The Coronavirus in India under Lockdown: The Myth and Some Facts About the Big Picture

Since the
reports emerged of a large number of participants at the Tablighi Jamaat
congregation in Delhi’s Nizamuddin area being infected with the Coronavirus, a
concerted effort has been made in the daily press conferences of the Union
Ministry of Health to push a certain narrative about the course of the epidemic
in India. In this narrative, this one event has been responsible for much of
the surge in confirmed cases of the infection in India seen since the
nationwide lockdown came into force (from just over 500 on 24th
March 2020 to around 6500 on 9 April 2020). 

It is suggested that if the
Nizamuddin related cases are excluded, India has been doing quite well in
controlling the rate of expansion of the disease in comparison to trends
worldwide. However, in addition to using facts selectively and twisting them, which has fed
the process of poisonous communalization of the battle against the epidemic, there
is a second dimension to this narrative. This is that by focusing only on the
all India figures, and not on the regional variations in trends, it conceals
the real picture of what is happening. This picture has elements which suggest
that the situation could turn very grim in the next few weeks and others that
indicate the very real potential to control the Coronavirus epidemic in India
before it wreaks havoc on the Indian people. The former would be the price of
inaction and that is what would be the tendency if we focus on the Nizamuddin
event while latter requires very proactive measures on the part of the
significance of the Nizamuddin event in influencing the number of confirmed
cases of the Coronavirus varies extremely widely across states. In Tamil Nadu,
763 of the total 834 confirmed cases as on 9 April 2020 are said to originate
in that single event. However, the state with the highest number of cases in
India as of now, namely Maharashtra, has very few related to the same event
(Only 25 out of the state’s total of 1135 cases reported till 8 April 2020) –
and yet has seen a surge. A closer look at the trends in Maharashtra, however,
shows what kind of danger might be in store.

Repeating Europe’s Story with a Lag?
As on 9 April
2020, Maharashtra reported 1364 confirmed cases of Covid-19 infection and 98
deaths. There is a heavy concentration of these cases in Mumbai and its suburbs
(Table 1), a metropolitan region which account for about 16-17 per cent of
Maharashtra’s total population of 12.5 crores (125 million). Densely populated
Dharavi accounts for 15 odd confirmed cases.
Table 1: Coronavirus in
Mumbai: Confirmed Cases and Deaths as on 9 April 2020 (6.00 p.m.)
Municipal Corporation
Other Municipal
Corporations in Mumbai Metropolitan Region
If the number
of confirmed cases in Maharashtra continue to rise at the same rate as
they have between 30 March and 9 April (a 10 day period), the state will have
upwards of 52,000 confirmed cases by 29 April (20 days from 9 April) or
thereabouts. Table 2 shows for comparison a picture of selected severely
affected European countries and their journey from a similar starting number as
Maharashtra had on 9 April 2020 to a tally of around 52,000.  Each of these countries has a smaller
population than Maharashtra – around half or less, but with a land area that is
similar or much larger than Maharashtra. As the table shows, the Maharashtra
projection of 52,000 odd cases by the end of April would mean a very similar
movement to that which these countries have made previously but in different
periods of time. In other words, it is a very realistic prospect and
Maharashtra would be beginning from a much larger number of deaths at the
starting point.
Table 2: Increase in
Number of Confirmed Cases and Deaths in Selected Periods: Maharashtra and
Selected Countries
Country/ State
Number of days
Change in Number of
Confirmed Cases
Change in Number of
March to 6 April
22 days
1391 to 51608
35 to 5373
February to 21 March
21 days
1128 to 53578
29 to 4825
March to 27 March
18 days
1169 to 51224
30 to 5138
March to 31 March
23 days
1209 to 52128
19 to 3523
April to 29 April
20 days
1364 to ?
98 to ?
The question this
then poses is the following – is Maharashtra in danger of seeing a repeat of
what happened in these countries, with a lag that ranges between 25 to 40 days?
Can Mumbai become Maharashtra’s equivalent of Italy’s Lombardy region, the
Coronavirus epicentre in that country? The more unlikely the authorities think
them to be, the greater is the likelihood that these outcomes will materialize.

The Kerala Story: Offering Hope and Something
to Learn From?
In stark
contrast to the Maharashtra picture is that of Kerala, which was the first
state in India to report confirmed Coronavirus cases. Kerala too has cases
linked to the Nizamuddin event but the point about Kerala is that in the
opposite way to that of Maharashtra, this has no significance for its trend.
On 24th
March 2020, the eve of the nationwide lockdown, Kerala had 109 confirmed cases
from the beginning of the outbreak, the highest number among all states
and just ahead of Maharashtra’s tally of 107 on the same day. On 9 April 2020, however,
Kerala reported only 357 cases against Maharashtra’s 1364 – and another 7
states had by this time a higher number of confirmed cases than Kerala. The
share of Kerala in all confirmed cases in the country fell from around 20% on
24 March to less than 6% on 9 April. This is despite Kerala having conducted the
largest number of tests after Rajasthan. Like everywhere else, there is a
geographical concentration of the numbers in Kerala too – with Kasargod and
Kannur districts accounting for 161 and 62 confirmed cases respectively.
With regard to
deaths, 13 states have by 9th April 2020 reported more Coronavirus
deaths than the number of just 2 in Kerala. On the other side, despite the
lower number of cases, the number of patients who have recovered (97) are also
high in Kerala – second only to Maharashtra’s 125 so far – and accounting for
over 15% of the countrywide total. As a result, the number of currently active
cases (those who have not yet recovered or died) as a proportion of the total
confirmed cases reported is in Kerala among the lowest in the country – at just
above 72 per cent compared to nearly 84 per cent in Maharashtra and nearly 95
per cent in Delhi. Practically in no state in India is this proportion less
than 80 per cent at the moment.
The lower
proportion of active cases in Kerala says something about the movement over
time of new cases versus recoveries in Kerala. Table 3 describes the progress of
confirmed cases in Kerala over the three weeks ending on 9 April 2020. It
reveals a clear trend of a rapid slowing down of the rate of spread of the
infection to the extent that even the absolute number of new cases have started

Table 3: Weekly
Progression of Confirmed Coronavirus Cases in Kerala: 19 March 2020 to 9 April
Number of Confirmed
Cases at the end of the Previous Week
Increase in Confirmed
Cases During the Week (Number)
Percentage Increase in
Confirmed Cases over the Week
March to 26 March
27 March
to 2 April
April to 9 April
The implication of this is revealed
in Graph 1 which shows the trend in the number of active cases in Kerala – a
clear flattening of the curve since the beginning of April.

Graph 1: Number of
Active Cases Under Treatment in Kerala, 19 March 2020 to 9 April 2020

The battle
against the Coronavirus is not over in Kerala and the possibility of a reversal
of trends described above is not entirely ruled out. Equally, a reversal of the
opposite kind in Maharashtra is not ruled out. It is also nobody’s case that
the state government in Maharashtra is making much less of an effort than the one
in Kerala. The conditions and the possibilities do differ across states.
However, at a time when most states in the country are behind both Maharashtra
and Kerala in terms of their position in the time trajectory of the infection,
but exhibiting trends that lie somewhere between that of these two states, the Kerala
story offers hope that it is possible to check the march of the Coronavirus
before it overwhelms the country. For this, however, it would be necessary to
examine closely what is happening where, draw appropriate lessons and formulate
practical actions according to the prevailing conditions (the Kerala Government
is perhaps the most forthcoming in providing relevant information and data,
through its daily bulletins that have been issued every day since 1 February
2020). The key agents are clearly going to be state governments but to be able
to do what is required of them, they need massive support from the Central
Government. This support has not been forthcoming, and won’t be if the Central
Government is content with thinking that the lockdown will do its job, and
explain away any trends which suggest otherwise by conveniently making the
Nizamuddin event the scapegoat.

The Author is Professor at CESP, JNU, New Delhi