Analysis of COVID-19 Case Fatality Rates in the States and Union Territories of India

Abstract Although the Covid-19 Case Fatality Rate (CFR) in the Indian States and UTs has been changing with time, some states constantly appear to show significantly higher CFR than the national average. Our objective is to calculate the CFR of all the states/UTs of India and analyse the possible factors behind the disparities in it. Research papers and news articles on Covid-19 were explored to understand the factors responsible for the CFR disparities in the States/UTs. State-wise CFR was calculated and Correlated with Covid-19 Testing Rates and data from Demographic & Healthcare factors, using Spearman’s Rank Correlation Coefficient Methodology. The overall Covid-19 CFR in India was among the lowest (1.76%) in the world but varied vastly from one state to another. Where the states like Punjab and Maharashtra constantly have the highest CFR in the country, states like Assam, Kerala, and Bihar have the lowest. In the correlation analysis, a weak agreement (+0.33) between state-wise CFR and ‘Test Positive Rate’ was found. CFR and ‘Life Expectancy at 60’ showed a moderate agreement (+0.49). Healthcare components like ‘Number of Doctors Per Million People’ and ‘Number of Hospital Beds’ showed very weak agreement with CFR. Where the higher Life Expectancy and Test Positive Rates clearly tend to increase CFR, Healthcare Facilities had surprisingly little effect on it. Analyses of various news articles suggested that Comorbidities, Availability of Essential Drugs, Trained Manpower, Contact Tracings, and Hospital Referral Time were also some of the major factors affecting CFR.