Measuring the infection fatality rate (IFR) for SARS-CoV-2 has been a major research objective since the beginning of the global pandemic. Reliable IFR estimates are essential for policy decisions on non-pharmaceutical interventions and vaccine allocation, and comparison of waves and variants. IFR estimates almost universally rely on large-scale seroprevalence samples drawn from the general population, matched to official death data. Because of these data requirements, the vast majority of age-specific IFR estimates are based on data from high-income countries (HICs); meta-analyses estimating age-specific IFR in low-income and middle-income countries (LMICs) rely on untested assumptions that key epidemiological characteristics (eg, transmission dynamics, age-specific death rate) in HICs are generalisable to low-income settings.

Studies measuring IFR in LMICs mostly report age-aggregated IFR, which are difficult to compare across contexts; the age pattern of infection may vary and aggregate IFRs skew higher where older people contract a larger share of infections. This study provides representative estimates of the age-specific COVID-19 infection fatality rate (IFR) in four socioeconomically diverse regions of India, a major lower-middle-income country, using the standard method for estimating IFR.

The paper was published in BMJ and can be accessed here.

Note: This work was done by the author/s when they were a part of the IDFC Institute and is republished here with permission.