Objectives To evaluate the effect of four-phase national lockdown from March 25 to May 31
in response to the COVID-19 pandemic in India and unmask the state-wise variations in
terms of multiple public health metrics. Design Cohort study (daily time series of case
counts). Setting Observational and population based. Participants Confirmed COVID-19
cases nationally and across 20 states that accounted for> 99% of the current cumulative
case counts in India until 31 May 2020. Exposure Lockdown (non-medical intervention) …

Methods Using data on confirmed COVID-19 cases across 20 states that accounted for more
than 99% of the cumulative case counts in India till May 31, 2020, we illustrate the masking
of state-level trends and highlight the variations across states by presenting evaluative
evidence on some aspects of the COVID-19 outbreak: case-fatality rates, doubling times of
cases, effective reproduction numbers, and the scale of testing. Results The estimated
effective reproduction number R for India was 3.36 (95% confidence interval (CI):[3.03 …