Reassessing Reported Deaths and Estimated Infection Attack Rate during the First 6 Months of the COVID-19 Epidemic,Delhi, India |
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Authors: | Margarita Pons-Salort Jacob John Oliver J Watson Nicholas F Brazeau Robert Verity Gagandeep Kang Nicholas C Grassly |
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Institution: | Imperial College London School of Public Health, London, UK (M. Pons-Salort, O.J. Watson, N.F. Brazeau, R. Verity, N.C. Grassly);Christian Medical College, Vellore, India (J. John, G. Kang) |
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Abstract: | India reported >10 million coronavirus disease (COVID-19) cases and 149,000 deaths in 2020. To reassess reported deaths and estimate incidence rates during the first 6 months of the epidemic, we used a severe acute respiratory syndrome coronavirus 2 transmission model fit to data from 3 serosurveys in Delhi and time-series documentation of reported deaths. We estimated 48.7% (95% credible interval 22.1%–76.8%) cumulative infection in the population through the end of September 2020. Using an age-adjusted overall infection fatality ratio based on age-specific estimates from mostly high-income countries, we estimated that just 15.0% (95% credible interval 9.3%–34.0%) of COVID-19 deaths had been reported, indicating either substantial underreporting or lower age-specific infection-fatality ratios in India than in high-income countries. Despite the estimated high attack rate, additional epidemic waves occurred in late 2020 and April–May 2021. Future dynamics will depend on the duration of natural and vaccine-induced immunity and their effectiveness against new variants. |
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Keywords: | COVID-19 coronavirus disease severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 infection attack rate infection fatality ratio epidemics mathematical modeling respiratory infections viruses India zoonoses |
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