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Estimating COVID cases & deaths in India over the coming months

by GeneSmith1 min read24th Apr 20217 comments



Does anyone have a good method to estimate the number of COVID cases India is likely to experience in the next couple of months? I realize this is a hard problem but any method I can use to put bounds on how good or how bad it could be would be helpful.

I'm trying to convince some people who work in global health to send the US stockpile of unused and unapproved Astra Zeneca vaccines to the hardest hit parts of India. My naive calculation indicates sending 25,000,000 doses (basically our whole stockpile) would save at least 17,000 lives using fairly conservative assumptions. But that was based on an estimate that 20% of the total population would be infected and a third of those would be infected after the vaccines we send are injected and become effective.

The 20% is based on the rate of US infections and the 1/3rd is basically a random guess about how many infections there would be left between vaccination and the end of the pandemic.

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This site attempts to provide a forecast for 130 countries, India included, and provides information on both sources and methodology. The data appears to be refreshed regularly, so it isn't stale. https://covid19.healthdata.org/india?view=total-deaths&tab=trend Maybe it will be of help to you.

The policy briefing file is pretty useful, a useful summary and then a bunch of neat graphs. (I've been jealous of Zvi's posts on Covid-19 in the US for quite some while, and this is probably the closest we'll get for India.) They also include comparison with other model projections from different groups at the end, which gives some other possible projections to look at.

Good news: the Biden administration announced today that they will be sending our entire Astra Zeneca stockpile of up to 60 million doses with other countries. This is more or less the outcome I wanted. Apparently the defense production act forces companies producing vaccine supplies and vaccines in the US to prioritize domestic markets, which apparently means literal banning of exports. Seems like there are definite downsides to invoking that act.

The only question now is speed and distribution priority. In my mind we would deploy with absolute maximum blitzkrieg speed. I did some rough calculations yesterday and concluded that roughly 50 people die for every day we delay the shipment of 1 million doses. With 20 million doses ready right now that's 1000 preventable deaths per day we could save just by increasing speed.

Knowing how the government tends to operate, this will probably take much longer. And we might end up prioritizing lower risk countries like Canada and Mexico which would in my view be a sub-optimal use of excess supply.

But we are at least beginning to take the right steps. I am hopeful for that reason.

With regards to estimating the death rate, I would caution against applying American infection fatality rates. On the one hand, India has fewer very old/overweight people, but you might have already accounted for that. 

On the other hand, there is some evidence that severity in Indians and Bangladeshis is substantially lower. Among migrant workers in Singapore, who are mostly from India and Bangladesh, rate of ICU admission was only 0.0002 (20 out of 100 000 cases), which even accounting for the age of the average migrant worker is far lower than what we see in the US/Europe. I have seen some speculation that endemic coronaviruses in that region provide partial protection. I would look further into this to estimate expected death rates.

Indian death counts are substantially dubious with regional and local authorities frequently giving contradictory figures. However, the general feeling is that the government figures heavily underrepresent the actual mortality. This is due to substantial increase of traffic at crematoriums and graveyards. 

In 12 months US experienced a rate of infection of about 33%. In 4 months, Indian infection rate will be about a third of that, so 10%, unless their dominant variant has a much higher R0.

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(frontpaging despite not normally frontpaging covid content, out of a general policy this-particular-month of erring on the side of frontpaging it so people can collectively make sense out of "under what circumstances is the pandemic over / changing?")