Dubai: India has said that the next four weeks will be “very, very critical” in the fight against COVID-19. Senior government health official Vinod Kumar Paul warned that the respiratory disease was now spreading much faster than in 2020.
"The pandemic has worsened in the country...There is a serious rise in cases," Paul told reporters.
India added 96,982 new infections on Tuesday to reach a total of 12.7 million cases. It also registered 446 new deaths taking its toll to 165,547.
So why are cases rising in India? The spurt comes after months of gradual decline, which prompted scientists to ask why cases were dropping when there was no such trend around the world.
Global coronavirus figures are not encouraging either.
Coronavirus-related deaths worldwide crossed 3 million on Tuesday and a global resurgence of COVID-19 infections is challenging vaccination efforts across the globe. Brazil accounts for a quarter of worldwide deaths every day.
Scientists have cited various reasons for surging COVID-19 cases in India. Health officials earlier blamed public fatigue with lockdowns and other restrictions as a reason for the rising number of COVID-19 cases, but now believe that infectious variants that were first detected in the United Kingdom and South Africa could be playing a key role.
“The first reason why COVID-19 is spreading so fast in India is the complacency among the people. They think that COVID-19 has been eliminated and are back to celebrating, and taking part in social functions without adhering to protocols and appropriate behavior,” says Dr Rajni Kant, Director, Regional Medical Research Centre & Head, Research Management, Policy, Planning and Coordination, Indian Council of Medical Research (ICMR).
During the recent Holi celebrations in the country, while some northern states observed the restrictions, in many other areas large numbers of youth gathered ignoring all COVID-19 protocols. Recent research has pointed to an increase in coronavirus cases among the 18-45 age group in the second wave of infections in the country.
“The people don’t look serious and alert any more. COVID-19 appropriate behavior is missing as also social distancing,” said Dr Nivedita Gupta, Scientist, Epidemiology and Communicable Diseases Division, ICMR.
Speaking during a video conferencing with Health Ministers of 11 states to review the COVID-19 situation, the minister said: "It is a matter of concern for us... After one year of experience, we have gained knowledge but with time there are some lapses. I believe everything is still under control. If we implement our strategy properly which we followed earlier, then the number of new cases will drop."
"All activities have been resumed. A casual approach emerged in society. Carelessness is a big factor."
The minister said a sudden increase in cases is largely event-driven - including grand weddings, local body elections and farmers' protests.
Vardhan said that the worst affected COVID-19 state is Chhattisgarh with a positivity rate of 20 per cent.
In Punjab, 80 per cent UK variant cases were found, which was confirmed by genome sequencing," he said.
Another reason attributed to the spike in cases is the presence of coronavirus variants. “Though not confirmed, there might be some variant strains of the coronavirus in some parts of the country. But there is no clear-cut study that could prove that,” Dr Kant said.
Dr Gupta added: “Variants, of course, have been detected in India, But there is no evidence whether they are the cause of increased transmission.”
“Even when the variants are there, they can be prevented [from playing havoc] by following COVID-19 appropriate behavior.”
Dr Ragini Mishra, State Epidemiologist, Bihar, blames inter-state migration and international flights for the rising cases.
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“One of the main reasons behind the rising COVID-19 infection is the inter-state migration of people during the Holi festival without following the basic guidelines.
“The second reason could be that the international flights have resumed. Variant strains of coronavirus have been detected in the UK, Spain and Brazil but we are not aware about the nature of these viruses.”
“Lockdown is only a temporary solution; we can’t impose it always (to check the spread of COVID-19). The people will have to be alert but sadly they are back to the old style of functioning.”
Over the past year, restrictions have been eased as conditions improved.
Dr Ranjit Mohan, Consultant - Internal Medicine, Infectious Diseases, Manipal Hospitals, Bengaluru, feels the spurt in cases is directly linked to this. “This rise has been caused to a large extent by the easing of restrictions on travel, the resumption of economic activities, and the reopening of educational centres.
“Election campaigns, political rallies, and socio-cultural gatherings have been on the rise in various states since December 2020. Safety regulations and crowd control norms were often flouted at such venues. The newer strains of the virus have already been identified in patients in various parts of the country and this is a factor fuelling the second wave.
“Given India's vast population, the monumental task of vaccinating all the vulnerable persons will be a healthcare exercise unprecedented in human history. Until this is achieved, the potential for the spread of the infection remains enormous.”
Combination of events
Dr Sachin D, Interventional Pulmonology, Bengaluru, says a combination of events and behavior could be behind the spike.
“By the start of 2021 as COVID-19 cases declined steadily in India, people lowered their guard. They thought they had seen the last of the coronavirus, when in reality the virus was still lingering around waiting for the opportunity to strike again.
“Secondly, international and interstate restrictions were downsized resulting in regular travel, which in turn resulted in surge in cases. Third and most important is the opening up of malls, social gathering, cinemas and events. This enabled a large population coming in close contact resulting in a cluster of COVID-19 cases in the community.
“The current problem of new variants of concern being detected in India is also a major threat as these are possibly more infectious and might cause a more severe disease, although the number of such variants of concern is still negligible in number to be responsible for the current surge.”
What measures are being taken?
The government has so far shied away from reimposing a repeat of nationwide restrictions imposed in March last year - one of the world's toughest lockdowns - as it seeks to revive the economy.
But the Indian capital of New Delhi on Tuesday imposed a night-time curfew until April 30. New Delhi authorities launched the 10pm to 5am curfew a day after India surpassed 100,000 new daily infections for the first time.
New Delhi, which is home to 25 million people, and other major cities have all ordered a clampdown on public movement.
The Delhi regional government said the "sudden increase in COVID-19 cases" and "high positivity rate" meant a night curfew was needed.
Only essential services or people travelling to and from vaccination centres will be allowed on the streets.
Delhi reported 3,548 new positive cases on Monday, still below its peak of nearly 9,000 in November.
India's wealthiest state Maharashtra, which includes Mumbai, on Sunday announced a weekend lockdown and night curfew on its 110 million population.
The state currently accounts for more than half of the new cases reported each day nationwide.
Maharashtra on Monday began shutting shopping malls, cinemas, bars, restaurants, and places of worship, as hospitals are being overrun by patients.
How many people have been vaccinated?
India, with a population of 1.35 billion people, has administered 80.9 million vaccine doses, the most after the United States and China.
Healthcare and similar frontline workers as well as people over 60 have been the main recipients of vaccinations so far. Inoculations of people above 45 began on April 1.
- with inputs from Reuters