COVID- 19 Mortality and the Role of Social Capital

How can we explain the low death rates in some states that have a very high number of positive cases of COVID-19?

And still, they have a very low death rate compared to other states. 

At least one way of explaining that would be by exploring the concept of social capital. 

Almost one and a half years ago, on 24th Jan 2020, a 21-year-old lady who was a fourth-year medical student in a medical college in Wuhan, China reached Trissur in Kerala, her hometown that also happened to be my hometown. Two days after reaching Trissur, she developed a dry cough and was immediately admitted to the Trissur medical college hospital. 

By 29 January 2020, we came to know that the pandemic had reached  Kerala and this 21-year-old became the first case of Covid-19 in India. Soon Covid- 19 appeared in other parts of India and we had the first wave, the lockdown and when we thought we did manage the pandemic well, we had the second wave. Our healthcare infrastructure crumpled and we struggled to manage the spread of the disease and the death rate increased exponentially. 

Most of us now know that we might have to learn to live with the virus. Thus it becomes important that we look at what helped some states to manage this pandemic relatively well, better than others, and kept the death rate low. 


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When we look at the data, total positives cases and total deaths,  we see that Maharashtra has the highest number of total positive cases followed by Karnataka and then Kerala. When we look at the total death rates, it’s again Maharashtra at the top, followed by Karnataka and then Delhi.  Kerala which is ranked 3rd in the case total number of positive cases is ranked 10th when it comes to the total number of deaths.

What could be the reason for Kerala’s low number of deaths when they have a very high number of positive cases? 

While there could be many reasons, I would like to explore one specific ad important aspect that we often overlook when we try to answer a question like this. Our usual answers are about the quality of leadership, the healthcare infrastructure, the resistance of the people, etc.  I am sure all of these aspects will have an impact on the death rate. 

One of the factors, something that we completely miss out on,  that could influence the lower mortality rate could be the Social Capital embedded in that society or state. What exactly is social capital?

Social Capital is the interpersonal relations, social networks, shared sense of identity, and trust within a society.  In other words, social capital refers to features in a social organisation such as trust, norms, and networks that can improve the efficiency of the organisation. The concept of social capital was initially defined by sociologists as the aggregated value of connections between individuals and the norms of reciprocity developed from the network. Social capital is a commonly identified trait of social organization and includes trust between individuals and interpersonal connections that could increase the efficiency of society and create platforms that could be beneficial to all the parties. 

Social Network Analysis(SNA) and Organisational Network Analysis(ONA) helps us understand the social capital of a community or Organisation. 

In the book “Building Resilience- Social capital in post-disaster recovery”  published in 2012, Daniel P Aldrich Professor at Northeastern University,  Boston mentioned that people with strong social networks experience faster recoveries and have access to needed information, tools, and assistance. Communities and neighbourhoods with little social capital may find themselves unable to keep up with their counterparts with these deep networks.  His observation was about any kind of disaster not specifically about COVID-19. 

In 2005 he and his family had their home, car, and all of their material possessions in New Orleans destroyed by Hurricane Katrina and began studying what makes communities and neighbourhoods more resilient. He published the book “Building Resilience” to share these insights on the role of friends, neighbours, and social cohesion after the crisis. After Japan was hit by the devastating triple disasters of an earthquake, tsunami, and nuclear meltdown, Aldrich wrote another book BLACK WAVE about the factors that helped people and communities bounce back, again emphasizing the importance of Social Capital. 

In the book “Black Wave” he mentioned that Individuals and communities with stronger networks and better governance had higher survival rates and accelerated recoveries. Less-connected communities with fewer such ties faced harder recovery processes and lower survival rates.

So if Kerala has a lower mortality rate, the social capital of Kerala, the social cohesion, and social identity,  possibly must be higher than other states. Then what could explain the higher infection numbers of Kerala?  Most probably that is also the factor of Social Capital.  Because social capital is all about the strength of relationships, connections, and networks, the spread of the virus also will be easy, the way help, resources, and knowledge spread. 

Combined with the high population density and a large number of people from other states and countries landing up in Kerala, the number of positive cases could be high but they have managed to bring down the mortality rates low compared to other states. So the social capital can be positively correlated to the higher spread of the virus and also positively correlated to the low mortality rate in Kerala. 

This reminds us that we need to focus on social capital more both in our societies and in our organisations so that we would be able to demonstrate resilience and reduce the mortality rate.

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