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Has India’s deadly second wave peaked? »Kashmir Media Services

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New Delhi, May 27 (KMS): India has recorded 26 million Covid-19 cases, second only to the United States. This is the epicenter of a pandemic.

The second wave of the last few weeks has overwhelmed the healthcare system, hospitals are struggling to deal with it, and they are deficient in important drugs and oxygen.

However, the infection now seems to be slowing down. On Monday, cases fell below 200,000 for the first time since April 14.

So is the second wave nearing the end?
Experts believe the waves are weakening at the national level.

According to health economist Dr. Rijo M. John, the 7-day moving average of newly reported cases during the wave peaked at 392,000 and has been steadily declining since the last two weeks.

But there are pitfalls.

Even if the second wave appears to be declining across India, it does not apply to all states.

It seems to have reached its peak in states such as Maharashtra, Delhi and Chhattisgarh, but it is still rising in Tamil Nadu, for example, as in many northeastern states. The situation in Andhra Pradesh and West Bengal is unknown.

Therefore, according to Dr. John, the waves are not uniform and there are some states that have not yet found a peak in new cases every day.

Indeed, infections are declining in most major cities.

Dr. Murad Banaji, a mathematician at Middlesex University in London, said: “The total national infection may not yet have peaked, but the number of cases does not tell us, as the infection is now mostly widespread in rural areas,” he said.

According to Dr. Sitabra Singha, a scientist at the Institute of Mathematical Sciences in Chennai, is the overall Indian trend of a sharp decline in active cases due to such heterogeneity at the regional level currently sustainable? Is very difficult to guess.

Bhramar Mukherjee, a biostatistician at the University of Michigan, who closely tracks the pandemic, agreed.

“The idea that the peak has passed may give everyone a false sense of security when their state is actually in crisis mode,” she said. “We need to make it clear that no state is safe yet.”

Does the number of virus reproductions provide any clues?
Basic reproduction number of the virus or R0 (a method of assessing the ability to spread the disease) estimates the number of people infected with one person who is already infected.

The number of effective reproductions or simply R measures the diffusivity. That is, the average number of people infected before one becomes isolated, recovers from illness, or dies.

According to Dr. Shinha, India’s R number fell below 1 on May 9.

“If this is a persistent trend and will decline further in the weeks that follow, yes, we can expect a sharp decline in the number of cases,” said Dr. Shinha.

However, R of India said, “It should be noted that this is not a fluke, as it remained close to 1 throughout the preparation period until the second wave.”

“Therefore, things can get worse if a state with a high R but a low number of active cases at the moment goes up the chart because the epidemic is not properly contained.”

When can the second wave end?
The rate of decrease in cases from the first wave was slow, and active cases began to decrease in late September last year, and this trend continued until the beginning of the second wave in mid-February.

The decline seems to have been faster in the second wave, for unknown reasons.

According to experts, one reason could be that the virus burned out most of the population.

But what about the fact that the second wave appears to have been caused by a mutant strain that may not be completely resistant to previously infected people?

Dr. Mukherjee said her model showed that cases could decrease from 150,000 to 200,000 by the end of May and return to the state of February by the end of July.

But she said it depends heavily on how the Indian state gets out of the local blockade.

According to the World Health Organization, the positive rate should be less than 5% for at least 14 days before a state or country can safely reopen.

Dr. John states that if India succeeds in testing an average of 1.8 million samples per day, a 5% positive rate means about 90,000 new cases per day.

“It will be a healthy sign that things are in control,” he said.

How about the increase in deaths?
India is only the third in the world with more than 300,000 deaths after the United States and Brazil.

The actual death toll can be much higher, as many deaths are not officially recorded.

Dr. Banaji said daily mortality has not yet clearly peaked due to the time lag between the peak cases and the peak mortality.

But again, as is the case, there are significant differences in mortality monitoring and recording between states and between urban and rural areas.

“Even if the number of deaths recorded begins to decline, we need to be careful not to read too much until we stop listening to reports of large numbers of deaths in rural areas,” said Dr. Banaji. I did.

Dr. Mukherjee said more deaths are likely to occur in the months from mid-May to June. The model estimates 100,000 deaths during this period.

How does the second wave of India compare to other countries?
The second wave of both the UK and the US showed sharp rises and falls, both peaking in early January.

However, according to Dr. Shinha, comparisons with the decline of the second wave in other countries may be problematic.

He says most of Europe had a second wave around November-January, which is the normal flu season.

Even in normal years, many people suffer from respiratory problems during this time. So, “Spike wasn’t unexpected at all.”

And the decline from the second wave is occurring at different rates in different countries.

In Germany, in fact, the decline from the peak of the second wave was slower than the decline from the peak of the first wave, Dr. Shinha said. In France, both declines occurred at about the same rate.

“I don’t think the universal rules we’ve collected from the second wave of decline can be applied to India, which is an escape from the waves associated with this particular flu season,” he added. ..

What will happen next?
India will need more subtle and strategic planning to ease the blockade of the second wave.

Experts say indoor dining, pubs, coffee shops, gyms, and similar “high-risk facilities” should be delayed.

Meetings should be allowed outdoors or in a well-ventilated area with less than 10 people. Dr. Mukherjee states that a large summer wedding in an air-conditioned hall is a “virus pit.”

Experts say Indians should not relax their vigilance after the restrictions have been relaxed.
Most importantly, flagging vaccination drives need to speed up, and mobile and high volume vaccination drives need to be deployed.

Also, according to experts, India needs to use real-time epidemiological and sequencing data to closely track new variants and uptics of infection.

The country should also consider pool testing (combining test samples to save time and supply) and wastewater testing (collecting wastewater and analyzing viruses).

Dr. Banaji said it was wrong to think that the virus was out of fuel.

“Immune is not all or zero. People previously infected with early variants of the virus are vulnerable to reinfection and can even infect the disease.”

So far, India has only vaccinated 10% of its population.

“I don’t think we should consider returning to normal until at least 80% of the population can be vaccinated,” said Dr. John.

In the meantime, you can check for infection by maintaining Covid’s proper behavior (masks, social distance, disinfection, avoiding mass gatherings).

“The early declaration of victory over Covid-19 has already had disastrous consequences, and we don’t want to repeat it,” said Dr. Shinha. — Courtesy BBC

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