key: cord-1016784-s1f18nde authors: Bhattacharjee, Atanu; Kumar, Mukesh; Patel, Kamalesh Kumar title: When COVID-19 will decline in India? Prediction by combination of recovery and case load rate date: 2020-06-23 journal: Clin Epidemiol Glob Health DOI: 10.1016/j.cegh.2020.06.004 sha: f19184549b3c45e567e5f43a5d9d0a25441a10bb doc_id: 1016784 cord_uid: s1f18nde BACKGROUND: The World Health Organization (WHO) declared COVID-19 as a pandemic on March 11, 2020. There is sudden need of statistical modeling due to onset of COVID-19 pandemic across the world. But health planning and policy requirements need the estimates of disease problem from clinical data. OBJECTIVE: The present study aimed to predict the declination of COVID-19 using recovery rate and case load rate on basis of available data form India. METHODS: The reported COVID-19 cases in the country were obtained from website (https://datahub.io/core/covid-19#resource-covid-19_zip/). The confirmed cases, recovered cases and deaths were used for estimating recovery rate, case load rate and death rate till date June 04, 2020. RESULTS: A total of 216919 confirmed cases were reported nationwide in India on June 04, 2020. It is found that the recovery rate increased to 47.99% and case load rate decreased to 49.21%. Death rate is found to be very low 2.80%. Accordingly, coincidence of the difference of cases load rate and recovery rate (delta) will reveal a declination in expected COVID-19 cases. CONCLUSION: The epidemic in the country was mainly caused by the movement of people from various foreign countries to India. Lockdown as restricting the migration of population and decision taken by the government to quarantine the population may greatly reduce the risk of continued spread of the epidemic in India. This study predicts that when the case load rate gets lesser than recovery rate, there after COVID-19 patients would be started to decline. Since, December 2019, a pneumonia infection broke out in Wuhan, Hubei province and spread in entire China and many other countries. Chinese health authorities observed notoriously a cluster of pneumonia cases of unknown aetiology. 1 Relations between the key cases and the city's South China Sea food market were found. The chance of another zoonosis or severe acute respiratory syndrome (SARS) outbreak was at the top of the priority, investigations were attempted that result in recognition of a novel coronavirus, SARS-CoV-2 (formerly 2019-nCoV), as the agent has entered as international outbreak in Hubei. China has revealed total of 72,528 confirmed cases on February, 17, 2020. 2, 3 The novel coronavirus 2019 (COVID-19) has spread across 210 nations and regions with 1.2 million confirmed cases and 67594 deaths noted on April 6, 2020. The WHO declared public health emergency at international level. The worldwide community gets worried about COVID-19 and its impact on public health. WHO is trying to control the impact of pandemic through identification, testing, treatment of patients, clinical trials for drugs and development of new vaccines. 4 In India, first case of COVID 19 was reported on January 30, 2020 who returned from Wuhan, China. Considering the first case as a matter of great worry, screening of traveller at airport has been started, immediate Chinese visas have been cancelled, and people who were found affected from COVID-19 had been quarantined. 5 The Ministry of Health and Family Welfare (MoHFW) of India had primarily warned to avoid travelling to China and quarantine of those returning from China. 6 However, India is at high risk being the second highest populated country in the world. Most of the studies show the prediction of COVID 19 through modeling for growth of infected population. In the absence of a licensed vaccine or effective therapeutics for COVID-19, other advises from hand cleanliness to quarantine, a basic strategy to control spread of epidemic and alleviation mediation towards the early detection and quarantine of cases can break the chain of transmission. The SARS-CoV-2 pandemic is currently a great challenge for researchers, clinicians, health-care workers, and decision makers. We depict the most striking difficulties for statisticians who need to provide support in this pandemic with their proficiency. Having a knowledge of the dynamics of case load rate and recovery rate of COVID-19 can enhance the basic understanding to a large extent based on the current patterns of the severity of the epidemic. As COVID-19 cases are increasing day-by-day, case load rate will be of utmost importance in predicting the declination of the epidemic. In this article, we want to predict the exact date when the recovery rate of patients would be more than new confirmed cases in India. This date is defined as disease declined date. Data safety, patient's consent, ethical approvals are essential in non-pandemic circumstance but there are administrative barriers to get access to clinical data. Pandemic circumstances need precise handling of these issues and should be examined on nationwide. Clinical data are extremely time-dependent and involve progressive statistical methods. 7 Data has been obtained with parameters as cumulative confirmed cases, recovered cases and deaths from the online websites (https://datahub.io/core/covid-19#resource-covid-19_zip/. Total 216919 cumulative confirmed cases, 104107 recovered cases and 6075 deaths were found till date 04 June2020 and included in the study. The whole analysis has been carried out with data available on cumulative confirmed cases, recovered cases and number of deaths. Recovery rate is defined as the proportion of number of recovered cases to total confirmed cases, while the case load rate is defined as the proportion of case load to confirmed cases. Following formulae have been used for estimation purpose in (Table 1) . Total 2169191 confirmed cases and 104107 recovered cases were involved in the study. Recovery rate had been estimated as 47.99% on the basis of confirmed and recovered cases. Total case load was found to be 106737 cases and case load rate was estimated as 49.21 %. Death rate was obtained as 2.80% based on 6075 dead patients. Delta being the difference of case load rate and recovery rate was obtained as 1.21 percent on 04 June 2020 as evident from ( Table 1 ). The value of delta has been estimated from 30 January 2020 to 04 June 2020. It has been predicted that the value of delta would be least on 12 June 2020; it means the difference between cases load rate and recovery rate would approach a negligible value. This indicates that confirmed cases expected would start to decline thereafter with respect to recovered cases as shown in (Figure 1 ). Investigation has been made on the issue of COVID-19 pandemic spread in India in the current challenging scenario. Trend knowledge has been observed with the help of recovery rate and case load rate obtained for the data available. The various strategies implemented as lockdown, quarantine of population have played a significant role in reducing the risk of spread of epidemic. This study predicts that when the cases load rate gets lesser than recovery rate, there after COVID-19 patients would start to decline. This study is restricted within the time period of analysis till 04 June 2020 in India. Different models were considered to estimate COVID-19 extent, and claimed to be precise, however they critically revealed data gaps and prerequisite to adjust difficult variables such as effect and uncertainty of lockdown, risk factors and social distancing might be reflected before generalizing the findings. The authors declare no conflict of interest. The authors did not receive any funding for this work. Time-varying transmission dynamics of Novel Coronavirus Pneumonia in China Now casting and forecasting the potential domestic and 3. international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modeling study Novel coronavirus pneumonia epidemic of early containment strategies outlined Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) Shally Awasthi and learned referee for their suggestions to improving the quality of contents of manuscript. The confirmed cases, recovered cases and deaths were used for estimating recovery rate, cases load rate and death rate till date 04 June 2020. It is found that the recovery rate increased to 47.99% and case load rate decreased to 49.21%. Death rate is found to be very low 2.80%.This study predicts that when the cases load rate lesser than recovery rate there after COVID-19 patients would be started to decline. The authors declare no conflict of interest.