Factors affecting COVID-19 infection and deaths in the million-plus cities of India

ABSTRACT

Big cities are highly complex spatial units and have diverse subpopulations and neighborhoods with different sociocultural needs and vulnerable groups concerning public health emergencies, such as COVID-19. When these cities face an epidemic that spreads rapidly within the urban community, then human density and the urban setting have proven to be a tremendous liability and a matter of concern. The present study in this context is a preliminary attempt to understand the COVID-19 pandemic in the Indian context. The paper presents a city-level study of 46 million-plus cities in India to identify major determining factors (demographic, economic, environmental, infrastructural, and institutional interventions) of the COVID-19 infection and related deaths in different lockdown and unlock phases. Using the multiple regression model we found that the impact of these factors does significantly explains the variation in the COVID-19 infections and related deaths. However, the role of individual indicators does seem to have a differential impact across phases of the lockdown strategy. Indicators, such as GDP, hospital-doctor ratio, public transport usage, and administrative status of the city have been found to be the most significant factors influencing COVID-19 cases and deaths. On the other hand, co-morbidities do not appear as consistent significant factors, while the much-debated density parameter plays an insignificant role in the Indian big cities. We would like to emphasize that the results are at best indicative in nature, and for an in-depth understanding of each of these factors and spatial complexity, we require further detailed analysis at a more disaggregated level. © 2021 Institute of Indian Geographers. All rights reserved.