Hierarchical Modelling of COVID-19 Death Risk in India in the Early Phase of the Pandemic

Abstract We improve upon the modelling of India’s pandemic vulnerability. Our model is multi-disciplinary and recognises the nested levels of the epidemic. We create a model of the risk of severe COVID-19 and death, instead of a model of transmission. Our model allows for socio-demographic-group differentials in risk, obesity and underweight people, morbidity status and other conditioning regional and lifestyle factors. We build a hierarchical multilevel model of severe COVID-19 cases, using three different data sources: the National Family Health Survey for 2015/6, Census data for 2011, and data for COVID-19 deaths obtained cumulatively until June 2020. We provide results for 11 states of India, enabling best-yet targeting of policy actions. COVID-19 deaths in north and central India were higher in areas with older and overweight populations, and were more common among people with pre-existing health conditions, or who smoke, or who live in urban areas. Policy experts may both want to ‘follow World Health Organisation advice’ and yet also use disaggregated and spatially-specific data to improve wellbeing outcomes during the pandemic. The future uses of our innovative data-combining model are numerous.