Is the Coronavirus pandemic finally coming to an end in India?
Is the pandemic firmly in retreat in a country where many early modellers had predicted millions of deaths due to Covid-19?
In October, I had written extensively on why the pandemic appeared to be slowing down in India. Cases had hit a record peak in the middle of September – there were more than a million active cases. After that daily deaths and caseloads began declining despite consistent testing and some short and fierce spikes of infections in cities like Delhi.
The situation has markedly improved since.
By the middle of last week, India was barely counting an average of 10,000 Covid cases every day. The seven-day rolling average of daily deaths from the disease slid to below 100. More than half of India’s states were not reporting any Covid deaths. On Tuesday, Delhi, once an infection hotspot, did not record a single Covid death, for the first time in 10 months.
So far, India has recorded more than 10 million infections – the second-highest in the world after the US. There have been over 150,000 reported deaths from the disease. The number of deaths per million people stands at 112, much lower than what has been reported in Europe or North America. It is also clear that the decline in cases is not because of lower testing.
Most pandemics typically rise and fall in a bell-shaped curve. India has been no exception. Also, it has seen a high proportion of cases and deaths of people above the age of 65 living in densely packed cities, hewing to infection trends around the world.
“There’s nothing unusual about infections dropping in India. There’s no miracle here,” says Dr Shahid Jameel, a leading virologist.
Experts say there’s no dearth of possible causes – explained below – for the relatively low severity of the disease and its toll.
So why are cases dropping?
Experts say there could be a couple of different reasons.
For one, India has seen a “patchwork” pandemic with cases waxing and waning at different times in different parts of the country.
More people have been infected in cities – especially in packed slums – and in developed, urbanised districts than in smaller towns or villages. In all of these places, their exposure to the virus has varied significantly. Cases have now slowed down in most urban areas, but rural India still remains a bit of a mystery.
Is the low death rate a mystery?
Most scientists believe that many more Indians died of the infection than what the official figures reveal. India has a poor record of certifying deaths and a large number of people die at home.
But even such a scale of under-reporting has not caused public panic or overwhelmed hospitals. Consider this. India has some 600,000 villages. Even one undiagnosed and unreported death from Covid in each village every day would not overwhelm the public health system.
India imposed a sweeping, early shutdown in late March to halt the spread of the virus. Scientists believe that the shutdown, which stretched to nearly 70 days, did prevent a lot of infections and deaths.
Transmission slowed in the badly-hit cities because of the expanded use of face masks, physical distancing, school and office closures and people working from home.
Scientists have also attributed lower fatalities to a young population, protective immunity, a vast rural populace with negligible links with cities, genetics, poor hygiene, and ample lung protecting protein.
Has India avoided a second wave?
It’s too early to say.
Some experts fear that India could see a spurt in infections with the onset of the monsoons, which also marks the beginning of the country’s influenza season. It lasts from June to September and wreaks flood havoc across South Asia every year.
“The beginning of the upcoming monsoon season is going to be critical. We can only make an informed assessment on whether the pandemic has truly run its course in India after the season is over, ” says an epidemiologist who preferred to be unnamed.
The real elephants in the room, say scientists, are the new variants of the virus identified in South Africa, Brazil and the UK.
Since a large number of Indians have still not been exposed to Covid-19, a dominant strain could easily travel to relatively uninfected areas and trigger fresh outbreaks.
India had reported more than 160 cases of the UK variant until the end of January. It’s not clear whether the other variants are already circulating in the country. India could also easily have home-grown variants.