Among 18 states and Union Territories that have reported over 10,000 cases so far, Andhra Pradesh is growing at the fastest rate, followed by Bihar, Karnataka, Odisha and Kerala in that order. The daily average growth rate of cases was 9.3% for Andhra Pradesh and 6.1% for Bihar in the past week. Karnataka, Odisha and Kerala are the only other states where cases are growing at above 5% per day.
Unlike Andhra Pradesh, Karnataka and Kerala, which have between 145 and 400 hospital beds per lakh population, Bihar has less than 26 beds per lakh and Odisha is only slightly better at just under 56 per lakh (see g raphic).
The two states also have registered such rapid growth in cases despite rates of testing that are lower than the national average. Bihar in fact has the lowest testing rate in the country, a mere four tests per 1,000 persons, which could mean a large number of undetected cases and continuing spread. Similarly, Odisha has a testing rate of 11 per 1,000. Such low testing could mean that the actual number of cases could be much higher and hence a potential pressure on the health system too.
Out of 86 countries/territories for which Our World in Data has compiled data, there are only 15 where the testing rate is below 10 per 1,000. Bihar and three other states with a testing rate of 9 — Uttar Pradesh, West Bengal and Madhya Pradesh — fall in this category and Odisha and Telangana are only just above it.
The worry is that if cases continue to grow at this rate, Bihar and Odisha could face a major health crisis given the poor state of health care infrastructure. The only silver lining is that so far, the case fatality rate in the two states has remained low at 0.6 for Bihar and 0.5 for Odisha, the lowest in the country after Kerala and Assam. But deaths too have been increasing at a fast rate in both states of late.
Out of 38 districts in Bihar, 13 are growing faster than the state average of 6.1% daily increase in cases. All of them have over 500 cases. In Odisha, 9 districts are growing at a rate faster than the state’s average. Seven of them have over 500 cases.
In the case of Bihar, the Indian Medical Association’s district-wise data on membership shows that more than half the doctors are concentrated in just three districts, Patna (33.5%), Darbhanga (8.9%) and Muzaffarpur (8.6%). Thus even within the state, healthcare availability is severely skewed. The scenario is unlikely to be very different in Odisha as the bulk of doctors being concentrated in a few urban pockets is true in most states, though more pronounced in some.