How vulnerable are different states to coronavirus? MP ranked the worst, Sikkim the best

All states in India, ranked in order of vulnerability

Passengers onboard a train at Charbagh railway station in Lucknow | PTI Passengers onboard a train at Charbagh railway station in Lucknow | PTI

Districts predominantly in the northern and western parts of India, including Madhya Pradesh, Bihar and Telangana, could be the most susceptible to the coronavirus spread, according to a study in the medical journal The Lancet. Nine states—Madhya Pradesh, Bihar and Telangana, Jharkhand, Uttar Pradesh, Maharashtra, West Bengal, Odisha, and Gujarat—have high vulnerability to the coronavirus pandemic, according to researchers, including Rajib Acharya from the Population Council of New Delhi, who collaborated on the study. The researchers took into account multiple factors including vulnerabilities in socio-economic, demographic, housing and hygiene, and epidemiological strata. 

"COVID-19 is spreading rapidly in India and other parts of the world. Despite the Indian government's efforts to contain the disease in the affected districts, cases have been reported in 627 (98 per cent) of 640 districts," the study noted, adding some states were much more suscpetible than others. 

The study noted: As of June 17, 2020, there are eight states in India that have contributed to over 80 per cent of the confirmed COVID-19 cases in the country—Maharashtra (33 per cent), Delhi (14 per cent), Tamil Nadu (13 per cent), Gujarat (5 per cent), Rajasthan (7 per cent), Uttar Pradesh (4 per cent) West Bengal (3 per cent), and Madhya Pradesh (3 per cent). Of these eight states, five states had a high overall vulnerability index value (ranging from 0.771 to 1.000), and the remaining three had medium vulnerability (ranging from 0.514 to 0.686)

Ranking all the states in order of vulnerability:

Sikkim                         0.000 (vulnerability to COVID-19)

Arunachal Pradesh    0.029

Himachal Pradesh     0.057

Chandigarh                0.086

Daman and Diu         0.114

Andaman-Nicobar    0.143

Mizoram                     0.143

Puducherry                0.200

Lakshadweep           0.200

Assam                        0.257

Meghalaya                 0.286

Chhattisgarh              0.314

Kerala                         0.314

Goa                             0.314

Haryana                     0.400

Punjab                        0.429

Uttarakhand              0.429

Dadra-Nagar Haveli  0.486

Delhi                           0.514

Manipur                     0.543

Tamil Nadu                0.571

Karnataka                  0.571

Tripura                        0.629

Nagaland                    0.657

Rajasthan                    0.686

Jammu-Kashmir        0.714

Andhra Pradesh         0.714

Gujarat                        0.771

Odisha                        0.800

Maharashtra               0.829

West Bengal                0.829

Uttar Pradesh              0.886

Jharkhand                    0.914

Telangana                    0.943

Bihar                             0.971

Madhya Pradesh         1.000

Madhya Pradesh had an overall vulnerability score of one, making it the most vulnerable, and Sikkim on the other end had a score of zero, deeming it the least vulnerable. Arunachal Pradesh and Himachal Pradesh were two other states on the lower overall vulnerability end of the scale.

The study noted: As of June 17, 2020, there are eight states in India that have contributed to over 80 per cent of the confirmed COVID-19 cases in the country—Maharashtra (33 per cent), Delhi (14 per cent), Tamil Nadu (13 per cent), Gujarat (5 per cent), Rajasthan (7 per cent), Uttar Pradesh (4 per cent) West Bengal (3 per cent), and Madhya Pradesh (3 per cent). Of these eight states, five states had a high overall vulnerability index value (ranging from 0.771 to 1.000), and the remaining three had medium vulnerability (ranging from 0.514 to 0.686). 

Nine states with an overall vulnerability index more than 0·75 mostly ran through the centre of the country, from West Bengal in the east to Gujarat in the west, covering Bihar, Odisha, Jharkhand, Uttar Pradesh, Madhya Pradesh, Telangana, and Maharashtra, according to the study. "Most of these states have high vulnerability according to several individual domains. As many as 14 states and union territories had a vulnerability index lower than 0.4, one from the north (Himachal Pradesh), five union territories (Chandigarh, Daman and Diu, Andaman and Nicobar Islands, Puducherry, and Lakshadweep), five from the northeast region (Sikkim, Arunachal Pradesh, Mizoram, Assam, and Meghalaya), one from the west (Goa), one from the south (Kerala), and Chhattisgarh from the central region," the study noted.

"Although our intention was not to predict the risk of infection for a district or a state, we observed similarities between vulnerability and the current concentration of COVID-19 cases at the state level," they wrote in the study.

The aim of the index, Acharya said, is to provide a tool to identify districts that are vulnerable to the consequences of the infection, including spread, morbidity and mortality and social and economic consequences. "A state may be low in overall vulnerability, but may be high on a particular domain," he added. 

The study ended on a note of caution: "India faces the threat of a serious COVID-19 outbreak that would have far reaching consequences due to its large population but also for other reasons, including challenges in practicing social distancing, densely populated urban areas, non-universal access to water and soap for handwashing, a large number of people with chronic morbidities, a substantial proportion of the population living below the poverty line, and a large number of migrant workers who move from one state to another for their livelihoods. According to data from the Indian government, more than 80 per cent of confirmed cases in India are asymptomatic, making the population vulnerable to community spread of the virus. Although the epidemic appears to be concentrated in more affluent and industrialised districts, with millions of migrant workers from these areas moving to their home districts after the lockdown eased, it is only a matter of time before the virus spreads to the rural hinterlands of India. The question arises over whether these districts are ready for the virus and its consequences."