Factors influencing COVID-19 case burden and fatality rates findings from secondary data analysis of major urban agglomerations in India

Deodatt M. Suryawanshi, Raghuram Venugopal, Ramchandra Goyal


In December 2019, SARS COV-2 which originated in the Chinese city of Wuhan achieved pandemic proportions and spread rapidly to countries through International air traffic causing acute respiratory infection and deaths. Presence of International airports, demography, health financing and human developments factors were assumed to influence COVID-19 cases burden and case fatality rate (CFR). So, this study was undertaken to find a association between these factors and COVID-19 cases and deaths. The study used 48 districts using purposive sampling as proxy for cities and used secondary data analysis. Data was obtained for various variables like demographic, Health Financing, Indices and Testing infrastructure, COVID cases burden and case fatality from trusted sources. Descriptive statistics correlational statistics using Pearsons coefficient students T was used to describe, correlate and find significant difference in the data. The analysis found a significant difference between COVID cases burden in districts with International Airports (p<0.039) and those without it. Positive correlation of population density (r=0.65) with COVID-19 case burden and negative correlation of case fatality rate with NITI Aayogs health index (r=-0.12), human development index (HDI) (r=-0.18), per-capita expenditure on health (r=-0.072) and a correlation of r=0.16 was observed for gross state domestic product. Decongestion of cities through perspective urban planning is the need of the hour. Stricter quarantine measures in those districts with international airports can help reduce the transmission. Negative correlation of HDI and NITI Aayogs health index with CFR emphasizes the importance of improvements in social determinants of health.


COVID-19, Urban area, Case fatality, Population density, Per capita health expenditure, Human development index

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