TY - JOUR AU - Pons-Salort, Margarita AU - John, Jacob AU - Watson, Oliver AU - Brazeau, Nicholas AU - Verity, Robert AU - Kang, Gagandeep AU - Grassly, Nicholas T1 - Reassessing Reported Deaths and Estimated Infection Attack Rate during the First 6 Months of the COVID-19 Epidemic, Delhi, India T2 - Emerging Infectious Disease journal PY - 2022 VL - 28 IS - 4 SP - 759 SN - 1080-6059 AB - India reported >10 million coronavirus disease (COVID-19) cases and 149,000 deaths in 2020. To reassess reported deaths and estimate incidence rates during the first 6 months of the epidemic, we used a severe acute respiratory syndrome coronavirus 2 transmission model fit to data from 3 serosurveys in Delhi and time-series documentation of reported deaths. We estimated 48.7% (95% credible interval 22.1%–76.8%) cumulative infection in the population through the end of September 2020. Using an age-adjusted overall infection fatality ratio based on age-specific estimates from mostly high-income countries, we estimated that just 15.0% (95% credible interval 9.3%–34.0%) of COVID-19 deaths had been reported, indicating either substantial underreporting or lower age-specific infection-fatality ratios in India than in high-income countries. Despite the estimated high attack rate, additional epidemic waves occurred in late 2020 and April–May 2021. Future dynamics will depend on the duration of natural and vaccine-induced immunity and their effectiveness against new variants. KW - COVID-19 KW - coronavirus disease KW - severe acute respiratory syndrome coronavirus 2 KW - SARS-CoV-2 KW - infection attack rate KW - infection fatality ratio KW - epidemics KW - mathematical modeling KW - respiratory infections KW - viruses KW - India KW - zoonoses DO - 10.3201/eid2804.210879 UR - https://wwwnc.cdc.gov/eid/article/28/4/21-0879_article ER - End of Reference