PONE-D-20-34338

District level correlates of COVID-19 pandemic in India

PLOS ONE

Dear Dr. Saikia,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Considering the reviewer comments, I am going with a decision of major revision. Either your respond to reviewer comments or revise according to their suggestions. We would like to see a revised version of the paper. 

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Please submit your revised manuscript by Apr 04 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Srinivas Goli, Ph.D.

Academic Editor

PLOS ONE

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2. Please include a copy of Table A1 which you refer to in your text on page 5.

Additional Editor Comments:

Considering the reviewer comments, I am going with a decision of major revision. Either your respond to reviewer comments or revise according to their suggestions. We would like to see a revised version of the paper.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this manuscript on a very topical issue. The overall idea, writing style and intent is good . The concerns regarding the study itself are however as below:

1. The study analyses data between march to July 2020 and therefore the timeliness of the publication and its findings itself may not resonate with the reader. Apart from the fact that things have changed since this study was done, the pandemic is now on the decline and in reality, widely prevalent in states like Kerala which did not need mention early in the pandemic given the State did so well.

2. It may be pertinent to revisit the timeline and consider maybe an analysis atleast till the start of the winter months to make this a more relevant piece today.

3. The use of open source data , including NFHS is a good step, but NFHS data from next round too is now available.

4. rather than only using above 60 age group, considering the middle age-groups - the working age groups may have also helped give important insights.

5. The Sociodemographic variables did not include one on household income or occupation, while education may have filled some of that gap but skewed the findings.

6. I was intrigued too by the selection of health indicators- fasting glucose , use of tobacco etc for women? Would this not under-represent prevalence across males of important co-variates like smoking? The access to healthcare is another important variable besides the consideration of pre-existing respiratory illness. A lot of selected variables related to immunisation and childhood illness and health indicators while this age group was largely the unaffected age group in the pandemic.

7.Line 283 - has an important spell edit - in terms of CoVID-19 protocols- not wearing the mask in pubic place to be edited to public place!

8. The overall intention of district-level correlates determining oVID-19 and feeding policy and management of the pandemic will be well-served if the right variables are selected for the analyses, and over a longer time window to help district-level planning and management.

9. Use of the infection ration is welcome but the correlates and determinants need addressing...

10. Thank you for the clear and succinct writing style but do revisit some of the points addressed above.

Reviewer #2: The study on “District level correlates of COVID-19 pandemic in India” about exploring the hot and cold spots in terms of districts and finding the socio-economic, demographic and health-related determinants of COVID-19 disease in India. The study uses publicly available data from COVID19 India API. The study uses descriptive statistics of COVID-19 disease and linear regression model using indicators from NFHS-4 and Census of India to establish the findings. The outcomes of the study are based on three major findings from: (a) trend analysis of COVID-19 cases, (b) infection ratio (hot and cold spots) and Moran’s Index and (c) determinants based on regression.

The study needs to give attention to these corrections:

Main comments:

1) The Introduction section, Summary and Discussion, and Conclusion section need to be strengthened. Introduction section may be well connected with the other sections of the manuscript.

2) Trend analysis, infection ratio, hot and cold spots, and regression results are interpreted independently. Trend analysis may be interpreted for its plausible role of the concentration of COVID-19 cases in a few districts of India and infection ratio. Authors may explain what are the implications of manifold rise of recovery rates until July 2020 on the infection ratio or the implications of increase of average deceased cases by 734 times during studied period.

3) A large focus is given to explaining unadjusted beta coefficients from the results of regression model. Rather, the adjusted figures may be given more writing space. Independent variables are in percent in the linear regression model. Understanding that, the variables effects are interpreted in terms of levels. The interpretation of Table 2 may be revised.

4) In Table 2, authors may check the significance values and the respective confidence interval for unadjusted coefficients. These may be serious errors.

5) The manuscript may conclude strongly about the four determinants connecting it with the trend analysis, infection ratio and hot and cold spots.

6) The manuscript needs an English language editing and flow may be maintained.

Minor comments:

A) In abstract section, (1) the full form of COVID-19 disease may be written correctly, (2) whether authors have used prevalence rate from the crowdsourced data? (3) authors may specific reasons for using data from 14 March 2020, (4) authors may mention crucial information for policy discourse in the conclusion.

B) In Introduction section, (1) line no. 4-6: authors please check the sentence and growth rate of COVID-19 disease in the first three months from Jan to Mar 2020 perhaps, (2) line no. 8-10: check for definite measures, the reduction in doubling time is not apparent from Fig S1, and the second part of the same sentence is contradictory to the first part, (3) line no. 18-19: adults being less susceptible to disease compared to older is based on some assumptions, (4) line no. 22-23: Co-morbid situations are important but reference is missing, (5) line no. 26-27: under-five mortality and nutritional status children may not be associated with the spread of disease.

C) In Outcome variable section, (1) line no. 72, authors check formula.

D) In Spatial Analysis section, (1) line no. 111: description of “low-low” is not given in text.

E) In Result section, (1) line no. 114: authors may check the source used for data if they wish to write “every day since”, (2) line no. 116: Fig S2 and Table S1 provide the same results, (3) line no. 118-121: based on average bi-weekly and base numbers, authors may choose a different growth rate, also Table A1 is not found in text, (4) line no. 129-130: per one hundred thousand versus 100 thousand, authors may use same wording, (5) line no. 146-147: how one confirmed case and positive case are different? (6) line no. 193-194: the interpretation of likelihood in case of linear regression results, (7) line no. 195: which levels of infrastructure has higher effects is not clear from text and Table 2.

F) In Summary and Discussion section, (1) line no. 213: if demographic transition is an appropriate reason, then assumption need to be mentioned in this manuscript, (2) line no. 249: undefined term “unavoidable economic activities”, (3) line no. 259: study design may not be appropriate reason for not explaining co-morbidities in association with disease.

G) In Conclusion section, (1) line no. 267: understanding of disease only by Spatial distribution and its determinants is not supported by the analysis.

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Review_PLOSONE_34338.docx

PONE-D-20-34338R1

District level correlates of COVID-19 pandemic in India during March-October 2020

PLOS ONE

Dear Dr. Saikia,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

ACADEMIC EDITOR: Considering concerns raised by the reviewers, I am sending this paper back to you for necessary amendments. I request the authors to carefully consider both the reviewers suggestions and make desired changes before submitting the revision. 

==============================

Please submit your revised manuscript by Jul 16 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Srinivas Goli, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

Considering concerns raised by the reviewers, I am sending this paper back to authors for necessary amendments. I request the authors to carefully consider both the reviewers suggestions and make desired changes before submitting the revision.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: (No Response)

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: No

Reviewer #3: Partly

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: N/A

Reviewer #3: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: No

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The study on “District level correlates of COVID-19 pandemic in India” about exploring the hot and cold spots in terms of districts and finding the socio-economic, demographic and health-related determinants of COVID-19 disease in India has remained more or less at the same position.

Authors may consider these suggestions for future works.

1) The result section is crowded with minor small descriptions such as data description of recovery rates, death rates, which is nowhere connected with any succeeding results, state level and then district level infection ratios, and then again descriptive statistics as shown in Table 1 from which standard deviation for many considered variables are described.

2) The regression results are very poorly summarised. Researchers have ignored the importance of adjusted over unadjusted models. The results clearly warn through the change in P values and coefficients while showing the case of unadjusted and adjusted models. It is percent population in 15-59 years, population density, % urban population, testing, and stunting which are outcomes from regression analysis but not adequately explained in result as well as discussion section of the manuscript.

3) The introduction should be updated with more evidences from the works of literature. The transmission rate of virus of COVID-19 disease is higher during initial times whereas authors have considered it slow based on some works of literature. The widespread of media coverage are not supported by good references. These are controversial and dithering statements given the pandemic.

4) Authors have not taken the numbers and its interpretation seriously. There is ignorance on the part of authors.

5) The term bi-weekly is cumulative or point COVID-19 cases, it is not clear in the text. The bi-weekly numbers of 11 lakhs are shown in Appendix S1 which reveals the bi-weekly peak, as terminology used by authors, was 1244430 in the next week in contrast to the previous week mentioned in text. The Figure 1 and Table S1 shows average numbers; this bi-weekly peak/number is not a meaningful description when original COVID19 data from the API itself provides a more robust measurement.

6) The percent of women whose husbands are away for the last six months is taken as the proxy of out-migration but not taken as one of the variables in analysis. However, percent of marginal workers is considered with the same max and min values of that variable as explained in text.

7) Again, ‘positive (absolute values)’ wording is used in the panel A in Fig 2 and 3. Legends of the maps shown in Fig 2 are inconsistent with Fig 3.

8) The write-up needs to be much more scientific and richer in content which is lacking throughout.

Reviewer #3: The study is important, interesting and generally well written. I have some small recommendations which should be addressedbefore it can be published.

Comments:

1. This study clearly states that it's analysis focuses on the months between July and October 2020. Clearly the covid-19 pandemic is ever-changing and India is clearly in the midst of a catastrophic second wave. The authors have clearly put much effort into their paper so to expect them to include data beyond October 2020 is unreasonable. Instead, the authors should provide a comparison between the first and second waves in their discussion - perhaps comparing case numbers in districts during the first wave to the second? Perhaps discussing which of the factors discussed in this paper may have contirbuted to this devastating second wave?

2. As with a fellow reviewer I'm confused by the use of health related variables focussing only on women (% women with diabetes, % women with cancer, % women consuming tobacco etc). As men are at greater risk of covid-19 why have they been excluded from these analyses? Why also are socioeconomic variables such as religion (% hindu) used? There may be good reasons for this, however the manuscript would benefit from the explanation of such reasons.

3. The manuscript makes no mention of the causative agent of covid-19, SARS-CoV-2. At least one sentence explaining that SARS-CoV-2 is the virus whilst covid-19 is the disease cuased by the virus. Furthermore, the authors must make an effort to discriminate SARS-CoV-2 and covid-19 when discussing spread. For instance, the authors says "COVID-19 has been spreading rapidly in the urban areas". This is inaccurate, SARS-CoV-2 has been spreading.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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Attachments

Attachment

Submitted filename: Review_PLOSONE_34338_2.docx

District level correlates of COVID-19 pandemic in India during March-October 2020

PONE-D-20-34338R2

Dear Dr. Saikia,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Srinivas Goli, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Authors revised the paper according to reviewers comments, thus I am recommending this paper.

Reviewers' comments: