Every other day, India is creating grim milestones with the number of new Covid-19 cases. For the past three consecutive days, the country has witnessed over a lakh new cases daily, with new records of ‘biggest-ever daily cases’ being demolished every next morning for another fresh and deadlier record. Last Sunday, with 103,796 new cases, India became only the second country after the United States to hit the 100,000 daily cases mark. Beginning April 6, the new cases are constantly above the 1 lakh mark, with 1.15 lakh, 1.26 lakh and 1.32 lakh fresh cases on Tuesday, Wednesday and Thursday, respectively – a strong enough signal to conclude that India is in an intense grip of a second wave of the deadly novel coronavirus.
In just the last fortnight, we have added 5.56 lakh new active cases, a rise of over 100 per cent over the March 25, 2021 figure. 6,700 deaths were reported in the same period.
What is happening in India currently, though, is not unique. Other countries affected by the pandemic too have gone through various successive waves of raging infections. Experts had anticipated well in advance that India may be in for another, sooner or later. And now, we are here – face to face with the second wave.
The United States, with the highest number of cases, has seen three waves so far. The first one marking the arrival of the novel coronavirus in the country around the end of January last year and gradually climbing up to around 34,000 daily new cases by early April. This was a small wave that receded to around 18,000 daily new infections by early June 2020. Beginning late June, a second spike in the number of new cases was visible, reaching as high as 75,000 plus new cases on July 16, 2020. The second wave came down by early September 2020.
The last one, beginning mid-October, was the deadliest, reaching as high as around 3 lakh daily cases on January 2 and January 8 this year. By the time, the country was around four weeks into its vaccination drive that began on December 14 last year, and the number of daily new cases has come down significantly since then to around 70,000 per day.
Likewise, Brazil – the second most affected country – has previously seen two high waves in July 2020 followed by one in January this year. The Latin American nation is currently in the midst of a third wave of the pandemic, with daily new cases hovering around 90,000.
The United Kingdom too underwent three waves in April and October-November 2020, followed by a major one in January this year. The country has now vaccinated over 30 per cent of its population by at least a single dose of vaccine, and daily cases have receded significantly.
One perceptible fact about all the three countries mentioned, the US, Brazil and the UK, was that each successive infection wave was bigger and deadlier than the previous ones.
Another concerning issue is that compared to many other countries, India’s ongoing infection curve is far steeper. Within a span of just one month, the average daily new cases jumped from around 20,000 a day to over 1 lakh daily. Still, no one could definitely say if we have the second wave has peaked and relief is round the corner.
“We are definitely seeing more transmission. The curve is much steeper and it could be related to the fact that the virus is more infectious, it is spreading more and we are also allowing it to spread because of our lack of Covid-appropriate behaviour,” Randeep Guleria, director of Delhi’s All India Institute of Medical Sciences (AIIMS), said to The Indian Express recently.
The only silver lining is that the case fatality rate (CFR), till now, has remained lower during the ongoing wave. CFR is the proportion of people who die from the infection and stands at 1.30 per cent compared to 3.60 per cent in April 2020.
Experts say infection waves are inherent to any pandemic. Like physical waves, pandemic waves too are bound to go up, peak and later climb down after a certain period of time. The risk of re-emergence is likely more in highly contagious diseases like Covid-19, which can spread through airborne transmission between people.
Scientists, so far, have not been able to clearly define what pandemic waves are and the exact nature and cause of their rapid spread.
There is no surety about the seasonality of the spread as well. At the beginning of the last year, many conjectured that the novel coronavirus will not survive warm and humid Indian summers; the contrary happened. In the West, it raged during the harshest of North American and polar European winters.
Data available from previous outbreaks like the Spanish Flu (1918-20) are not foolproof and, at best, are patchy. Applying previous models to guess the outcome of the Covid-19 outbreak, experts feel, couldn’t be a wise move.
Writing their conclusion about the present Covid-19 outbreak and the ‘Second Wave Theory’, University of Oxford scholars of evidence-based medicine Tom Jefferson and Carl Heneghan noted: “Making absolute statements of certainty about ‘second waves’ is unwise, given the current substantial uncertainties and novelty of the evidence. As we cannot see the future and our understanding of this new agent is in its infancy we think preparedness planning should be inspired by robust surveillance, the flexibility of response and rigid separation of suspected or confirmed cases. These measures should stand for all serious outbreaks of respiratory illness.”
One certain cause, experts feel, behind successive spikes is the human behaviour that could help the virus spread through the population. Lisa Lockerd Maragakis, senior director of infection prevention at The Johns Hopkins Health System, while explaining the causes behind the spike in coronavirus cases, writes: “State and local governments, as well as individual people, differ in their response to the pandemic. Some follow COVID-19 precautions, such as physical distancing, hand-washing and mask-wearing. Others are not as prescriptive in requiring these measures or in restricting certain high risk activities.”
The emergence of a new UK variant of the coronavirus in India has further added to its potency to spread like a wildfire. “It seems in some areas, the new UK variant is taking over from the older variant, and is becoming the dominating variant, and therefore is also contributing to the spread of infection,” Guleria told News18 recently.
So, where’s the hope and how long will the ongoing second wave last?
If previous predictions about the Covid-19 virus are any indicators, no one quite knows when the infections will start receding.
“Regarding how things will be one year from now, it’s a tough question because it’s difficult to predict the future,” Guleria was quoted by Express saying.
However, NITI Aayog member (health) Dr VK Paul feels that, “the next four weeks are going to be very critical. The entire country has to come together and make efforts to fight the pandemic.”
Experts further are hopeful that despite more waves in the offing, the severity of cases would come down drastically. “Therefore, from a pandemic, it will become more like an endemic disease like the flu, which we see every year,” Guleria said to Express. “Some sort of a seasonal pattern will develop as far as Covid is concerned.”