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COVID-19 Pandemic in India: Chronological Comparison of the Regional Heterogeneity in the Progression of the Pandemic and Gaps in Mitigation Strategies

Satabdi Datta1 , Neloy Kumar Chakroborty2 , Deepinder Sharda1 , Komal Attri1,3, Diptiman Choudhury1,3*

Background: The progressions of the first and second waves of the COVID-19 pandemic in India were heterogeneous in different regions and their respective states and union territories. Our work aims to understand the major differences between the two waves and the mitigation strategies implemented during these waves.

Methods: A cross-sectional analysis of the temporal variations in new cases and fatalities in all the states of India was done for both the first wave (30^th January 2020 to 31^st January 2021) and second wave (1^st February 2021 to 29 ^th May 2021) of the pandemic. Variations in different epidemiological parameters, like case fatality ratio (CFR), cumulative case ratio (CCR), and cumulative death ratio (CDR) were quantified. In the majority of states and UTs, the test-to-case ratio has been found below than the WHO recommended mark.

Results: The Southern and Western regions were the top contributors of cases and fatalities in both waves. The state of Punjab and Maharashtra reported the highest CFR (3.24 and 2.5 respectively) in the country during the first wave and Andaman and Nicobar Islands (2.6), and Punjab (2.25) reported the highest CFR during the second. Goa and Delhi respectively showed the highest CCR and CDR during the first wave, whereas Lakshadweep and Goa respectively reported the highest CCR and CDR in the second wave.

Conclusion: The study comprehends the chronological heterogeneity in the patterns of pandemic progression and the severity of the second wave over all the states of the country, highlighting the major hotspot regions and some gaps in mitigation strategies.