India has plunged into its second wave – and this time, with new variants, fatigue setting in among the population and several massive religious meetings taking place, it threatens to be worse than the first.
The country registered 103,558 new cases on Monday, according to India’s Ministry of Health – the highest number in a single day since the pandemic began.
But cases started to increase again in early March. Now, less than two months later, daily cases have increased more than tenfold.
“There is a shortage of private beds and beds in the main government institutions,” said Deepak Baid, president of the Mumbai Medical Consultants Association. “Since there are no beds available, in fact many patients are still in the home quarantine, patients are admitted to hospitals outside Covid when they are positive.”
“Covid cases in India are increasing very sharply right now, very different from a year ago, when the rate of increase seemed much less rapid,” said Ramanan Laxminarayan of the Center for Disease Dynamics, Economics and Policy in New Delhi.
A big difference is that when the first wave started to emerge in late spring last year, the country was emerging from a blockade that lasted for months, which closed the state borders, ended national travel and paralyzed business. Strict blocking and gradual and phased easing of restrictions “significantly slowed” infections, said Laxminarayan – which “is not the case now”.
There are some factors that can help to lessen the impact this time: the medical infrastructure is better prepared now and the team has experience on their side, which can decrease the mortality rate even if it increases the case rate. The country’s vaccination program is also underway, with two vaccines approved for use. And in large cities that have been hit hard before, like Delhi and Mumbai, people who have been infected before may have some natural immunity.
Even so, said Laxminarayan, “this will not be enough to prevent a second wave of cases”.
Locks and curfews
Authorities rushed to reinstate restrictions over the weekend in the most affected states. The western state of Maharashtra is the top concern, accounting for nearly 60% of all new cases in India in the past two weeks, officials said. And eight of the ten most affected districts across the country are in Maharashtra, including its capital, Mumbai.
The entire state will undergo new restrictions starting on Monday, including a daily curfew at night and rigid blockades on weekends, Cabinet Minister Nawab Malik announced on Sunday. Public spaces such as parks, shopping malls, cinemas and religious centers are closed until further notice and all restaurants can only serve take-out food.
Several other states have also seen the virus spread in recent weeks, including Karnataka, Chhattisgarh, Kerala and Punjab.
Modi also sent a team of public health experts to be sent to Maharashtra, instructing the hard-hit states to take steps so that “the collective gains of Covid-19 management in the country in the past 15 months are not wasted,” the statement said. .
There are several reasons why Maharashtra saw such a dramatic peak, said Randeep Guleria, director of the All India Institute of Medical Sciences. As one of the most populous cities in the country, with around 18.3 million inhabitants, public spaces tend to be crowded.
It is also an industrial and transportation center, home to international companies and many migrant workers, which means that there are frequent movements in and out of the state.
Maharashtra also has a high level of testing across the state and a good health system, which may mean it is better at detecting cases than in other parts of the country, said Laxminarayan. “You see this consistently, that states with better health systems and more urbanized populations will see more cases of Covid,” he said.
And across India, the success of the winter, the launch of the vaccine and the feeling of fatigue culminated in a dangerous complacency, said Oommen Kurian, senior researcher and head of the health initiative at the Observer Research Foundation in New Delhi. The authorities were less alert, people went out more and the public became more free with care such as social detachment and wearing masks.
“With all this discussion about vaccines and India’s role as a major producer, many people think the virus is losing the battle and is letting its guard down,” said Kurian. “Unfortunately, that doesn’t seem to be the case.”
Great meetings and new variants
Experts warn that cases may skyrocket in the coming weeks, due to a series of large gatherings and congregations in various states.
The biggest and best known is the Kumbh Mela, one of the most important Hindu festivals. The largest religious pilgrimage on Earth is taking place this year in the city of Haridwar, in the state of Uttarkhand. The daily attendance is estimated to be up to one million people on “normal” days and up to five million visitors on “auspicious” days.
State and federal authorities have already taken steps to help contain the risk – visitors must register online and provide a negative Covid-19 test to participate in the sacred baths in the Ganges. Thousands of police were deployed for security and surveillance during the festival, with the public urged to follow caution and wear masks.
But experts and medical professionals fear that this may not be enough to prevent an increase in cases. After all, most people take off their masks when they dive into the sacred waters, and the photos show crowds crowded during night prayers and other ceremonies.
There are also state elections taking place across the country for legislative assemblies, local bodies and both houses of parliament. Many political figures joined the campaign to hold rallies, often speaking to crowds of people gathered.
On Saturday, the day before his Covid-19 meeting with federal officials, Prime Minister Modi attended a rally in Tamulpur, in northeastern Assam, campaigning for the ruling Bharatiya Janata party. Videos posted on Modi’s social media accounts show hundreds, if not thousands, of participants applauding and cheering, many without masks.
All of the big gatherings – not just religious or political ones – are “at risk of becoming events that spread,” said Laxminarayan, who pointed to massive marriages that have also occurred.