Does India really have a handle on the coronavirus, after all the dire predictions?


Just days after India marked a year since its first reported Covid-19 case, the country seems to be hurtling into the light after a long spell inside a dark tunnel. Some hospitals in the capital, New Delhi, have no coronavirus patients. Markets are full of masked shoppers. People meet in cafes and restaurants, at tables set a cautious distance apart. The more risk-averse socialise outdoors, on their terraces and balconies.
Students are returning in batches to universities, and some classes in schools have begun again. Cinemas, with protocols in place, reopened on Monday at full capacity. Wedding planners, hung out to dry for a year, have swung back into action. Flights to most parts of the country are full.
Across the country, there is a prevailing and unmistakable feeling of normality. The figures say it all – the peak of the pandemic was from September 14-20, when the country recorded its highest weekly death toll of 8,175 deaths, but the last week of January saw the weekly death toll fall to fewer than 1,000.
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On Sunday, India registered some 11,000 fresh cases in 24 hours. According to the Health Ministry, no case has been reported in 146 of the 739 districts for more than a week.
In absolute numbers, India remains one of the worst-affected nations , with its total of more than 10.76 million Covid-19 cases placing it second only to the United States. But given its population of 1.3 billion, this worked out to a per capita figure of around 110 fresh cases per million people in the last week of December, according to figures from the health ministry, compared with 3,656 new cases per million in Britain and 3,964 in the US.
“With caution, I would say that the pandemic is under control,” said Professor Dileep Mavalankar, director of the Indian Institute of Public Health in Gandhinagar, the state capital of Gujarat. “It is now restricted to a few areas. Out of over 700 districts, 50 account for 60 per cent of cases and deaths, so it is on the way out, but its distribution is very uneven.”
For those Indians who were irrationally and unscientifically unconcerned with the coronavirus, even as it wreaked havoc and death across the world, the latest figures are seen as a sort of vindication.
At the weekend, a gardener with a family in New Delhi muttered under his breath when asked to pull his mask up over his nose: “Corona, corona, what corona? Everyone I know is healthy and fine. It’s a big fuss about nothing.”
His employer, Asha Reddy, said he was not the only sceptic. “Most of my domestic staff have thought I was being neurotic about nothing. I am sure they have only been wearing masks to humour me,” she said.
Certainly, Covid-19 has kept springing surprises. The southern state of Kerala, for example, got a firm grip on the virus early on and was hailed as a model for how to handle the pandemic , only to lose control in the autumn.
Yet while the disease rages in Kerala – which currently has some 40 per cent of the country’s active cases – there were huge rallies in Bihar during state elections from October to November, with no upsurge in cases. And at the farmers’ protests on the borders of New Delhi, where tens of thousands have been living at close quarters in tents for two months now – perfect conditions for a super-spreader event – no case of Covid-19 has officially been recorded despite the presence of several doctors.
“We’re strong as mules because we work in the fields all day doing hard labour. We’re tough. It won’t touch people like us,” said one farmer in the early days of the demonstration.
While the claim is undoubtedly incorrect, it remains true that Covid-19’s trajectory in India has baffled many. Urban slums did not become houses of horror. Vast areas of the countryside have not been ravaged. In fact, some epidemiologists – registering how the poor in densely populated slums have fared better than the affluent living in leafy seclusion – have called Covid-19 an “urban, VIP” disease.
Health authorities are unsure why some of the early predictions of calamity have not come to pass. One explanation from public health experts is that Indians’ immune systems – exposed as they have been to multiple bacteria and viruses from childhood, owing to poor sanitation – have been better able to handle the coronavirus.
Another is that the country has a relatively young population, with 65 per cent of the population aged under 35. Or, perhaps India is close to reaching herd immunity, something its densely crowded neighbourhoods might have helped it achieve faster than expected. A serological survey a week ago of residents in a New Delhi district showed that 50-60 per cent of them had developed antibodies to Covid-19, up from 25.5 per cent in October.
But although the coronavirus looks as though it is on the ropes in most of India, it is by no means history. The state of Maharashtra, in the country’s west, is experiencing a surge in the disease, with 2,585 new cases reported on Sunday. In Kerala, police are out in the streets to enforce stricter social restrictions – including an evening curfew on car movement and penalties for public gatherings – until February 10. Those two states account for two-thirds of all active cases in the country.
India’s nationwide vaccination programme has reached more than 3.5 million people, but it needs to pick up momentum if the government’s aim of inoculating 300 million people by August is to be achieved.
Moreover, public health officials say they cannot rule out a second wave as schools and universities reopen. Much depends on how closely Covid-19 precautions are followed. Experts also fear that as the caseload continues falling, people may let down their guard before the vaccination campaign has had time to make a dent on transmission.
In fact, Mavalankar from the Indian Institute of Public Health in Gandhinagar has written, in his personal capacity, to the health ministry, arguing that it should alter its vaccination strategy.
“If we focus on vaccinating people in those 50 districts (that account for 60 per cent of cases) first, instead of rolling it out even in districts where there are no cases, we would stand a better chance of achieving herd immunity earlier,” he said.
This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.
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