example are among those aged 65 years old and older according to the Centers for Disease Control and Prevention — but India has a relatively youthful population with a high fertility rate. As a result, the elderly only makes up 6.7 percent of India’s population, compared with almost 16.5 percent in the U.S.

Put another way, if India’s population were as old as the U.S., instead of 12,000 dying on the worst day, the number might be more like 29,000, or instead of 1 million dead by August 1 per IHME’s current estimate, it might be more like 2.45 million.

Or, if in the U.S., the infection rate were as high this past winter as it currently is in India, instead of 3,300 deaths per day at the height of the pandemic would have reached 8,000.

So, age matters a lot when it comes to COVID. And so does mitigation, which is why protecting the elderly is so important and must continue to be prioritized.

In the U.S., despite the aging demographics, the fatality rate has been steadily falling since last winter when the pandemic began, per IHME data. Early on, in April 2020, the death rate was 0.928 percent. But by Aug. 2020, it had dropped to 0.58 percent as better treatments and medicines became available. In Jan. 2021, the fatality rate remained steady at 0.6 percent, and now it is down to 0.36 percent as the vaccine is being distributed.

That is certainly good news, and could mean that we’re beginning to see the light at the end of the tunnel in the pandemic.

So far, 105 million in the U.S. are fully vaccinated out of 145 million who have had at least the first dose, the distribution of which from production to mass manufacturing to getting the centers up and running to dosing the most vulnerable first took almost a year. As the number of doses rises, we should hopefully see the fatality rate continue to drop.

For India, it is likely too late to massively administer the vaccine in time, even as more than 150 million doses have already been administered to 11.5 percent of the 1.3 billion population. And other countries around the world, who do not have large supplies of the vaccine on hand will undoubtedly experience outbreaks as well while the rollout continues through the summer.

The biggest difference in the U.S. appears to have been Operation Warp Speed that began under President Donald Trump in 2020, which mass produced tens of millions of vaccines before they were even approved by the Food and Drug Administration, such that if one or more of them worked, they would already be in production, and it could be administered as soon as possible.

The mass production was facilitated by the federal government spending $18 billion ahead of time to mass produce the vaccine the government was uncertain would even be effective. That presumably covers dosing the entire population. For countries that want more vaccines, like India with a population of more than 1.3 billion, the cost would be much greater.

Undoubtedly, as the science proves which vaccines are more effective than others, that will cause governments to spend more money on mass production and distribution, finally slowing down the COVID pandemic and helping life to finally return to normal. But as India is experiencing, we’ve still got a long way to go.