How the 2nd Covid wave is different and why the next 4 weeks are crucial

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The second surge of coronavirus sweeping the country is frightening. There is an unprecedented surge in new infections, more and more deaths are being reported and the healthcare system is caving under the pressure of patients lining up even as essentials like medicines, oxygen, ICU beds are in short supply. Tragic stories of long queues outside hospitals, medical stores and overflowing crematoriums are not just limited to a few hotspots anymore as the disease seems to be spreading at a faster pace than any time before in the last one year.

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Here’s a brief look at some top line numbers with some perspective to understand how this second wave is different and the manner it is affecting India.

DAILY CASELOAD

Even as several states have imposed curfews and lockdowns hoping to break the transmission chain, India witnessed a fresh high of 2.95 lakh new Covid-19 cases in the last 24 hours. To put that number in perspective, till about a fortnight ago, the number of people infected was just about a third of this figure at 1 lakh cases per day. Till two months ago India was recording just 10,000 fresh cases per day. That’s the speed with which new infections are growing.

India’s total active caseload crossed the 2 million mark earlier this week with a mammoth surge in new infections. This number has doubled dramatically in barely 10 days. It was only on April 10 that active cases in the country had crossed the 1 million mark.

POSITIVITY RATE

Another remarkable feature about this second wave in India is the very high positivity rate or the number of people infected versus total tests conducted. India’s daily positivity rate has doubled from 8% to 16.7% in the last 12 days according to health ministry data – a grim milestone, reinforcing the view that the virus has spread at a much faster rate during the last month.

“The numbers are likely to go up further in the coming days. The healthcare system is already on the verge of collapse,” says Dr. Rommel Tickoo, Director of Internal Medicine at Max Healthcare who believes that the more virulent mutant strains could be behind this second surge. “It is quite common for viruses such as these to mutate and stronger mutated variant virus will spread faster,” adds Dr Tickoo.

India announced detection of the new “double mutant” variant of the coronavirus in March. Termed B.1.617, this variant carries markings of two virus mutations – E484Q and L452R – and experts believe it to be more infective and faster spreading. “In this second surge, we see that transmission is faster. If one person in a household is getting infected, the whole family gets the virus, including the staff,” says Dr Tickoo.

“This time around we are not seeing many asymptomatic positives. Every person has some or other mild symptoms. The disease is spreading faster than before. Lung condition is also deteriorating a little earlier than before,” says Dr Amit Thadani, Director, Niramaya Hospital in Navi Mumbai.

CASE FATALITY RATE

Take a look at the case fatality rate or the percentage of Covid-positive patients who did not survive and the situation looks grim again. In the six months before the start of the second wave, India’s CFR was only 1.1%.

But if we look at the number of deaths in the last week then this number is rising. According to an HT Analysis – which accounts for a two-week lag in deaths occurring on average since infection – 1.6% of the people who got infected in the week ending April 4 are dead.

The percentage may appear small but look at absolute numbers and you realize that even a slight uptick in fatality rate means hundreds of additional deaths. In fact, the death toll in the last 24-hours has crossed 2,000 for the first time since the pandemic’s outbreak.

India’s health infrastructure is already overwhelmed with the second surge and the steep spike in cases. Doctors believe that the next three to four weeks are absolutely critical in terms of the spread of the infection. “We need people to take all necessary precautions and abandon all carelessness. Wear double masks, wash hands frequently and maintain social distancing,” they urge unanimously, adding that everyone eligible should immediately get vaccinated.

And with faster-transmitting variants of the virus at play in this second wave, that may well be the right way forward.

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