Effect of testing and social distancing measures on COVID‐19 deaths in India: Role of pre‐existing socio‐economic factors

• Published date: 01 February 2023
• Author: Ritika Jain,Tirtha Chatterjee
• Date: 01 February 2023
• DOI: http://doi.org/10.1002/pa.2828

RESEARCH ARTICLE

Effect of testing and social distancing measures on COVID-19

deaths in India: Role of pre-existing socio-economic factors

Ritika Jain | Tirtha Chatterjee

Center for Development Studies, Trivandrum,

Kerala, India

Correspondence

Ritika Jain, Centre for Development Studies,

Trivandrum, Kerala 695011, India.

Email: ritika@cds.edu

We examine the effect of testing and social distancing measures on the severity of

COVID19 across Indian states during the 68th day nationwide lockdown period. We

also explore whether pre-existing socio-economic factors such as quality of health

care and the ability to practice social distancing influences the effect of these policy

measures across states. Using daily level data between April 1 and May 31 for 18 of

the major states, we find that both testing and social distancing have a negative

effect on COVID-19 fatalities in India. Further, testing is more helpful in reducing

CFR for states with lower per capita health expenditure and weaker medical infra-

structure. This highlights how ramping up testing can aid states that have a weak

health care system through the detection of infection, contact tracing and isolation.

In contrast, social distancing measures are more effective in states that are less popu-

lous and have lesser people dwelling in single-room houses. Our results confirm the

role of pre-existing institutional factors in shaping the effect of policy actions on

health outcomes.

KEYWORDS

COVID-19, fatality, India, social distancing, testing

1|INTRODUCTION

The outbreak of COVID-19 in 2020 was one of the most severe

health crises that policymakers and governments continue grappling

with even now (Wang & Tang, 2020). With no vaccine or established

cure in place in 2020, most governments had resorted to nonpharma-

ceutical intervention measures ranging from stay-at-home orders to

stringent lockdowns (Demirgüç-Kunt et al., 2020; Tian et al., 2021).

These measures ensured social interaction and mobility restrictions in

common and public spaces. Given the highly infectious nature of

COVID-19, social distancing and lockdowns acted as a cushion in miti-

gating unusual spikes in cases and hence avoided overstressing health

care systems (Arshed et al., 2020; Chetterje, 2020; Yang et al., 2021).

Since the outbreak of the pandemic, there has been a plethora of

research documenting different aspects and impacts of COVID-19.

Several papers have examined various factors, including seasonality

(Liu et al., 2021), lockdown stringency (Hartl et al., 2020), and social

network that determine the spread of COVID-19. However, fewer

studies have focused on exploring deaths due to it (Briggset al., 2021;

Pormohammad et al., 2020;Wangetal.,2021). An essential aspect of

COVID-19 infection is that all deaths occur only in critical cases. Thus,

people with mildto moderate levels of illnessdo not die unless their ill-

ness severity worsens to the critical level (Pormohammad et al., 2020;

Wang et al., 2021). This implies that timely testing can be crucial in

identifyinginfections at early stages,and with sufficient carepostdetec-

tion, it can avert deaths. Additionally, testing also aids in constraining

future infections and deaths by isolatingthe infected and hence advert-

ing further infection spread and severity. Thus, both testing and social

distancing are instrumental in mitigating COVID-19 health costs (Aleta

et al., 2020).

The success of the twin strategies of testing and social distancing

requires coordination between government and citizens (Bhalla,

2021). Aggressive testing and strict lockdowns will fail if citizens do

not isolate after testing positive for COVID-19 or do not comply with

lockdown guidelines. Similarly, in the absence of testing, lockdowns

will not mitigate deaths if the infected are not detected, isolated and

treated. Thus, transparent and timely communication, active participa-

tion of local governments, and collaborations with grassroots-level

Received: 1 October 2020 Revised: 6 June 2022 Accepted: 10 June 2022

DOI: 10.1002/pa.2828

J Public Affairs. 2023;23:e2828. wileyonlinelibrary.com/journal/pa © 2022 John Wiley & Sons Ltd. 1of11

https://doi.org/10.1002/pa.2828