While the response to COVID-19 by the Government of India has been more or less uniform across the country, in that a lockdown was imposed throughout, the death rate has varied across the states. This suggests that region-specific factors are likely to be relevant to the determination of this rate. A significant aspect of this study is the use of three different measures of the death rate in the empirical exercise. This showed all three measures of the death rate to be strongly related to health expenditure as a share of the gross domestic product but hardly at all to public health infrastructure. This can be interpreted as a sign of the role of the public health system-comprising medical personnel, infrastructure and protocols-in the prevention of death, with health expenditure as a key determinant of its effectiveness. It has an implication for public policy beyond the immediate health emergency due to COVID-19.