Has India beaten back the pandemic?
The TLDR: Yesterday, a panel of the nation’s top scientists confirmed that India has indeed passed its peak in mid-September. But does this mean we are out of the woods? We look at what the present numbers reveal, lay out the forecasts and strong cautions issued by experts. The period that will determine our future path: festival season!
Tell me what the panel said
The panel: is comprised of seven scientists—including the world-renowned microbiologist Dr Gagandeep Kang. They used a special mathematical model that looks at the rates of infection, recoveries and deaths—and the percentage of patients who have severe diseases. It also maps the trajectory of the disease by accounting for asymptomatic cases. You can check it out here.
The assessment: We passed our peak in mid-September when we had more than a million cases—and were adding over 93,000 new ones each day. If we stay safe and take the required precautions, the pandemic will run its course by February. Four additional findings:
- The lockdown did indeed ‘flatten the curve’. Without it, the number of active cases in India would have peaked at more than 14 million, and we would have witnessed 2.6 million deaths—which is way above our current number, 114,610.
- Key quote: "The peak would have arrived by June. This would have resulted in overwhelming our hospitals and caused widespread panic."
- The return of migrants to villages had “minimal impact”—which “indicates the success of quarantine strategies adopted for the returning migrants.”
- They do not advocate imposition of new lockdowns unless there is a real danger of hospitals etc being overwhelmed.
- According to their estimate, around 30% of the population is currently infected. And that number will go up to 50% by February—which in turn will help stop the spread (presumably due to herd immunity, explained here).
See their projected graph below:
The reasons: As we noted yesterday, the panel does not have an explanation for the slowdown, but offered two related hypotheses:
One: The disease is being spread by a smaller set of ‘super-spreaders’—who have already been infected and now have become immune. They pointed to a Tamil Nadu/Andhra Pradesh study that found over 60,000 of the 85,000 confirmed cases never passed on the infection to others. OTOH, less than 10% of the cases were the cause for 60% of secondary infections.
Two: These ‘super spreaders’ are simply those who have a large number of interactions with a large number of people. Most of us interact with at best 10-15 others in our inner circles—and the disease has run its course within those cliques.
What are the numbers now?
- We reported a daily average of 62,000 cases and 784 deaths over the past week—even while we conducted an average of a million-plus tests each day.
- The number of active infections on Monday: 772,055—which is only 10.23% of our total number of cases.
- Total number of recoveries: 6.6 million. Over 66K recovered in just the past 24 hours on Monday. Our recovery rate has improved to 88.03%.
- The number of deaths during the same period: 579—the lowest in the last three months.
- Our positivity rate—percentage of daily tests that turn up positive—has remained below 8% for the past four days.
- The growth rate of total infections has halved from 92% to 42%.
The state numbers: A big reason for this slowdown is a dramatic turnaround in key states. The growth rate in Chhattisgarh, for example, fell from 388% to 97%. Other rapidly decelerating states: Odisha, Punjab and Haryana. Among states with the highest number of cases—Maharashtra, Karnataka, Tamil Nadu etc.—Andhra Pradesh has shown the fastest improvement. The only state that is still accelerating: Kerala.
Ok, I’m waiting for that big ‘but’...
Lol! Yes, all these happy predictions rely heavily on our good behaviour—especially during festival season which is already upon us. Experts warn that without adequate social distancing right now we will hit a new peak of 2.6 million active infections by the end of October.
Point to note: Kerala’s current woes are directly related to the Onam celebrations in September—which reversed its path to recovery:
“Kerala… experienced a sharp rise in cases in the weeks after Onam, its seven-day average of daily cases climbing from around 2,000 in early September to more than 8,400 by mid-October. Kerala now has the third-largest number of active patients (over 87,000) after Maharashtra’s 247,000 and Karnataka’s 115,000.”
WHO’s regional director responded to the report, saying: “There should be no complacency in view of the declining numbers in recent weeks,” and in fact our “response needs to be strengthened further.”
But we’re opening everything up…
Yes, there are very few restrictions left—other than schools and colleges that remain mostly closed. But High Courts around the country are stepping in to ensure some checks remain in place during the festivities. Take, for instance, West Bengal where Durga Pujo is a big concern.
The ruling: The Calcutta High Court yesterday mandated that no visitors will be allowed within the pandals. Plus: Areas within 10 metres of a big pandal or five metres of a small pandal will be barricaded as “no-entry zones.” But it also noted the near-collapse of social distancing in Bengal over recent weeks:
“If the guidelines issued cannot be implemented in the lead-up to the pujas and the overcrowding in the markets in big city Calcutta and the small towns elsewhere in the state has remained by and large unchecked, the same cannot be allowed to be repeated over the four or five days during the Durga Puja celebrations.”
The big risk: of pandals becoming ‘superspreader’ locations is fairly obvious. Last year’s pujo season saw 2,500 pandals that attracted six million visitors. Also: The state recorded its highest single-day tally of 3,612 cases on October 11—just days before the festival and in the midst of pre-Puja shopping sprees. And it has been recording new single-day peaks ever since.
Point to note: Merely restricting entry into the pandals may not help, say experts: “If there are crowds on the streets there may be more physical closeness and jostling near the entrances of the pandals.” A risk even the Calcutta High Court conceded. But the judges hope that people—faced with the prospect of socially distanced viewing—will opt for a more close up darshan on their television screens instead.
So what's the prediction...
As we said, the panel predicts that the pandemic will recede by February if we stay on course. But other experts say a second peak—similar to the one currently underway in Europe—is almost inevitable:
"If the natural experiments across the world tell us anything, there will be another peak, when and how high is hard to tell. The key is to keep cases and hospitalisations lower than the hospital capacity at a given location and keep practicing the public health guidelines. Let us worship human health, life and dignity this autumn."
Not helping: Other than pujas and festivals, there are several added worries:
- The onset of winter, i.e. flu season—which has already resulted in a 40% spike in the UK. Experts predict 120,000 deaths in the country this winter.
- Also a worry: respiratory problems due to pollution in places like Delhi—which will result in more severe symptoms in new cases.
- Plus: this is also the holiday season. We can expect a big spike in travel across the country—with city residents spreading the disease as they travel to resorts or back home—to villages and smaller towns.
The bottomline: We will be just fine as long as we party like this awesome doctor entertaining patients at a hospital in Assam—in the right spirit and with the right protection.
Reading list
BBC News offers an excellent overview of the panel’s report. Indian Express lays out the expert hypothesis for the slowdown. The Print has the latest charts and numbers.
The Telegraph reports on the Calcutta High Court ruling, and its immediate effect on pandals. India Spend has the best analysis of the risks posed by Durga Pujo. Hindustan Times sums up the risks posed by winter and pollution.