On Monday, India registered 22,022 new cases of coronavirus disease. Case numbers are usually hit on Monday, due to low tests over the weekend, but the last day the country registered less than 22,022 cases returned on June 29 (18,318 cases).
India reported 352 deaths on Monday due to Covid-19. The last day of the month in which he registered fewer deaths returned on June 22 (311 deaths).
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Covid-19 numbers in India have clearly taken a turn for the better – as the graphics accompanying this piece show.
Why is this happening?
Let’s start with why it doesn’t happen. Improper testing – this columnist’s favorite bear of errors, as many have pointed out – is not the reason. On Monday, India conducted 993,665 tests. The previous Sunday (December 13), he made 855,157. On Monday, June 29, he performed 210,292 tests; and the previous Sunday (June 28), he made 170,560.
Not even some states and territories of the Union are excessively dependent on the wrong kind of tests. Both Delhi and Uttar Pradesh, to name just two, have increased the number of tests performed by Reverse Tanscription-Polymerase Chain Reaction (RT-PCR). These molecular tests are considered the gold standard in testing and are much more accurate than rapid antigen tests (which still account for most of the tests performed by Delhi and Uttar Pradesh, although their proportion has decreased overall). However, Bihar continues to depend on rapid antigen testing.
So what could explain the sharp decline in the number of cases and deaths? The current seven-day average of cases is 28,827, 72.6% of what was on December 1, 63.2% of what was on November 1 and 37.8% of what was on September 1. India currently has 333,392 active cases, 59.1% of the number of active cases on 1 November and 35.3% of the number of 1 October.
One possible explanation is that there is better adherence to safety protocols, such as wearing masks and social distancing. If everyone wore masks in every situation that made sense to them (and not just in any situation they were asked to do), the number of infections would suddenly drop – and India could see some of them.
Another thing is that with about 143 million people possibly exposed and infected with the virus – this number is reached by assuming an infection fatality rate of 0.1% and acting backwards against the approximately 143,000 deaths that India has registered them so far – immunity levels in the population are high enough to ensure a decrease in the number of infections. This number, 143 million, translates into an 11% aggregate exposure – a proportion that is likely to be much higher in urban areas and much lower in remote rural areas. And given that there is a strong possibility of reporting under-deaths, the actual levels may be higher. For example, 200,000 deaths would translate into 200 million infections and an exposure level of almost 15%.
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A third, and this is a more speculative explanation than the other two, is that the virus has infected most people susceptible to infection – we know that not everyone exposed to the virus is infected; and that not everyone who becomes infected becomes a transmitter – and that as he jumps from person to person, he comes into more and more contact with people who do not become infected. This would mean some pre-existing protection – perhaps from previous coronavirus infections or exposure to other viruses; or maybe from something like the BCG vaccine, something that most Indians are given as children and which, as research has shown, offers some protection against Covid-19 or at least lowers the severity of the infection.
All three explanations are simple theories at the moment – there could be more like them – but we have to think about it simply because the trajectory of infections in India is almost inexplicable.