India faces a “serious and intensive” second wave

A woman wearing a face mask passes by a graffiti drawn to raise awareness about coronavirus disease. Graffiti is drawn not only to raise awareness of the coronavirus pandemic, but also to beautify the walls of Vasi (a suburb of Navi Mumbai).

The reported surge in infectious diseases is surprisingly high

By mid-February, healthcare professionals in vast hospitals in western India had begun to believe that the deadly outbreak of the coronavirus pandemic was rapidly mitigating.

The Covid-19 ward of the 1,000-bed non-profit Casturva Hospital in Walda, Maharashtra, had only 28 patients from 180 at the peak of the pandemic last summer. The intensive care unit (ICU) has been emptied for the first time in a few months.

One-third of the 300 beds in the Covid-19 ward have been moved to other wards to accommodate patients suffering from other illnesses.there were Nationwide sharp decline in reported infectious diseases Walda was no exception. In most cities, life has returned to normal. Healthcare professionals and frontline staff have begun to receive jabs of the coronavirus vaccine.

At Kasturba Hospital, health care workers endured a tough year, 70 of whom were infected with the virus and many others suffered from terrible malaise and burnout.

However, the relief between the 650 doctors and nurses turned out to be cruelly short-lived.

“Our celebration was premature,” Dr. SP Calantri, the hospital’s medical director, told me.

India’s second wave has not escaped the hospital, about 50 miles (80 km) southwest of Nagpur, one of India’s most devastated cities.

Covid chart

Covid chart

The Covid-19 ward, which has 100 fewer beds, fills up rapidly again. Over the last few weeks, 170 patients have been hospitalized and the 30-bed ICU is full of highly ill patients. The death toll is increasing.

“The virus seems to be more contagious in the second wave. We admit the whole family infected, and we often see young people under the age of 40 getting sick,” Dr. Kalantri said. say.

“I’ll be back here. The situation is alarming.”

India has more than 12 million recorded coronavirus cases, the third highest in the world after the United States and Brazil. With more than 160,000 reported deaths from infection, case fatality rate (CFR), which measures the death of Covid-19 patients, is one of the lowest in the world.

How deadly is the second wave?

Many experts believe that India faces a catastrophic and deadly second wave threat of the virus.

Covid chart

Covid chart

The doubling rate of infection, or the time it takes to double the number of cases of coronavirus, has decreased from the highest of 590 days on February 28 to less than 170 days on March 30. It was in November that the infection doubled within 170 days.

More than 68,000 cases were reported on Monday, the most reported in a day since October.

How different is the second wave?

Dr. Murad Banaji, a mathematician at Middlesex University in London, who closely tracks the pandemic, said the infection spread so rapidly last May. However, the daily case load reaches thousands, not the current average of 55,000.

Tests are higher than they are today and detection could be better in many parts of India. “But it doesn’t explain the speed of the rise in itself,” he told me.

The surge is prominent in Maharashtra, which accounts for 60% of active cases in India. However, as Dr. Banaji points out, growth is high in almost every state.

Covid chart

Covid chart

And “something unprecedented” has happened in the last two weeks. Cases are growing rapidly in all states reporting more than 100 cases, with the exception of the southern state of Kerala. They are “rapidly expanding epidemics” in low-test states, weakening detection, he says.

What fuels the second wave?

Experts believe that the second wave of India is being driven by people being less cautious and a mixed message by the government.

After being locked up in their homes for nearly a year, many Indians began to gather at crowded weddings and family events without taking precautions.

“It’s behavioral fatigue, which has led to dangerous forms of fatalism and a tendency to risk,” says Dr. Calantri.

On Tuesday, a senior official warned that India “is facing a serious and focused situation, potentially endangering the country as a whole.”

But experts say the government itself must take some of the responsibility for allowing the people to act recklessly.

During the COVID-19 pandemic in Playagraj, Uttar Pradesh, northern India, on March 30, 2021, people danced by throwing colored powder and spraying water during the Holi Festival. I will.

Mass rallies at festivals like Holy can easily lead to a surge in infection

Prime Minister Narendra Modi talked about the need to control the infection and take risks. “National outbreak”.. However, there are no restrictions on free political movements. India is in the midst of five major state elections, attracting top leaders and large crowds. And in recent weeks, religious gatherings, festivals and cricket matches have been allowed to attract tens of thousands of barely masked people.

Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, said: ..

But this may not give us the big picture.

India still denies that the surge is connected Coronavirus variants detected in the population, Many experts Highly contagious British, May play a role.

Serum studies (studies that collect antibodies) show that the majority of people living in Mumbai, Pune, and Delhi have the disease. So why are these cities showing a surge in infectious diseases?

“We need to wonder if they are more contagious or are broad circular variants that can bypass the immune defenses built after previous infections,” Banaji said. The doctor says.

How long can this second wave last?

Experts believe this will be a long distance.

In some states, cases are increasing exponentially.

On March 29, 2021, during a Covid-19 pandemic, closed shops and deserted streets were photographed in Nagpur, Maharashtra.

One of the most devastated cities, Nagpur, had to implement a blockade to contain the spread of the virus.

As in Maharashtra, Gujarat and Punjab, cases have already surged to near or above their previous peaks.

Other regions such as Andhra Pradesh, Bihar, Uttar Pradesh and West Bengal appear to be in the early stages of a surge.

However, if the case continues to rise at its current rate and exceeds its previous peak, Dr. Banaji says the country as a whole has a national peak that is significantly higher than the first peak.

We hope that vaccination will play a role in controlling the waves.

However, the current pace of vaccination (in countries with a population of 1.3 billion or more, over 50 million doses in just over two months) says, “There is almost no effect of delaying the spread of the virus in a month or two.” is. Dr. Banaji says.

Should India be relieved with “low” mortality?

According to doctors, fewer people are dying from the disease in the second wave. This is primarily due to improved clinical management of the disease and greater efficiency.

Dr. Mukherjee says that even with a case fatality rate of 0.1%, people will never get tired of reminding people that more than 500,000 deaths have been reported if the virus is violently executed. I will. Simply put, more infections will inevitably lead to more deaths.

“Is it okay to sacrifice another 500,000 lives and feel the satisfaction of low case fatality?”

She also says that the more the virus spreads, the more likely it is to mutate.

“Discussing low mortality is now wishful thinking,” says Dr. Banaji.

What should India do?

Experts believe India needs to strengthen genome surveillance Track variants and increase vaccination in high-incidence areas and states where elections are being held to prevent the spread of the virus.

On March 27, at the Vaccination Center in Ahmedabad, India, women respond when they are vaccinated with COVISHIELD, a coronavirus disease (COVID-19) vaccine manufactured by the Serum Institute of India.

Experts say India needs to strengthen its immunization drive

You should also target the states most affected by the last wave, as the immunity of the population may be weakened.

If the health care system is overwhelmed, blockades may be required in areas with very high infection rates. And because of the delay in hospitalization and death by Covid, the government must act swiftly and proactively.

“I’m dissatisfied with India’s failure to deploy vaccination drives more aggressively while the curve is in the valley,” says Dr. Mukherjee.

“If the infection is not very high, it is much easier to deploy vaccination. Currently, medical capacity is expanding between vaccination and Covid care.”

Posted on