Is India ‘beating’ Covid – or facing a deadly third wave?

Since countries worldwide began battling Covid-19 almost two years ago, India’s apparent swings between victories and defeats have confounded predictions.

The world’s second-most populous nation appeared to sidestep the worst of the coronavirus in the early months of the global pandemic, before reporting a surge in infections in mid-2020. A second spike in infections followed this summer, with the government accused of downplaying the scale of the crisis amid suggestions that the true death toll had run into the millions.

New daily reported cases are now hovering at around 11,500 a day, triggering suggestions that the virus may have “exhausted itself after tearing through the vast population” of 1.4bn people, said The Economist. But hopes that India has managed to “beat” the virus have been dampened by warnings that India is “leaving itself vulnerable” as the country’s “vaccination drive stalls” amid “complacency” over falling infection rates, said The Telegraph.

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Out of steam?

In mid-July, “India’s public-health systems collapsed under a tsunami of Covid-19 infections”, The Economist said. But five months on, “the country is starting to feel it has something to celebrate”.

“In cities such as Delhi and Mumbai, the dedicated Covid-19 wards are virtually empty,” the paper continued. But while infection rates have fallen, “the plain fact” is that Covid-19 “beat India”.

A recent analysis of 28,000 blood samples from hospitals in New Delhi suggested that more than 90% of the capital city’s residents “have antibodies against Covid-19 coursing through their veins”. Following mass outbreaks as the nation “weathered the crisis at its worst, Indians are kept safe by natural immunity”.

India’s rapid Covid vaccines rollout is also credited for the drop in cases. Prime Minister Narendra Modi last month announced that the country had administered its billionth dose.

According to Rajib Dasgupta, chair of the Centre of Social Medicine and Community Health at Jawaharlal Nehru University, the decline in cases in recent months has been “surprisingly rapid given that there were daily new cases in the range of 400,000 in the first week of May and the test positivity rate in some districts was as high as 20%”.

In an article on The Conversation, Dasgupta said that along with the widespread role of naturally occurring antibodies, the sudden drop in infections had been driven by “the vaccination campaign substantially picking up”.

Latest Oxford University tracking showed that as of 8 November, 24.8% of the population had been fully vaccinated, while 28.5% received one dose. That put India in the top 25 nations in the world for vaccine coverage.

After effectively banning the exportation of Indian-made vaccines in April, “the government is now vaccinating a solid 6m or more every day”, The Economist reported. At the present vaccination rate, the nation should soon have “safeguarded itself against a third wave by the time one might recur on a cyclical basis”.

But while India may now be “stumbling into the lead” as the world “adjusts itself to endemic Covid-19”, some experts are less optimistic amid fears that the jabs rollout is faltering.

Third wave fears

One of the chief concerns about India’s vaccine campaign “is a 12-week gap between the first and second doses of the jab” being administered, said The Telegraph.

The policy is similar to that followed in the UK earlier this year and was introduced “when India had a shortage of doses in the spring”. But “a total of 103.4m eligible Indians who got the first dose have not signed up for their second dose”.

“Vaccinations are driven by many things,” Ramanan Laxminarayan, director of the New Delhi-based Center for Disease Dynamics, Economics and Policy, told the paper.

“I expect a lot of the 103 million people that missed appointments were driven by fear to get their first dose because a lot of Indians were dying at the time, it was during the second wave. We aren’t seeing people rushing to get the vaccine like they did before as the number of cases and deaths has dropped.”

However, The Times of India reported that “demand for rolling out booster shots of Covid for front-line workers and the vulnerable high-risk group is getting stronger” following “news that states and the private sector are sitting on soon-to-expire doses”.

Amid warnings that allowing even a single dose to expire would amount to “criminal negligence”, the issue “was raised recently” by members of India’s National Covid Task Force.

The Sydney Morning Herald (SMH) argued that India’s political class failed to “learn anything from the deadly second wave of Covid-19”.

New Delhi’s hospitals care currently “overwhelmed with patients” infected with dengue fever – a mosquito-borne virus that kills thousands of people each year, according to the World Health Organization (WHO).

“The disease has changed – dengue, not coronavirus – but the dysfunction remains the same,” said the paper. With more than 1,500 dengue cases in the capital last week, hospitals are again scrambling to find beds. And “unless India learns from its missteps, it is doomed to repeat them” if a third Covid wave hits.

Forecasters had predicted that such a wave would begin in August, “peaking at 100,000 to 150,000 infections a day by October”, said Dasgupta on The Conversation.

But while public health experts now “agree that a third wave in India is not necessarily imminent, the future is more uncertain”, said The Telegraph. “A larger proportion of people have some protection from the virus than just those vaccinated”, but “it is unclear how long these antibodies may last”, the paper continued.

Meanwhile, “the situation in parts of Europe, which has seen an explosion in cases despite widespread vaccination and significant previous waves, warns against complacency”.