Patients suffering from COVID-19 get treated at a casualty ward in a hospital in New Delhi, April 15, 2021. Photo: Reuters/Danish Siddiqui
New Delhi: On the morning of July 24, India almost 40,000 new COVID-19 cases over the last 24 hours – a jump of 10% that portended the third wave of the epidemic that epidemiologists have said is coming.
Most of the new cases were reported from around a third of the states: Kerala (17,518), Maharashtra (6,753), Odisha (1,917), Tamil Nadu (1,830), Andhra Pradesh (1,747), Karnataka (1,705) Assam (1,621) and Manipur (1,284). All other states reported fewer than a thousand new cases.
Together with the number of people who recovered from COVID-19, the total number of active cases rose by a little over 5,000 in the same period.
Earlier, India’s first COVID-19 wave reached a peak of 1.01 million active cases in mid-September 2020, after which the number of daily new cases began decline, but not below around 1.36 lakh active cases.
Similarly, in early May this year, India’s total number of active cases began to plummet after reaching a staggeringly high peak of 3.7 million cases during the second wave. Public health experts had expressed concern over the fact that the number of active cases didn’t drop below around 4 lakh.
This meant the novel coronavirus, which causes COVID-19, was and is still circulating in some populations. The longer the virus persists in a population, the more opportunities it will have to accumulate mutations that could allow it to evade the human immune system.
The virus’s waxing and waning spread has paralleled India’s bumpy COVID-19 vaccination drive. Thus far, 6.8% of the country’s population has been fully vaccinated – i.e. has received both doses of Covaxin, Covishield or Sputnik V – and 18.5% has received only one dose.
According to the Union health ministry’s CoWIN dashboard, 87.1% of people who have received at least one dose have received Covishield (37.15 crore), 11.9% have received Covaxin (5.1 crore), and 1% have received Sputnik V (3.7 lakh).
Fluctuations in the population of active cases alone may not be cause for concern. For example, the number of active cases increased by 10,000 from July 14 to July 15, by 1,000 from July 20 to July 21 and by 2,000 from July 21 to July 22.
But experts have expressed concerns based on the patchy availability of vaccines, vaccine hesitancy, widespread data manipulation or suppression by governments, emerging virus variants and some pockets of the country still being susceptible to new infections.
In June this year, Reuters published the results of a small poll of 40 experts, saying that most of them believe India’s third COVID-19 outbreak could happen sometime around October-November 2021. Many of them also expected it will be better controlled than the second wave, which was marked by a widespread shortage of liquid medical oxygen.
However, they advised caution and suggested that state governments don’t remove lockdown restrictions too soon.
Currently, Kerala is India’s most affected state; Maharashtra is a distant second and the other states are even further behind. Kerala’s case load curve also shows a clear rising trend. An analysis by Murad Banaji, a mathematician at the Middlesex University who has been studying disease-transmission models, found Kerala’s COVID-19 epidemic has the following attributes:
- Limited disease spread in the first wave
- Detected 20% of cases through tests, versus national average of 4%
- Lower excess mortality than other states
- Lower infection fatality rate than expected
- Vulnerable to short-term surges