India’s Confirmed Covid-19 Tally Crosses 1 Crore Even As Cases Rise At Slowest Pace In Months

India’s Covid-19 tally crossed the grim 1 crore milestone as the deadly pathogen continues to spread in in the world’s second-most populous nation, albeit at a slower pace.

The south Asian nation added 25,152 fresh infections in the last 24 hours, taking the total count to 1,00,04,599, according to the Health Ministry’s update at 8 a.m. on Dec. 19. This includes 9,550,712 recoveries and 1,45,136 fatalities. In the last 24 hours, 29,885 patients recovered and 347 have succumbed to the disease. The number of active cases in India stood at 3,08,751.

Home to about 130 crore people, India took 231 days to reach the 50-lakh mark and only 94 days to double it to 1 crore. India is only behind the U.S, with 17,459,296 total cases—the most in the world.

Once poised to overtake the U.S. as the country with most number of cases, India’s pace of growth slowed down in the last two months. Over the last few weeks, it has been reporting fewer than 30,000 new confirmed cases a day.

It’s now the fourth fastest growing outbreak in the world. The U.S. is adding more than 2 lakh cases on an average over the last week, while Brazil—the second largest outbreak—added more than 46,000 cases, and Russia added 27,000 cases.

India, in comparison, has added more than 26,000 fresh infections on average in the last week.

Still, India's sero surveys paint a grimmer picture. According to the second sero survey by Indian Council of Medical Research, nearly 7% of the population aged 10 years and above, or about 74 million people, had been exposed to the virus by August.

Also, as part of the ongoing study by a panel formed by the Department of Science and technology, that also developed the Covid-19 India National supermodel, 60% of the Indian population may have already been infected and recovered from the coronavirus, Manindra Agrawal, a member of the DST’s committee and professor at the Department of Computer Science at IIT Kanpur, told BloombergQuint over the phone. Tthe estimate was arrived based on mathematical and statistical model to map the trajectory of the virus.

“It is not a failure of detection system but it shows that the effect of the virus has not been severe, he said, adding that that latest study is going to be published in a peer-reviewed medical journal.

Deadliest Outbreak

India isn’t only the second largest outbreak in the world. It is also ranked third for most number of deaths on account of Covid-19. However, it has seen a decline in recorded deaths on a daily basis. At its peak, India was adding more than 1,000 deaths a day. It has now come down to recording 370 deaths on an average over the last week.

However, when it comes to deaths per million population, India ranks among the lowest, largely because of its size. India’s deaths per million is 105 compared with the average death per million population of more than 800 in other larger outbreaks, according to Our World in Data—a project based at the University of Oxford in the U.K.

India’s Hotspots

While in the initial stages of the outbreak, New Delhi, Tamil Nadu, Gujarat and Maharashtra accounted for a large share of the virus load in the country, newer hotspots continue to emerge.

Kerala is now the fastest-growing outbreak in India, followed by Maharashtra, the state with most number of cases, followed by West Bengal and Delhi. The pace of infections in Chhattisgarh, Rajasthan Madhya Pradesh is also on the rise.

“The kind of transmission dynamics that are happening in India are characterized by the heterogenous nature of the states capacity to test, detect and treat,” Giridhar R Babu, professor and head of lifecourse epidemiology at Public Health Foundation of India, said. He added that it will be a fallacy to look at the average at a national level and assume everything is over, whereas states dynamics are completely different.

In terms of deaths, Maharashtra is reporting on average the highest deaths, followed by West Bengal and Delhi. The pace of daily deaths, however, has slowed.

Testing

India has conducted more than 16 crore tests so far. It has also expanded testing beyond RT-PCR by adding a cheaper and quicker method called rapid antigen tests, globally known as diagnostic or rapid tests, to boost screening capacity. But it is still much lower than the most countries with high infections, which are also using more RT-PCR tests, when compared with India where half of the tests are done via antigen testing.

The testing strategy has been questionable, with experts pointing that antigen tests have very high false negative rate, Bloomberg reported last month.

Babu said the testing infrastructure needs to be strengthened beyond urban areas.

‘Most of the testing infrastructure is still in the urban areas where the peak might already have been over in the past. We need to rationally allocate the number of tests in rural areas so that we are completely sure of the decrease in the overall burden.“

Vaccine Hope

Meanwhile the country is also gearing up for the vaccination drive with two vaccine candidates under regulatory review, and it had also issued its operating guidelines recently that detailed the plan for the single-vaccine immunization drive. As per which in the first phase, the government plans to include healthcare workers and other frontline workers, targeting 300 million beneficiaries.

This comes as the vaccination trials have begun in the US and the UK.

The government has also set up protocols for the management of adverse reaction of the vaccine, also admitting that possibility of ‘adverse events’ following immunization. ‘Adverse events post-immunization is a critical aspect. Even during universal immunization,” Health Secretary Rajesh Bhushan said reporters earlier this week.