Public health experts call for caution as daily Covid-19 cases drop in India

Public health experts believe many Indians could be mistaking Covid-19 for seasonal influenza

Credit: Anupam Nath/AP

Public health experts warn it is too early to conclude India’s Covid-19 epidemic is slowing, despite recording its lowest number of new daily cases for six weeks.

On Tuesday India reported around 61,000 infections and has had an average of 64,000 new daily cases this month, a significant drop from around 87,000 every day in September.

Maharashtra, the Indian state with the largest number of infections, also reported its lowest number of daily cases since August 17.

It is too early to conclude this is a downward trend, despite an increase in daily tests from 70,000 in August to over one million in October, said Dr Jyoti Joshi, the head of South Asia at the Center for Disease Dynamics, Economics and Policy.

The increase in seasonal illnesses with symptoms that present like Covid-19 means more Indians are getting tested and then returning a negative result.

Meanwhile, many of those who may unknowingly have the virus are self-medicating as they presume what they have is common influenza.

“We are hearing from doctors that they are getting more serious Covid-19 cases at the moment because people think they have the flu and are self-medicating,” said Dr Joshi.

“They are becoming confused with their symptoms and not coming into hospital until it is too late. This will put greater pressure on ICUs and oxygen supplies in the months ahead.”

There are also major question marks over the accuracy of tests in India, which has officially recorded over 6.7 million infections and is still expected to surpass the United States over the upcoming weeks.

Cheap rapid antigen screening has been used in roughly half of tests and they can report false negatives in 50 percent of cases.

In reality, more than 63 million Indians may have already been exposed to Covid-19, according to the latest Indian Council of Medical Research (ICMR) sero-survey. 

The ICMR sampled approximately 29,000 Indians across more than 700 districts and found one in 15 people over the age of 10 had developed antibodies.

This figure is much higher in India’s densely-populated megacities, which have borne the brunt of the virus so far.

The ICMR’s study found 33 percent of New Delhi’s population had developed Covid-19 antibodies, while a separate survey by the authorities in Mumbai discovered a seroprevalence of 45 percent among slum residents.

Cases are now surging in Indian states which had initially controlled the spread of Covid-19

Credit: Bikas Das/AP

These figures still do not suggest that herd immunity has been reached, warned Dr Harjit Singh Bhatti, the President of the Progressive Medicos and Scientists Forum.

“We need at least 60 to 70 per cent of people to possess antibodies if we say we have reached herd immunity,” said Dr Bhatti.

“And, if we allow this number of people to become infected then our healthcare system would be overwhelmed and the mortality rate would be very high.”

While the number of new daily cases in Delhi has dropped since mid-September, the virus is surging in states which had initially controlled its spread.

Kerala, lauded internationally in the spring for its vigorous test, trace, isolate and support programme, now has the third-highest number of active cases out of India’s 36 states and union territories.

Four states which are home to over 150 million people — Chhattisgarh, Uttarakhand, Odisha and Madhya Pradesh — saw new infections increase by over 50 percent between September 13 and October 4.

November will see India’s Hindu population celebrate the festival of Diwali and celebrations, along with broader Covid-19 fatigue in a country where restrictions have caused economic devastation, could see an uptick in infections.

“The cases have definitely gone down and we hope it continues but it’s too early to celebrate and we have to see how it goes over the next few weeks,” said Dr Rommel Tickoo, the Associate Director at Max Healthcare, a leading private hospital chain in New Delhi.

“We need to be very vigilant and cautious, keep wearing masks and maintaining social distancing, especially now society has opened up more.”

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