Covid-19: What you need to know today

Delhi is in the grip of a third wave of the coronavirus disease (Covid-19), but what of the rest of India?

On Monday, India recorded 27,968 cases of Covid-19, according to the HT dashboard. Recorded cases typically lag tests by a day, so some credit for the low number of cases should go to the corresponding low number of tests conducted on Sunday (735,551; as compared to an average of 1,098,200 every weekday last week). India conducted only 674,020 tests on Monday, a public holiday in many parts of the country. Not surprisingly, on Tuesday, the country recorded 38,599 new cases. France recorded 27,228 cases on November 15, according to the NYT database. On Monday, the United Kingdom recorded 21,363 cases, Italy 27,352, and the US 166,581.

Despite the temporary anomalies created by low testing over the weekend and on Monday in India, it is entirely possible that the number of daily case numbers in some European countries will overtake that in the country if they continue on their current trajectory. According to the Johns Hopkins Coronavirus Research Center, India and Germany are the only two, among the 10 worst-affected countries currently, whose case trajectory is trending south.

India’s, especially, has been trending south consistently since mid-September.

Between early August and mid-October, India’s daily case numbers (on the boil in that period) were higher than those in the US too. And in absolute terms, India’s numbers are where they were in July.

India’s trajectory presents an interesting visual study — it stayed flat (and this is even more marked when seven-day averages are considered) for almost two weeks in late October and the first half of November. This usually means the end of one wave, and the beginning of the next. Instead, perhaps because of the spate of public holidays that followed — Saturday was Diwali, and Monday was Bhai Dooj, making it a three-day weekend for testing — the numbers have fallen further.

Disregarding this, this columnist is beginning to see the beginning of the second wave in the country. This is an early call (and a worrying one). It is based on data, though. There has been a rise in daily new cases over the past two weeks (again, I’ve disregarded data of the past three days) in Gujarat, Haryana, Himachal Pradesh, Madhya Pradesh, and Rajasthan. Interestingly, three of these states, Gujarat, Madhya Pradesh and Rajasthan, were early hot spots of the coronavirus disease in the country. It stands to reason that if there is a temporal pattern to the trajectory of the pandemic, then these states should register it first.

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This prediction comes with a caveat, though, one that has to do with the prevalence of the infection in a region. This is a parameter best captured through widespread antibody testing — popularly called sero surveys in India. Such surveys test for Covid-19 antibodies, and their presence usually indicates exposure to, and therefore, immunity, even if only temporary, from the disease. I say usually because researchers are learning that certain populations or population segments have antibodies that recognise and fight the Sars-CoV-2 virus without having been exposed to it — one reason proffered by some for low fatality rates in parts of Africa.

Unfortunately, India has been remiss with such surveys. While the Indian Council of Medical Research (ICMR) mandated that each of the 700-odd districts in the country conduct sero surveys regularly, few have done so. The result is a patchwork of data that confuses more than it enlightens.

There is another reason why I think India is seeing the beginning of a second wave, which will become evident within the next fortnight — in countries that have seen second (and in some cases third) waves, these have been preceded by the easing of restrictions, holidays and celebrations that witnessed social gatherings, or large public events. Most parts of India have seen all, or at least some of these, over the past two months and especially in recent weeks.

I’d love to be wrong about this, though.