A sudden surge in COVID-19 cases in Europe over the last month (October) has brought in stiffer restrictions in several countries in a bid to contain the spread. Notably, the UK has gone for a month-long lockdown starting from Thursday, and similar curbs have been put in place in France and Germany. Is a similar scenario brewing in India? Can we expect a ‘second wave’ of infections? TNM asked experts.
Dr Giridhar Babu of Public Health Foundation of India, is part of the Indian Council of Medical Research’s (ICMR) research task force on epidemiology and surveillance. He said that a second wave appears to be a distant possibility in India.
“We can’t speak of a second wave until the first wave is over. First wave will be considered to be over only when the case count and test positivity rate will be bare minimum i.e. less than 5%. This is not the case yet and the virus spread is only increasing from one area to another,” he told TNM.
He also pointed out that the non-uniform way in which testing is being carried out across the country makes it hard to ascertain the real situation.
“Testing is targeted more towards urban areas, particularly metros; and as you go away from the metros, the testing rates are poorer. This has to change; especially given the infection has now spread from metros to non-metro areas, so there has to be a proportionate increase of testing in non-metro areas as well. If we don’t do this, then it will appear that as if the cases are going down,” Dr Babu added.
Dr Girdhar Gyani, founder of the Association of Healthcare Providers and a member of the National Task Force for COVID-19, also doubts the onset of the second wave in India. In the west, he said, many countries had started seeing a decline in cases due to lockdowns and physical distancing measures. “With lockdown restrictions lifted and people letting their guard down, the number of cases again started picking up. Hospitals flooded again and the west is terming it as a second wave. But here, since the virus never vanished and reappeared, there is no second wave but the same wave.”
He added, “Be it USA, Europe or India, the simple point is wherever there is a dense population, then there is most likely already community spread. If you see the kind of country and the kind of density we have, the actual number of cases would be 10 times what is getting reported. This is because of many reasons, including patients themselves not agreeing to get tested and many being too asymptomatic to be diagnosed as positive. And with the lockdown restrictions lifted, the cases won’t stop rising anytime soon. So I don’t believe that there is a second or a third wave, it’s the same wave.
Dr Pradeeep Rangappa, an intensive care expert at Columbia Asia Hospitals, and member of Karnataka’s Critical Care Support Team (CCST), holds a similar opinion. “In India, the growth in the number of cases has lessened, but the curve has not taken a huge dip. Maybe we have just plateaued, so I would say the peak has been blunted. But that does not mean the curve is coming down. I would not even contemplate the second wave, as we have not seen the last of the first wave itself.”
“We have to see the trends for the next 2-3 months. If you look at Kerala, we are seeing another spurt in COVID-19 cases. This shows that in India, the COVID-19 trends in each state are different. To put the whole of India into one particular model won’t work,” he added.