‘Much safer now’: Is India past the worst of COVID pandemic?

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Despite the long festive season and falling temperatures, the country seems to have dodged another deadly wave. or is it?

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New Delhi, India – On Tuesday, India reported 7,579 coronavirus cases – the lowest increase in 543 days, despite huge festive gatherings in recent weeks.

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“Even after [Hindu festival of] Diwali, we are not seeing a surge,” Dr MD Gupte, former director of the National Institute of Epidemiology, was quoted as saying in media reports, thanks to antibodies in a vast majority of Indians mainly through natural infection. was attributed to the presence of

“I think we are much safer now,” Gupte said.

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According to government surveys, nearly 70 per cent of Indians were naturally infected by July, after a record increase in infections and deaths during a brutal second wave in April and May.

In a statement last week, the health ministry said that active cases accounted for less than one per cent of the total cases, the lowest since March 2020.

Even as India emerges from its festive season and is currently in the grip of air pollution and falling temperatures – conditions considered optimal for a surge in coronavirus infections – it looks like the country has made another move. Dodge the deadly wave.

For the past 21 weeks, India has registered less than 50,000 cases a day. Since the second week of October, it has remained below 20,000 – a far cry from the second wave of fatalities in April and May this year, with more than 400,000 daily cases at their peak.

Government and health experts feared a third wave of the virus, with media reports in August and September warning of a peak of the wave in October or November.

One of those reports quoted the National Institute of Disaster Management (NIDM) under India’s home ministry warning of a third wave in October. The report, published in mid-August and submitted to the Prime Minister’s Office, cited government experts and institutions warning of an imminent wave.

Among those cited in the report was K Vijay Raghavan, the government’s principal scientific adviser, who said during a May 2021 press briefing that the third COVID-19 wave was “inevitable” and children would be at greater risk.

The report highlights possible scenarios projected by the Indian Institute of Technology – Kanpur, one of India’s premier government institutions, whose study estimated more than 300,000 coronavirus cases a day – compared to the peaks of the second wave. Less – in October if there were no restrictions. Place.

With strict interventions, a peak of over 200,000 per day was estimated at the end of October.

However, with no such increase, experts are now talking about a scenario where the disease could enter an “endemic phase” in India.

“We need to understand that the disease is nowhere close to being eradicated. It exists and continues to spread. It is endemic only if it does not take on the proportions of an epidemic,” said global coordinator of the People’s Health Movement and T Sundararaman, former executive director of the National Health Systems Resource Center.

For this to happen, Sundararaman explains, the R0 value of COVID-19 must remain below 1. In epidemiology, R0 or R-naught is the average number of people that an infected person can transmit a disease to. In short, it indicates how contagious the infectious disease is.

Some recent studies have put this number for the delta variant, the coronavirus responsible for the second wave in India, between 5 and 8 – meaning it is as contagious as chickenpox.

“It will be a low level of transmission that can persist indefinitely, like we get the flu or typhoid. In an endemic, there is no endpoint,” Sundararaman said, describing what an endemic COVID-19 scenario could look like.

In February this year, a survey in the journal Nature found an overwhelming majority – about 90 percent – of scientists “felt that SARS-CoV-2 is either very likely or likely to become an endemic virus”. Months later, scientists in India are anticipating at least the same.

Noted virologist and retired professor Dr T Jacob John, who claims, “The Himalayan magnitude of the second wave brought us to what epidemiologists call the ‘herd immunity threshold’, the point at which the epidemic is reduced to a ‘endemic’ with low and stable numbers. ‘ phase has to be taken.” Al Jazeera said that India is the first country to reach the endemic phase.

While some are confident about the endemicity of COVID-19, others remain cautious.

Shahid Jameel, an eminent virologist and research fellow at Green Templeton College, University of Oxford, told Al Jazeera: “I am cautious to say that India has reached endemicity because a bad variant emerging anywhere could change this balance. “

Fear of emerging variants

Earlier this month, fears of another lockdown were rumored as the southern state of Karnataka reported seven cases of the new Delta Plus variant, AY.4.2, a sub-lineage of the Delta variant.

According to news reports, around 40 cases of AY.4.2 were reported in at least six states.

Later, the Indian SARS-CoV-2 Genomics Consortium (INSACOG) stated that the frequency of AY.4.2 is very low (less than 0.1 percent of all variants of concern and interest) in India.

The Delta lineage is said to be driving the third wave in the United Kingdom. Sub-lineage AY.4.2, estimated to be 10-15 percent more permeable than Delta, is tearing through Europe, triggering restrictions amid rising case rates and hospital admissions.

According to the UK Health Protection Agency (UKHSA), the prevalence of the variant in the UK has risen to around 13 per cent of delta cases. Delta Plus, which was first discovered in July, was declared a “version under investigation” by the UKHSA last month.

“Clinical cases in Western countries are now among the non-immune (mostly uninfected). This means that population immunity (or herd immunity) due to past infections remains low, such that they are indebted to the delta variant,” said Jacob John.

UKHSA data shows the ongoing boom is driven by a younger, unvaccinated group. Jameel placed the blame on “poor compliance” and “opening up” of the country, where infections are driven by school-going children and teens.

“But the serious illness and mortality rate is very low. This is due to high adult vaccination rates and naturally mild infections among young people,” Jameel said.

vaccines to protect

According to virologist Jacob John, the delta had a relatively free run in India. And with two-dose vaccination slowly climbing up, it has added to a lot of herd immunity due to a massive second wave.

Last month, Mumbai, one of India’s worst-hit cities, reported no deaths for the first time since the start of the pandemic. New Delhi has already seen several zero-death days in the past few months. The two cities most affected by the second wave have high seropositivity (a sign of infection) in their populations.

“We found that 90 per cent of the vaccinated people had antibodies and about 79 per cent of the non-vaccinated people were found to have antibodies,” said Brihanmumbai Municipal Corporation (BMC) deputy executive health officer Dr Daksha Shah.

Shah points to the last serosurvey conducted by the BMC, released in September, which found that 86 per cent of Mumbai residents had antibodies against the coronavirus.

“The whole economy has opened up, from trains, buses to theatres. Most restrictions have been eased. Even after this the cases are not increasing. And of course, there is the effect of vaccination,” Shah said.

New Delhi’s recent serosurvey – its sixth – reported more than 95 percent seropositivity in samples from each of its districts due to vaccination or previous infection. Despite the lifting of all restrictions, the national capital has consistently reported some new cases and deaths.

In eastern India, Kolkata saw a spurt in daily cases after the Hindu festival of Durga Puja.

“Cases are falling, with official figures showing that in more hospitals, we may see empty beds again. There was a rise in cases after Pujo, but never a furious wave like the second wave,” Kolkata-based Dr Arjun Dasgupta, who is the president of the West Bengal Doctors Forum, told Al Jazeera.

“In exchange for millions of deaths, immunity and the first dose of vaccination together may have done the trick.”

The Government of India celebrated an important milestone of delivering one billion COVID-19 vaccine doses on 21 October, Prime Minister Narendra Modi celebrated it with an address to the nation. This month, the government lauded itself for vaccinating nearly 81 percent of the eligible adult population with the first dose.

Despite the initial celebrations, only about 40 percent of the population is estimated to be fully immunized and millions are skipping their second dose. Government data shows that more than 120 million people were unwilling to take their second dose.

India has recorded a total of 34.5 million COVID-19 cases, second only to the United States. The deaths rose by 236 to 466,147 in the last 24 hours.

Meanwhile, India’s reliance on digital solutions for its mega immunization plan has been criticized for being exclusionary and limited in approach.

On 2 November, in an effort to expedite immunizations and have second-dose vaccinations, the Indian government launched a month-long door-to-door campaign called “Har Ghar Dastak” (Knock on Every Door).

“Vaccine hesitancy is a serious problem. You can’t do it with OTP [one-time passwords] and apps. They [people] Need to go door to door to find out. We have an army of people who do miracles. That’s how we eradicated smallpox and polio,” Dasgupta said.

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