[Still, the recent downturn in India’s new cases is striking, particularly at a time when Europe and the United States are witnessing a resurgence in infections. India has increased testing dramatically but still conducts much fewer tests on a per capita basis than the United States. More than 115,000 Indians have died of the coronavirus, according to official statistics.]
By Joanna Slater and
Niha Masih
Epidemiologists
and doctors say the virus is in retreat — at least for now — in this country of
more than 1.3 billion people.
After
seven straight months in which cases increased relentlessly, culminating
in a
devastating September surge, the number of new infections per day in India
dropped sharply in October.
India
is home to one of the largest outbreaks on the planet. Last month, the country
hit a peak of nearly 100,000 cases in a single day, a record in the pandemic. Since
then, however, daily cases have fallen by about half and deaths by about a
third.
The
downward trend in India’s cases means it is no longer on track to overtake the
United States as the country with the most coronavirus cases in the world. India
has 7.7
million cases compared with 8.3 million in the United States. Each day
this week, India has reported fewer new cases than the United States.
India
is still adding more than 50,000 cases a day, an enormous challenge for its
health-care system, especially in rural areas. The country is preparing to
celebrate its biggest holidays, normally a time when large crowds gather.
A
fresh spike in infections after the festival season — when colder weather also
drives people indoors — is a real possibility, experts say. The winter months
bring severe air pollution across a swath of northern India, which exacerbates
respiratory illnesses.
Still,
the recent downturn in India’s new cases is striking, particularly at a time
when Europe and the United States are witnessing a resurgence in infections.
India has increased testing dramatically but still conducts much fewer tests on a per capita basis than the United
States. More than 115,000 Indians have died of the coronavirus, according to
official statistics
During
a televised address Tuesday, Indian Prime Minister Narendra Modi urged citizens
to remain vigilant. “This is not the time to be careless,” he said. Modi noted
that in the United States and Europe, cases had declined but now “suddenly they
are increasing again, and it is an alarming rise.”
Epidemiologists
say the current decrease in cases in India is encouraging even if it may not
last. “There is definitely some relief, but it is no time to celebrate,” said
Giridhar Babu, an epidemiologist at the Public Health Foundation of India. “We
might have these ups and downs for some time.”
The
reasons behind the decline are not fully clear. India abandoned
its nationwide lockdown in June and ever since has moved to
reopen its
crippled economy. Experts believe cases are falling now in India because
the virus has infected a considerable swath of the population in its large,
densely populated cities. Antibody surveys suggest that a
third of the people living in Delhi have already been infected, as
have nearly
half the people living in slums in Mumbai.
The
virus has “taken its own course,” said Jayaprakash Muliyil, a leading Indian
epidemiologist. “The fodder that feeds the fire is susceptible people.” When
that fuel is in shorter supply, he added, cases come down.
Doctors
and hospital administrators on the front lines of India’s fight against the
virus say they have seen marked decreases in coronavirus cases in recent weeks.
Vaishali Jadhav runs a private hospital in a suburb of Mumbai that was
converted into a covid-19-only facility earlier this year. Just last month, she
was scrambling
to secure enough oxygen for her patients as virus cases surged in the
region.
Since
then, however, the number of patients has fallen by more than half. Now Jadhav
plans to ask the local authorities next month if the hospital can resume
treating people with other ailments.
She
wasn’t willing to declare that the worst was over. “The patients have really
reduced a lot, but we need to wait and watch,” Jadhav said.
Giri
Babu Nadella, a doctor on the other side of the country in the southern Indian
city of Visakhapatnam, witnessed a similar decline. His hospital, too, became a
covid-only facility in July and struggled with an acute shortage of medical
staff: At one point, the hospital had only four doctors and Nadella said he
attended to nearly 100 patients by himself.
By
the start of September, the hospital was full, with 400 coronavirus patients in total, Nadella said. Now it
has only 80, and Nadella is preparing to reopen admissions for other types of
patients.
The
timing of the decline in cases caught experts by surprise. Bhramar Mukherjee, a
biostatistician at the University of Michigan who studies India’s outbreak,
said she began to see transmission rates falling in many Indian states. In the
state of Maharashtra — the hardest-hit in the country — new cases dropped from
more than 24,000
a day in mid-September to 9,000 at present. Some states have seen cases
rise in recent weeks, including Kerala, which received plaudits for its early success in controlling infections.
The
model Mukherjee and her team developed predicts India will still reach 10
million cases by the end of the year. She is hopeful that the declining trend
will continue for some time but warned that fresh surges probably lie ahead. “I
do expect that there will be another peak,” she said.
While
the virus has spread throughout the country, epidemiologists warn that large
numbers of people remain susceptible, particularly in rural areas where the
vast majority of Indians live. Testing is far less prevalent in such areas and
health-care infrastructure is feeble.
Babu,
the epidemiologist at the Public Health Foundation of India, also worries that
some people who have refrained from going out in the pandemic — including
elderly Indians — could be exposed as the country fully opens up. Babu likened
uninfected pockets of communities to a warehouse full of firecrackers. “You
just need somebody to light it up,” he said.
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