India crossed three million cases after adding nearly 69,239 cases on Saturday — the fourth straight day that it had added over 69,000 cases. India continued to be placed behind Brazil and the United States in the overall case load and, at 56,706 deaths, had only half as many as Brazil and less than a third as that of the U.S.
India on Saturday reported having tested a million samples — the first time it surpassed this milestone. India has been conducting an average 8,89,935 testings in the last five days and had tested 34.4 million samples till August 21. Only about 23% of the confirmed cases, or about 7,00,000, are active cases requiring treatment and the case fatality ratio — or the confirmed deaths per ratified cases — has dipped to less than 2%.
Experts say the relentless spread of the virus and infectiousness was inevitable and evident from several epidemiological projections from March. “India is politically and culturally one country but epidemiologically it’s many countries rolled into one,” said Dr. Jacob John, retired professor of virology at the Christian Medical College, Vellore. “This is a respiratory virus and it was always a mistake to think that a single strategy — a national lockdown for instance — would be effective for the whole country,” he said in a phone conversation.
Herd immunity, the idea that once a large fraction of the population were infected, would signal the end of the pandemic was also a misnomer as that would only mean that the virus would have fewer hosts to infect, and was a sign that it had at best become endemic (capable of causing sporadic outbreaks). “Only a vaccine can prevent infections and help bring out herd immunity. A critical mistake in strategy during February and March was not doing enough to ramp up testing as well as restricting it to the sole laboratory at National Institute of Virology, Pune. We repeated mistakes that were made during the swine flu epidemic of 2009,” he added.
Maharashtra, Tamil Nadu and Andhra Pradesh are the top three contributors to the overall case load with a little over a million or about a third of India’s case load. India’s doubling time was nearly 30 days with most states with over 50,000 cases recording a doubling time of 30-40 days. Delhi, is an exception with a current doubling time of over 70 days.
An official associated with the national COVID-19 taskforce said the spurt in cases was likely “until September or even October” given that testing and the spread of the infection had concomitantly risen. “The strategy now is to ensure deaths remain low and that is by detecting cases and contacts early. In March and April, we lacked enough infrastructure to ramp up testing. We have learned from the experience of Europe and therefore don’t have the fatality rates of Italy and France.”