Recovery rate: An incorrect indicator to assess COVID-19 impact?

Economists and health experts feel that this parameter has become unscientific

PTI17-07-2020_000076A Representational image | PTI

Questions are being raised on the entire process of calculating the recovery rate, making use of the available data, to its application to validating a performance in fighting the COVID-19 pandemic in the country. Several economists and health experts have criticised the method being followed. Currently, recovery rate is calculated by considering the total number of discharged patients with total COVID-19 positive patients as denominator. The output is then converted into percentage and shown as the recovery rate of a certain region. The Centre as well as the states are following the same methodology.

Indrakant Sulibhavi, a visiting professor at the Centre for Economic Studies (CESS), Hyderabad, termed the process “incorrect”. “Recovery rate plus mortality rate should add up to 100. This is not happening. If we have to go by the current figures of some states, recovery rate is around 60 per cent and the mortality is around 2-3 per cent in some states. If they are added, the total will not be more than 63 per cent. So, what happens to the remaining 37 per cent?” he said.

Sulibhavi’s argument is that the number of active patients should not be taken into account as their outcome is not known. “Those who are hospitalised can either recover or die. Since, we do not know their result, they cannot be included in the calculation of recovery rate. Instead, fatalities figures should be used.”

He feels that the Centre have promoted the wrong method out of ignorance and it is high time they corrected it.

If one were to apply Sulibhavi’s method, then the recovery rate will shoot up to more than 95 per cent for most states. “Why are we underestimating ourselves? The correct recovery rate figures will boost the morale of the people.”

Former Union health secretary and retired IAS officer, Sujatha Rao, raised concerns that the uniform way of calculating the recovery rate is not being followed. “It is a meaningless indicator and it does not mean anything,” she said. “Recovery at what level is very important to know. It should represent recovery in serious cases, medium or mild cases or those with co-morbidities. That is the way information should be let out. If they are putting everything together, even asymptomatic cases, one does not know who these patients are.”

Most states categorise discharged patients as recovered following ICMR guidelines. Those in home quarantine are required to isolate for 17 days, after which they are deemed to have been recovered. But, some field-level officials are marking patients in home quarantine as having recovered in 10-14 days after they stop showing any sign of illness. This way, the way data is being compiled is not uniform when it comes to recoveries.

Giridhar R. Babu, an epidemiologist and professor at Pubic Health Foundation of India (PHFI) said that the focus should be on mortalities rather than recoveries. “Ultimately, more than 80 per cent will recover. It is not the right way to determine in this pandemic. We should look at deaths per million as it will show the burden of the infection on the society. Many countries are not looking at recovery rate but only death rate.”