Estimating COVID-19 Early Pandemic Severity in Indian Context

Abstract

Objective: To explore the early pandemic severity of COVID-19 in India in terms of various case fatality rate (CFR) estimates. Methods: Various COVID-19 fatalities: confirmed CFR (cCFR), asymptomatic CFR (aCFR), symptomatic CFR (sCFR), and hospitalized CFR (HFR) were estimated along with relative susceptibility of developing symptoms (RSODS) and relative susceptibility of developing infection (RSODI) determination for Psym (probability of developing symptoms) 0.50, 0.75, and 0.95 each for all age groups. Results: The cCFR, aCFR, sCFR, and HFR estimates were 2.32% (2.05-2.59), 0.14% (0.12-0.16), 0.32% (0.27-0.36), 1.86% (1.64-2.07) respectively. The RSODS and RSODI of COVID-19 were ~33 times higher among people aged <45 years. The RSODS estimates were 1.97 (0.47-3.47), 0.62 (0.15-1.09), 0.29 (0.07-0.52), 0.06 (0.02-0.10) respectively, for patients <45 years, 45-60, 60-75, >75 years. Similar trend, for RSODI were found, with relatively higher value, compared to RSODS, which decreased with the increase of age. The 14-day lag estimate of CFR were 18.07 (15.67- 20.47), and outcome (deaths plus recoveries)-based estimate of CFR were 16.57 (14.65-18.49). The growth rate, serial interval, reproduction number and average time from onset of COVID-19 infection to death were 6.12% (5.30%-6.99%), 11.4 days (9.91-12.85), 1.03 (1.01-1.05), and 11.85 days (10.55-13.15), respectively. The average daily recovery was 19.45% (14.75- 24.15) and average cumulative recovery was 12.68% (10.70- 14.66) among COVID-19 patients. Conclusion: Detecting all possible cases throughout the course of the COVID-19 pandemic real CFR could be estimated to evaluate the effectiveness of healthcare systems and new treatments