Abstract: 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 its states. This suggests that region-specific factors are likely to be relevant to the determination of this rate. In this paper we address this issue. A significant aspect of this study is the use of three different measures of the death rate in the empirical exercise. As there is a dispersion of wealth, reflected in per capita income, among the states of India we first studied the relationship between income and death from COVID-19. This revealed none, implying that wealth is not a shield against death from the disease. It led us to investigate the possible impact of public policy towards healthcare, notably expenditure on health and the presence of physical infrastructure in the public sector. 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. We interpret this 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. Our finding has an implication for public policy beyond  the immediate health emergency due to COVID-19. Failing to invest in a public health system while prioritising growth could end up jeopardising health security.