As India gets ready to open up more of the economy, with restrictions such as those on malls and cinema halls likely to remain in force for some more time, the geography of the Covid-19 infections is changing quite rapidly.
As India gets ready to open up more of the economy, with restrictions such as those on malls and cinema halls likely to remain in force for some more time, the geography of the Covid-19 infections is changing quite rapidly. There is no alternative to opening the economy, but it has implications in terms of where India needs to ramp up medical infrastructure.
Urban India accounts for around 90% of all infections today, but if infection levels rise as they are right now, rural areas will account for as much as 15% of all infections within a month, and 26% by the end of July (see graphic). Keep in mind, there is just one functioning primary healthcare centre (PHC) for every 64,800 persons and one PHC doctor for every 38,000.
India does not classify districts as rural or urban, so we have classified any district with more than a 30% urban population-share as ‘urban’ – in keeping with the average urban-rural share for the country – and one that has between 20-30% urban population as ‘semi-urban’; the rest are ‘rural’. Based on this, it turns out that in the last 11 days – between the end of Lockdown 3 on May 17 and May 28 – infection levels in rural India grew by a compound growth rate of 7.2% per day compared to 4.8% for urban India.
A growth in the share of infected persons across the country from 5.9% on May 17 to 7.5% on May 28 may not seem much in itself, but that’s a 27% jump. The anecdotal evidence, in terms of the number of fresh infections surfacing in rural areas, as it happens, also corroborates this trend.
The shift in the spread of infections into the erstwhile definition of ‘green’ zones is equally dramatic. Between the end of Lockdown 3 on May 17 and May 28, the share of green zones in India’s infected population rose from 1.9% to 3.3%; again, the share looks small, but that’s nearly a three-fourths jump thanks to infection levels rising 10.2% per day on a compounded basis in green areas versus 4.8% in red areas.
Project this to the end of June, and 15% of India’s infections will come from green areas; this rises to 45% by the end of July. Shutting the economy is no solution as the hardship caused by this is enormous; and supply chain linkages imply that any shutting down in a zone can disrupt production across the country. But it does point to the need for local containment strategies, more effective social-distancing and, above all, sustained rollout of medical infrastructure.