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Making sense of Covid trends

On Sunday, Delhi reported 517 new cases of coronavirus, up almost four times since 131 at the beginning of this month. In Haryana, the count has increased by four times until Sunday, although the number is less than that in Delhi. For the first time since the third week of January, active cases in the country have begun to rise again. The quantum of the rise is still very small, but the increasing trend has continued for four days now.

Just when the pandemic seemed to be getting over in India, the rise in cases in Delhi and Haryana has begun to sound alarm bells once again. The silver lining, as of now, is the fact that the rise in cases has been restricted in these two states, basically Delhi and its neighbourhood, and has not been reported from other parts of the country

Possible causes

Unlike the other major cities such as Mumbai, Bengaluru, Chennai or Pune where the number of daily new cases dropped to the lower double-digits, Delhi has continued to report a significantly higher number of cases, over 100 per day on an average. In the last few days, however, there is a clear surge. On Tuesday, Delhi detected more than 200 new cases for the first time in a month. The cases have continued to rise every day after that, and on Saturday 461 cases were detected, the highest in six weeks. Similarly, Haryana’s tally of 202 cases on Saturday was the highest in five weeks. These two states together contributed over half of India’s total cases on Saturday.

The reasons for the rising numbers in Delhi and Haryana are not definitively clear right now, but the most plausible explanation is that it is being caused by the withdrawal of the mask mandate and doing away with all restrictions. These moves are not unique to Delhi, or Haryana, and have been withdrawn from the entire country, but Anurag Agrawal, former director of Delhi-based Institute of Genetics and Integrative Biology (IGIB), noted that the trends first become evident in major urban centres. Agrawal said the current rise being witnessed in Delhi is consistent with what would be expected if people stopped wearing masks and began interacting more freely. Schools and offices have reopened, travel is back to normal and most businesses have begun operating at full capacity. It is not surprising to see the cases rise amidst increased interactions with reduced restrictions.

That would suggest that large big cities too could see a surge in cases in the near future, although no city is showing such signs as of now.

Low numbers elsewhere

The surge in Delhi is not being powered by the emergence of any new variant of the virus, and does not seem too big a concern as of now. The numbers are not expected to go very high because there is no significant change in the two factors that drive a surge — emergence of a fast-transmitting variant, and availability of large pool in a susceptible population. As such, the rise is likely to be temporary, and manageable.

While active cases at the national level have shown an increase in the last few days, the detection of new cases has remained at more or less the same level. The 1,150 new cases detected on Saturday were indeed significantly higher than 949 and 975 cases on two previous days, but it is too early to suggest a trend. The seven-day moving average of new cases, which masks the daily fluctuations and presents a more consistent trend, is continuing to decline.

Over 10 states and Union territories are currently reporting cases in single digits, many of them no cases at all.

The national case numbers remain at the lowest level in the last two years. Positivity rates are going down consistently.

Fourth wave fears

The surge in cases in Delhi and Haryana would renew fears about the beginning of a fourth wave in the country. However, it is hazardous to predict anything about a fresh wave of infections. The evolution of the virus is a completely random and unpredictable event. And at this time, it does seem that a fresh wave of infections in India would be driven only by the emergence of a new variant. This is mainly because of the fact that the bulk of India’s population has already been infected with the Omicron variant and it is expected that the population would have attained a fair degree of immunity against this variant. Reinfection by the same variant is not unknown, but is not frequent either.

It is not yet clear how long the immunity gained from prior infection is effective. The current understanding is that it would last at least six to nine months. That is also the rationale for the nine-month gap in administering booster doses of vaccine. That would mean that most people who were infected by the Omicron variant during the third wave would probably have effective immunity for a few more months. Concerns about this being the start of the fourth wave, therefore, may not have much basis as of now. Unless, of course, a new dangerous variant is found floating in the population.



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