Age Pattern of Premature Mortality under varying scenarios of COVID-19 Infection in India

BackgroundIndia is vulnerable to community infection of COVID-19 due to crowded and poor living condition, high density, slums in urban areas and poor health care system. The number of COVID 19 infection has crossed 300,000 with over 7,500 deaths despite a prolonged period of lock down and restrictions in public spaces. Given the likely scale and magnitude of this pandemic, it is important to understand its impact on the age pattern of mortality under varying scenarios. ObjectiveThe main objective of this paper is to understand the age pattern of mortality under varying scenarios of community infection. Data and MethodsData from the Sample Registration System (SRS), covidi19india.org and country specific data from worldmeter is used in the analyses. Descriptive statistics, case-fatality ratio, case fatality ratio with 14 days delay, abridged life table,years of potential life lost (YPLL) and disability adjusted life years (DALY) is used. ResultsThe case fatality ratio (CFR) with 14 days delay for India is at least twice higher (8.0) than CFR of 3.4. Considering 8% mortality rate and varying scenario of community infection by 0.5%, 1% and 2%, Indias life expectancy will reduce by 0.8, 1.5 and 3.0 years and potential life years lost by 12.1 million, 24.3 million and 48.6 million years respectively. A community infection of 0.5% may result in DALY by 6.2 per 1000 population. Major share of PYLL and DALY is accounted by the working ages. ConclusionCOVID-19 has a visible impact on mortality with loss of productive life years in working ages. Sustained effort at containing the transmission at each administrative unit is recommended to arrest mortality owing to COVID-19 pandemic. What is known?The case fatality rate associated with COVID-19 is low in India compared to many other countries. The mortality level is higher among elderly and people with co-morbidity. ContributionThe case fatality ratio is illusive in the sense that the same with 14 days delay for India is at least twice higher (8.0). The COVID-19 attributable mortality has the potential to reduce the longevity of the population. Unlike developed countries, about half of the COVID-19 attributable mortality would be in the working age group of 45-64 years. With any level of community infection, the years of potential life lost (YPLL) and disability adjusted life years (DALY) world be highest in the working age group (45-64 years).