From 500 boxes to 57 lakh. Six months after a nationwide lockdown, Covid-19 is rapidly spreading across India with more testing and development on the vaccine front, but no clarity on when the disease will be controlled, say the scientists.
On March 24, Prime Minister Narendra Modi announced a 21-day shutdown for the entire country, stating that it was the only way to break the chain of infection. At that time, the number of people infected with the SARS-CoV-2 virus was just over 500 and the death toll 12.
Six months later, India has the second highest number of cases in the world after the US, with a case count of 57.32 lakh, 86,508 people testing positive in one day and a total of 91,149 deaths, according to figures. from the Union Ministry of Health on Thursday.
As COVID-19 rages on, and even laymen become familiar with the complexities of RT-PCR tests compared to cheaper but not as reliable rapid antigen tests, American economist and epidemiologist Ramanan Laxminarayan said that there is a “hidden epidemic” even as the pandemic spreads.
He noted that the infection is spreading widely throughout the country, including in rural areas of India, although visibility is lower in places where the evidence is weak or inadequate.
“We will probably see some increases in states like UP and Bihar, but only if RT-PCR testing increases. Right now, we have a hidden epidemic in many parts of the country that have weak health systems, ”the director of the Center for Disease Dynamics, Economics and Policy in Washington told PTI.
“While the infection is spreading at a slower rate than if people were not taking precautions, it is definitely not under control,” Laxminarayan added.
However, he expects the number of cases to start to decline in the next month or two as India approaches some sense of “population immunity.” Since a large part of the population is infected and recovering from the disease, the virus is unlikely to spread.
“Given the precautions that both the government and the people are taking, the epidemic has slowed down. This would mean that we would see a sustained plateau for a while before cases begin to decline, ”Laxminarayan said.
On March 23, a day before the prime minister announced the shutdown and two days before it took effect, India had analyzed 18,383 samples. As of September 22, this had risen to at least 6,62,79,462 tests, both RT-PCR and rapid antigen.
Recoveries have risen to more than 46 lakh people, bringing the national recovery rate to 81.55%. Immunologist Satyajit Rath issued a cautionary note, saying that India is still in the stage of spreading viral infection in communities.
“With global and international travel as the point of origin, the infection first established itself in high-density urban locations, and is now spreading from those to the rest of the country, at widely varying rates,” Rath, from the National Institute of Immunology (NII) in New Delhi, he told PTI.
The infection has never really been under control in India, he said.
“The early, severe, and prolonged blockade somewhat delayed the large-scale establishment of the infection. But “control” has never been a possibility. So we are certainly going to see a growth in the number of infections for quite some time to come, ”Rath added.
Immunologist Vineeta Bal agreed with Rath, saying that the Indian government did not learn much despite experiences from other parts of the world and announced complete “draconian closures” that spanned long periods.
“The leadership in the country lacked their vision and could not have an idea of the basic realities for poor people; or maybe he didn’t care, ”Bal from the Indian Institute of Science, Education and Research in Pune told PTI.
“Due to the great weakening of the public health infrastructure over decades, our preparedness for the management of epidemics was very, very poor. That could have been the only justifiable reason for imposing the blockade, “added Bal.
Laxminarayan took a different point of view. He said there were many positives to the control strategy, including an early recognition of the threat facing India and an early closure, although the implementation and planning could have been much better.
“The lack of early testing really cost the country. With better and more extensive testing from the outset, of which India was fully capable, the lockdown could have been more specific rather than national.
“Since then, there has been a lot of confusion in scientific communication, including the prospects for a vaccine and the utility of hydrochloroquine. The performance in different states has been very varied depending on the capacity of their health system ”, she pointed out.
Rath said the harsh and prolonged lockdown created more problems than it solved.
“It somewhat delayed the large-scale establishment of the infection, but it did so at a disproportionately massive cost of disrupting already fragile livelihoods, the economy and health systems,” he explained.
Bal also noted that India has been paying for its long-term neglect of healthcare infrastructure that should be accessible to the poor and needy.
“While there have been serious efforts to build infrastructure and improve facilities in the last six months, what has been done is still not enough,” he added.
Discussing the vaccine, on which the hopes of billions of people around the world rest, experts said there are nearly 200 efforts around the world to create and test candidates. A large number, growing weekly, are in real efficacy clinical trials.
In India, at least eight candidate vaccines are under development, two of which have entered phase 2 or penultimate phase trials.
“In all likelihood, several vaccines will emerge. Hopefully, the first vaccines will likely be licensed by the end of this calendar year, ”Rath said.
“Also, first-generation vaccines are likely to provide significant but not complete protection, and it will not be clear how long the protection will last and how well the booster vaccine will work,” he said.
Laxminarayan, also an affiliate professor at the University of Washington, added that it is too early to know if any of the vaccine candidates being developed in India will play a significant role in controlling Covid-19 in the country. “However, one should expect that,” he said.
“This is the first disease in human history that I know of where candidate vaccine trials began in less than eight to nine months from the day the virus was identified and its sequence published. This is an important technological achievement, ”added Bal.
The expert noted that in India the pandemic is unlikely to end in the coming months and that the number of infected people will continue to increase.
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