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In Health & Healthcare, Where Indian Stands Among Countries Hit By COVID-19

The COVID-19 outbreak has put the spotlight on several country-specific health indicators. A look at how India stands on pre-existing health conditions, age, and healthcare capacity:

Pre-existing health conditions

Early research from Italy and China suggests that COVID-19 patients who died those countries were more likely to have had pre-existing health conditions, namely diabetes, chronic kidney disease, and cardiovascular diseases. While experts have not yet finally concluded how exactly country-wide indicators interact with the spread of the outbreak, one factor may be these underlying diseases.

In comparison to six of the countries significantly affected by the outbreak — China, South Korea, Iran, Italy, the United Kingdom, and the United States — India has a higher burden of cardiovascular diseases than four of these countries, but lower than China and the US. For diabetes and kidney disease, India has a higher burden than Italy, China, and the UK, but lower than Iran, South Korea, and the US.

The Global Burden of Disease data measure the burden in terms of “disability-adjusted life years (DALYs)”, which is defined as the number of years of healthy life lost. According to research body Institute for Health Metrics and Evaluation,

India’s cardiovascular disease burden in 2017 was 4,716 DALYs per 100,000 population, way behind China (6,020) and close to the US (4,814). India is followed by Italy (4.350), UK (4,005), and Iran (3,911). South Korea has a very low burden with cardiovascular diseases, at 2,340 DALYs per 100,000 population. It was also one of the countries to experience heavy contraction of COVID-19 but not as many deaths as in the other hardest hit countries.

For diabetes and kidney disease, India was at 1,340 DALYs per 100,000 in 2017. Countries with a higher burden are the US (1,779), South Korea (1,447), and Iran (1,356), while Italy (1,266), China (1,068), and the UK (913) have a lower burden than India.

More than two-thirds of the deaths from COVID-19 in Italy, whose healthcare systems have been particularly stretched by the outbreak, were of patients with diabetes, cardiovascular diseases, or cancer, or were of former smokers, according to research published in The Lancet on March 13.

The Chinese Centre for Disease Control has reported that a majority of deaths were above age 60 “and/or had pre-existing, comorbid conditions such as hypertension, cardiovascular disease, and diabetes.” Research from Wuhan showed patients who developed acute respiratory distress syndrome after contracting COVID-19 had a mean age of 61 years and were more likely to have diabetes, chronic kidney disease, and cerebrovascular disease.

Indians are younger

There is varying research about the age distribution of those hospitalised for COVID-19. According to the research in The Lancet, the mean age of patients who died due to COVID-19 in Italy was 81 years. Again, of 1,590 hospitalised patients from across China, the mean age was 48.9 years.

The first descriptive research about COVID-19 patients in the US, released by the CDC, found that fatalities were highest amongst those above 85 (10 to 27 per cent). Nearly a third of all cases, 45 per cent of hospitalisations, and 80 per cent of deaths were of patients above 65.

Six per cent of India’s population is above 65 and more than a quarter is 14 or below. Iran has a similarly young population, with 5.4% above 65 and a little less than a quarter below 14. India’s under-14 population is the higher than the other six countries, World Bank data show.

Italy (23%), UK (18.5%), and US (15.4%) have a high population share of the eldest category. South Korea (13.9%) and China (10.6%) too have heavier elderly populations than India.

Healthcare capacity

The World Health Organization tracks country-wise data on hospital beds per 10,000 people. India stands at the lowest among the seven countries, at seven. Iran has 15, UK 28, US 29, Italy 34, China 42, South Korea 143.

There are currently 15,980 isolation beds and 37,326 quarantine beds available in India, according to the Ministry of Health. In other words, there is one isolation bed for every 84,000 Indians , and one quarantine bed for every 36,000 Indians.

-Indian Express