The new coronavirus disease turned into a global pandemic because this novel virus could spread weeks without detection. There are several data points that indicate that 20-50% of all coronavirus infections are asymptomatic. Almost all countries are merely reacting to this virus rather than proactively working on preventing its spread. India is one of these countries even though it moved faster than most countries to impose a national lockdown to stop COVID-19 speed train on its tracks.
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In this article I am going to model the number of infections in India and make conservative predictions about the minimum number of deaths that we should expect to see in the next couple of weeks.
In this article I estimated the infection fatality rate of COVID-19 at 1.2% for the United States. However, India has a relatively younger population than the U.S. and I believe its overall infection fatality rate will be lower. To be conservative and keep the math simple, I will assume that India's IFR is 1%.
The main implication of a 1% infection fatality rate is as follows: if 100 people are infected with the new coronavirus today, only 1 of them will lose their struggle with this virus and the remaining 99 people will survive this ordeal.
Approximately 5-6 days after a person is infected with the virus, she begins to show symptoms (fever, cough, fatigue, etc.). There are multiple data points in different countries that indicate that 20-50% of the infected people do not show any symptoms. Therefore, it is thought that these people have an important role in the spread of this virus so rapidly. After the patients show symptoms for 5-6 days, some of them become more severe and have to be hospitalized. The hospital stay is around 14 days on average and then the case is resolved (either recovery or death).
In total, it takes around 24 days for the patient to lose her life after getting infected with the virus. Some researchers use Gamma distributions to model this in their papers, but again we are using a simplified model so that untrained readers could understand our model (using a Gamma distribution doesn't lead to better conclusions).
This is an important figure.
In India today at least 86 people lost their lives because of the coronavirus (I am hoping that Indian authorities didn't undercount the COVID-19 deaths). These people were not infected with this virus today, nor were they infected with it yesterday. These people were infected with this coronavirus around 24 days ago.
In other words, 86 people were infected this virus on March 11th or earlier and lost their lives after fighting with this virus for 24 days on average. We also know that only one out of every 100 people who get the coronavirus lost their lives.
This means that on March 11th, in India there were 100 coronavirus infections for each deaths TODAY. So, there were a total of 8600 people infected with the new coronavirus in India on March 11th. If you understand how we calculated this 8600 figure, it's relatively easy to understand the rest of our model. I am aware that Indian authorities confirmed only 60 COVID-19 cases on March 11th, which explains why the number of infections have been growing exponentially since then.
In the USA, Italy and other countries the number of infections and deaths doubled every 3 days before they started implementing social distancing measures. The figures in India point to a slightly slower growth rate of 4 days. We know that 1% of those who are infected dies after about 24 days. Therefore, we can calculate the rate of increase in the number of infections by looking at the rate of increase in the number of those who lost their lives.
For example, in India the death toll was 32 on March 31st. This number doubled in 4 days and reached 86 (the rate of increase is a little more than 100%).
On March 27th the death toll in India was 20. This number quadrupled in 8 days and reached 86 (more or less).
Now we can start to predict the actual number of infections and project the death toll for the next couple of weeks.
We already calculated that there were around 8600 infections in India on March 11th. Since the number of infections is doubling every 4 days, we know that it will double to 17200 on March 15th, 34400 on March 19th, and 68800 on March 23rd.
Using a conservative growth rate between March 23rd and March 24th, we can safely estimate that there were at least 75000 coronavirus infections in India on March 24th.
On March 24th Modi ordered a 21-day lockdown to slow down the spread of COVID-19. So, we will stay conservative and assume that the number of infections stayed the same since March 24th.
The immediate implication of this figure is that on April 17th, 24 days after March 24th, the death toll in India will reach 750 (one percent of 75000 people is 750 people).
This isn't a big number compared to the United States, Italy, France, Spain, or UK. That's not the issue. The issue is that India is a poor country. Three-generation households are very common. On March 24th there were at least 75000 infections in India and these people were locked down in their small homes. Many of these people are asymptomatic and will spread this virus unknowingly.
Half of these 75000 people contracted this virus between March 20th and March 24th. This means most of these 37500 were asymptomatic or pre-symptomatic on March 24th. The average incubation period is 5-6 days, but it could be as much as 14 days in some people. This means it may take them as much as 2 weeks to spread this virus to one of their family members. If their family members don't develop any symptoms before the end of the 21-day lockdown, they are very likely to go on with their lives and start spreading the virus again.
That's why we believe Modi's 21 day lockdown will slow down the virus significantly, but won't be enough to contain it. If India doesn't extend the lockdown, the virus will start spreading freely again and India will be in the same situation before the end of May. I believe this will lead to a recession no matter what.
If India extends the lockdown another 4 weeks, it will potentially save millions of lives but its economy will be in a recession.
iShares MSCI India ETF (INDA) and iShares India 50 ETF (INDY) are two of the largest India ETFs and they lost close to 40% since reaching their 52 week highs. I would not short any of these two ETFs at this point, but I think they are likely to decline further as there is no economically good outcome whatever Modi decides to do.
Disclosure: None. This article is originally published at Insider Monkey.
