Most of the large European countries & the USA are currently experiencing a second wave of COVID-19. While the number of cases has increased significantly, the number of deaths hasn’t increased at the same rate. In fact, the second wave of COVID-19 has been significantly less fatal in all these countries than the first wave.
In the earlier story, we highlighted the prevalence of second wave of COVID-19 in few of the European countries & USA. While there has been an increase in the number of daily cases during the second wave when compared to that of the first wave, the Case Positivity Rate i.e number of cases being detected in respect to the tests being done is also higher than what was observed during the peak of the first wave.
While the case load & positivity rate indicate a wider spread of COVID-19 during the second wave, it does not necessarily mean it is more severe. During the first wave of COVID-19 witnessed early this year in these countries, substantial progress has been made regarding the understanding of COVID-19 and its treatment.
The first wave in many of these European countries was marked by high number of deaths. In this story, we look at the fatality data (number of deaths & fatality rate) during the second wave to better understand the severity of this second wave.
Number of Daily deaths less than during the first wave in Europe
As observed in the earlier story, the second wave of COVID-19 in the large European countries began around late August and gradually peaked during October & Novemebr’2020. In most of these countries, the number of daily cases has seen a decline over the last week to 10 days. Based on this information, it can ascertained that these countries in Europe have experienced peak phases of both the waves of COVID-19 infection, unless there is a reversal of trend in near future.
Spain & Italy were among the countries which reported a higher number of deaths during the first wave. An older population and not much understanding of COVID-19 was generally considered the reason for higher number of deaths. During the peak of the first phase, Italy has averaged around 700 daily deaths while Spain averaged around 800 deaths.
We have considered the data provided on Our World in Data, and have normalized the daily deaths as a 10-day average to account for inconsistencies due to any spikes on particular dates and data corrections by the authorities.
Italy is currently reporting around 600 daily deaths on an average and has recently started to report a fall in the number of daily COVID-19 related deaths. Comparatively, Spain has performed better during the second wave of the infection, with the peak average daily deaths being around 400.
France & UK which reported upwards of a thousand daily deaths during the peak phase of the first wave have managed to keep the number of daily deaths low during the second phase. Meanwhile, Germany had reported lower number of deaths even during the first phase and the numbers remain more or less the same for the second wave as well.
On the other hand, Russia, has seen an increase in the number of daily deaths which is a continuation of the trend observed over the past few months.
CFR during second wave much lower than during the first wave
It has to be noted that the absolute number of deaths depends on multiple factors such as case load, population etc. Countries with a higher population and high case load may report a higher number of deaths. Hence to understand the severity of the disease spread, ‘Case Fatality Rate’ (CFR) is a better indicator. CFR refers to the number of deaths per number of COVID-19 cases. In other words, it is number of deaths for every 100 reported cases.
The CFR also helps us analyse any improvements that might have been achieved over a period of time in treating COVID-19 enabling the recovery of those infected with the virus. Since the time frame of death due to COVID-19 varies, cumulative Case Fatality Rate (CFR) offers a better picture than daily numbers.
During the first phase of COVID-19 in Spain, CFR was around 9-10%. A subsequent fall in the number of cases but not deaths contributed towards a higher CFR in ensuing months with CFR for Spain peaking during June & July 2020 with around 11%. The emergence of second wave of COVID-19 has seen a near 10-fold increase in the number of COVID-19 cases. However, as highlighted earlier, the number of deaths during this second wave remained lower there by contributing to a lower CFR. A consistent decline in CFR is observed since the emergence of second wave.
Similar trend with slight variance in time period is observed in France, Italy & UK also. Because of the lower number of death cases in Germany all through, the decline is not as prominent, but the CFR has been comparatively lower during the second wave compared to the first wave.
In the case of Russia, the increase in the number of deaths is reflected in an increased CFR.
CFR in the USA has also decreased to about 2% now
During the first phase of COVID-19 in USA, the highest number of daily deaths in the world were recorded with upwards of 2,500 daily deaths on average at the peak. Over a period of time, the numbers reduced with around 800-1000 deaths being reported over a prolonged period of time. In the earlier story, we had observed that since late October 2020, there has been an increase in the number of COVID-19 cases. While there has also been an increase in the number of deaths, it is still lower than the numbers reported during April 2020.
In the meantime, the CFR is on a constant decline over the past few months to reach just around 2%, from a peak of about 6% in early May. However, unlike most of the European countries being discussed in this story, USA has not yet tided over the second wave , with greater numbers being reported even now.
The peak of first phase in India was around the time Europe was getting into a second wave
When compared to Europe and most of the other countries in the world including Asia, the COVID-19 infection spread later in India. It was only around early April 2020 that India started reporting average daily number of COVID-19 cases in the hundreds. By the end of April 2020, more than thousand daily cases were being reported. By the end of May 2020, the daily cases went up to 8-10 thousand, which was nearly the same numbers as reported by Italy, Spain, UK and other countries at the peak of their first wave.
However, these numbers are much lower than India’s peak, which it achieved in mid-September with around 90 thousand daily cases. Even USA, the country with the highest number of COVID-19 cases has not reported such numbers during the first wave with its maximum being around 75-80 thousand daily cases.
USA was able to breach India’s daily numbers only during its second wave. India’s daily case numbers started tapering off at the beginning of October 2020. By this time, USA was beyond its its first wave’s peak and most of the aforementioned European countries started to record higher number of cases as part of their second wave.
Unlike the European countries where in the peak was achieved relatively quickly with two odd months both during the first & second wave, it took a long time for India to reach its peak. The time period it took India to reach its peak is even longer compared to the USA.
India’s CFR down to 1.46%
India’s peak in terms of daily deaths coincides with the period when the country reported the highest number of COVID-19 cases. During most of September, India reported around 1000-1200 daily deaths on average. The numbers have since fallen to around 450-550 daily deaths on average over the last month or so.
A significant aspect of this is that the fall in cases & deaths resulted in a fall in CFR. India’s CFR is currently 1.46%, down from the peak of around 3.4% in Mid-May. This trend of higher cases & deaths with a lower CFR is also observed during second wave in European countries & USA.
What could this mean for India?
Statistically, the increase in the number of reported cases could be a factor in lower CFR in European countries during second wave, which was not the case during the first phase. Furthermore, the timing of EU second wave coinciding with India’s peak of first phase lends more similarity in the trends. Unlike EU’s first wave, the delayed first wave in India provided an opportunity to be more aware of COVID-19 and take necessary actions, which could have contributed to a lower CFR. It could also be a case of less-fatal strain of COVID-19 virus, though there is little evidence of the same. The numbers in India are currently on a decline, after the peak in September. Although the first half of November did give rise to apprehensions about a possible of second wave on account of the festive season & opening up, the recent numbers do not show any dramatic increase.
More than Europe, USA provides a more relatable picture to India’s trajectory. Going by the trend in USA, India could witness a possible second wave in the coming two months. Based on the trend of second waves across the world, while the numbers could rise the infection could be less fatal.
Another aspect which India could learn from the US experience is that during the second wave, the new cases are being reported in those states which managed to elude the first wave. India has been fortunate to an extent that more populous and lesser developed states did not report higher COVID-19 cases during the first wave. Spread of infection in these states could prove to be more fatal than our current experience with COVID-19. With improved understanding and preparedness, India could well avoid a second wave provided there is better planning, preparedness & public support.
However, it is still early to write off a second wave in India. We are in peak winter season following the festivities and December & January could be crucial and would determine India’s future trajectory.
Featured Image: Second wave of COVID-19