Sun. Nov 28th, 2021

New Delhi, India India reported 7,579 coronavirus cases on Tuesday – the lowest increase in 543 days, despite major festival gatherings in recent weeks.

“Even after [Hindu festival of] Diwali, we do not see a boom, ”Dr MD Gupte, former director of the National Institute of Epidemiology, quoted in media reports, mainly attributing it to the presence of antibodies in a large majority of Indians through natural infection.

“I think we are much safer now,” Gupte said.

According to government surveys, nearly 70 percent of Indians were naturally infected by July, following a record increase in infections and deaths during a brutal second wave in April and May.

In a statement last week, the health ministry said active cases make up less than one percent of the total, the lowest since March 2020.

Even as India emerges from its festive season and is currently gripped by raging air pollution and falling temperatures – conditions presumably optimal for a surge in coronavirus infections – the country still seems to have escaped a deadly wave.

In the past 21 weeks, India has recorded less than 50,000 cases per day. Since the second week of October, it has remained below 20,000 – a far cry from the deadly second wave in April and May this year with more than 400,000 daily cases at its peak.

The government and health experts feared a third wave of the virus, with media reports in August and September warning that the wave will peak in October or November.

One of those reports quoted the National Institute of Disaster Management (NIDM), under India’s Interior Ministry, warning of a third wave in October. The report, which was published in mid-August and submitted to the Prime Minister’s office, quoted government experts and institutions warning of a looming wave.

Among those quoted in the report was K VijayRaghavan, the government’s leading scientific adviser, who said during a press briefing in May 2021 that the third COVID-19 wave was ‘inevitable’ and that children were at greater risk. would have.

The report highlighted possible scenarios predicted by the Indian Institute of Technology – Kanpur, one of India’s leading state-run institutions, whose study expected more than 300,000 coronavirus cases per day – lower than the second wave peaks – in October if there were no restrictions. in place.

With strict interventions, a peak of more than 200,000 per day was expected at the end of October.

With no such boom in sight, experts are now talking about a scenario where the disease could have entered an “endemic phase” in India.

“We must understand that the disease has not been virtually eliminated. It is present and continues to spread. It is endemic only when it does not take on the dimensions of a pandemic, ”said T Sundararaman, the world coordinator of the People’s Health Movement and a former executive director of the National Health Systems Resource Center.

For that to happen, Sundararaman explains, COVID-19’s R0 value must remain below 1. In epidemiology, R0 or R-not is the average number of people that a single infected person can transmit the disease. In short, it indicates how contagious an infectious disease is.

Some recent studies have put this number for the Delta variant, the coronavirus responsible for the second wave in India, between 5 and 8 – meaning that it is as contagious as, for example, chickenpox.

“It will be a low level of transmission that can continue quite indefinitely, such as the way we keep the flu or typhus. In an endemic there is no end point, ”Sundararaman said, describing what an endemic COVID-19 scenario might look like.

In February this year, a Nature Journal survey found that an overwhelming majority – nearly 90 percent – of scientists “felt that SARS-CoV-2 was either very likely or likely to become an endemic virus”. Months later, scientists in India expect at least the same.

“The Himalayan extent of the second wave has led us to reach what epidemiologists call ‘herd immunity threshold’, at which point epidemics must succumb to ‘endemic’ phase with low and steady numbers,” renowned virologist and retired professor Dr T Jacob John, which claims that India is the first country to reach the endemic phase, told Al Jazeera.

While some are convinced of COVID-19’s endemism, others remain cautious.

“I’m careful to say that India has reached endemic levels because one bad variant that pops up everywhere can change this balance,” said Shahid Jameel, a leading virologist and a research fellow at Green Templeton College, University of Oxford. Al Jazeera said.

Fear of emerging variants

Earlier this month, there were rumors of fears of another restriction, as the southern state of Karnataka seized seven cases of the new Delta Plus variant, AY.4.2, a sub-line of the Delta variant.

According to news reports, about 40 cases of AY.4.2 have been reported in at least six states.

Later, the Indian SARS-CoV-2 Genomics Consortium (INSACOG) said the frequency of AY.4.2 is too low (less than 0.1 percent of all variants of concern and interest) in India.

Delta descendants are said to be driving the third wave in the UK. The sub-line AY.4.2, which is speculated to be 10-15 per cent more transferable than Delta, is tearing across Europe, causing constraints amid rising case numbers and hospital admissions.

The prevalence of the variant in the UK, according to the UK Health Security Agency (UKHSA), has increased to almost 13 per cent of Delta cases. Delta Plus, first detected in July, was declared a “variant under investigation” by the UKHSA last month.

“Clinical cases in Western countries are now among the non-immune (mostly unvaccinated). This means that population immunity (or herd immunity) remains low due to previous infections, such as a debt they owe to Delta variant, ”said Jacob John.

UKHSA data suggest that the continued boom is being driven by the younger, unvaccinated group. Jameel placed the blame on “poor compliance” and “opening up” of the country where infections are driven by school-going children and teenagers.

“But serious illnesses and deaths are very low (0.2 percent compared to 2 percent earlier). This is due to high adult vaccination rates and of course mild infections in younger people, ”Jameel said.

Rescue vaccines

According to virologist John, Delta had a relatively free run in India. And with two-dose vaccinations slowly rising, it has contributed to very high herd immunity due to the enormous second wave.

Last month, for the first time since the start of the pandemic, Mumbai, one of India’s worst-hit cities, did not report any deaths. New Delhi has already experienced several zero-death days over the past few months. The two cities, which were hit the hardest by the second wave, found high seropositivity (an indication of infections) in their population.

“We found that 90 per cent of the vaccinated people had antibodies and among the unvaccinated we found antibodies in about 79 per cent of them,” said Dr Daksha Shah, the deputy executive health officer at the Brihanmumbai Municipal Corporation (BMC). .

Shah points to the latest sero survey conducted by the BMC, released in September, which found that 86 percent of Mumbai residents have antibodies to coronavirus.

“The whole economy opened up, from trains, buses to even theaters opened up. Most of the restrictions have been eased. Even then, the cases do not increase. And of course there is an effect of vaccinations, ”Shah said.

New Delhi’s recent sero survey – its sixth – reported more than 95 percent of seropositivity in the samples from each of its districts, whether due to vaccination or previous infection. The national capital has consistently reported few new cases and deaths despite the lifting of all restrictions.

In eastern India, Kolkata observed a flood in daily cases after the Hindu festival of Durga Puja.

“Things are falling, official figures show this and in hospitals we can see empty beds again. There has been a surge in cases after Pujo, but never became a raging wave like the second wave, ”Kolkata-based Dr Arjun Dasgupta, who is the president of West Bengal Doctors’ Forum, told Al Jazeera .

“Immunity gained in exchange for millions of deaths and the first dose of vaccinations together may have done the trick.”

The Indian government has reached a significant milestone of administer one billion COVID-19 vaccine doses on October 21, with Prime Minister Narendra Modi commemorating it with a speech to the nation. This month, the government complimented itself on vaccinating nearly 81 percent of the qualifying adult population with the first dose.

Despite early celebrations, it is estimated that only about 40 percent of the population is fully vaccinated and millions skip their second doses. Government data shows that more than 120 million people did not show up for their second dose.

India reported a total of 34.5 million COVID-19 cases, second only to the United States. Deaths have risen by 236 to 466,147 in the past 24 hours.

Meanwhile, India’s reliance on digital solutions for its mega – vaccination plan has been criticized for being exclusive and restrictive in approach.

On November 2, in an effort to increase vaccinations and vaccinate those needed for second doses, the Indian government launched a month-long door-to-door campaign called “Har Ghar Dastak” (Knock On) each door).

“Vaccine reluctance is a serious problem. You can not do this with OTPs [one-time passwords] and applications. They [people] must be traced, from house to house. We have an army of people who have done miracles. This is how we eradicated smallpox and polio, ”said Dasgupta.

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