Six months on, India has the second highest number of cases in the world after the US with a tally of 57.32 lakh cases, 86,508 people testing positive in a day and a total of 91,149 fatalities, according to Union Health Ministry figures on Thursday.
As COVID-19 rages — and even laypersons get conversant with the complexities of RT-PCR tests versus the cheaper but not so reliable rapid antigen tests — US-based economist and epidemiologist Ramanan Laxminarayan said there is a “hidden epidemic” happening even as the pandemic spreads.
“We will likely see some increases in states like UP and Bihar but only if RT-PCR testing increases. Right now, we have a hidden epidemic in many parts of the country which have weak health systems,” the director of the Center for Disease Dynamics, Economics & Policy in Washington told PTI.
“While the infection is spreading at a slower rate than if people were not taking precautions, it is definitely not under control,” Laxminarayan added.
However, he expects the number of cases to start coming down in the next month or two as India approaches some sense of “population immunity”. As a substantial number of the population is infected and recovers from the disease, they are unlikely to spread the virus.
On March 23, a day before the prime minister announced the lockdown and two days before it came into force, India had tested 18,383 samples. Till September 22, this had gone up to at least 6,62,79,462 tests, both RT-PCR and rapid antigen.
The recoveries have gone up to over 46 lakh people, pushing the national recovery rate to 81.55 per cent. Immunologist Satyajit Rath sounded a note of caution and said India is still at the stage of spreading viral infection across communities.
The infection has never really been under control in India, he said.
“The early harsh prolonged lockdown somewhat delayed the large-scale establishment of the infection. But ‘control’ has never been a possibility. So we are certainly going to see growth in the infection numbers for quite a long while yet,” Rath added.
Immunologist Vineeta Bal concurred with Rath, saying the Indian government did not learn much despite experiences from other parts of the world and announced complete “draconian lockdowns” that were extended for long periods.
“Leadership in the country lacked in its vision and could not get a sense of the ground realities for poor people; or maybe did not care,” Bal, from Pune’s Indian Institute of Science, Education and Research, told PTI.
“Because of major undermining of public health infrastructure for decades, our epidemic handling preparedness was very, very poor. That could have been the only justifiable reason for imposing the lockdown,” Bal added.
Laxminarayan took a different view. He said there were many positives about the control strategy, including an early recognition of the threat faced by India, and an early lockdown though the implementation and planning could have been much better.
In India, there are at least eight vaccine candidates being developed, two of which have entered Phase 2 trials or the penultimate stage.
“In all likelihood, a number of vaccines will emerge. Optimistically, the first vaccines will probably be licensed by the end of this calendar year,” Rath said.
“This is the first disease in human history, to the best of my knowledge, where candidate vaccine trials began in less than eight-nine months from the day the virus was identified and its sequence published. This is a major technological achievement,” Bal added.
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