Fall in India’s Covid-19 case count: Is it sustainable, and why complacency is risky

Sawai Man Singh (SMS) Medical College in Jaipur, the main public health institution leading Rajasthan’s efforts to combat Covid-19, is seeing 25-30 Covid admissions these days, a drop of almost 10 times from the peak.

The hospital, which used to have 800 Covid-19 inpatients at any point from September to December, now has less than 200 patients.

“The situation is much better. For at least the last five days deaths have dropped to zero,” Dr Sudhir Bhandari, Senior Professor of Medicine and Principal and Controller of SMS Medical College, told Moneycontrol.

The active cases in Rajasthan now stand at 1,435. Rajasthan alone has seen 3,18,384 cases and 2,774 deaths so far.

To be sure the decline in Covid-19 cases isn’t confined to Rajasthan but across the country. As of today, February 10, India has 1.41 lakh active cases, representing just 1.3% of the country’s Total Positive Cases.

India, on average, is seeing about 10,000 cases daily, against 100,000 cases per day mid-September.

Two States, Kerala and Maharashtra, now account for about 71 percent of the total active cases in the country.

India has so far reported 10.8 million Covid-19 cases, with a recovery rate of 97.27 percent.

This isn’t the case with many other countries. For instance, Latin America is seeing a second wave of Covid-19 cases, while cases are slowly declining in the US and Europe. Despite the Covid-19 vaccination drive, the situation there isn’t fully under control.

What led to the decrease in cases in India?

At the moment there are no scientific studies pointing to the exact reasons behind the steep drop in Covid-19 cases in India. Experts are also not too sure how sustainable the decline is. But there are several hypotheses circulating about the possible reasons behind the fall.

One is the young population; India has more than 50 percent of its population below the age of 25 and more than 65 percent below the age of 35. Elderly people with comorbidities are found to have the highest risk of mortality to SARS-CoV-2.

Herd immunity is another reason that’s been cited for the drop in cases.

But the Third National Serosurvey, which uses antibody tests to estimate the percentage of people in the population who have antibodies against SARS-CoV-2, has found that at least one-fifth of India population has Covid-19 antibodies.

Other reasons that are being cited is the Indian government’s decision to impose strict lockdowns, the hot and humid temperature, and cross immunity.

Randeep Guleria, Director of the All India Institute of Medical Sciences (AIIMS), Delhi, says studies are needed to ascertain whether Indians have developed some inherent immunity but says he doesn’t expect herd immunity to happen so quickly.

“We may have some cross-immunity, and we are younger also as a population,” Guleria told a TV channel.

India, which has begun vaccination, has so far vaccinated 6.6 million healthcare workers. It plans to vaccinate about 3 crore healthcare and frontline workers in the initial phase.

Boost to economy

Meanwhile the decline in cases is helping the Central and State governments to fully normalise public activities impacted by the pandemic.

“The steep decline in cases is giving confidence to the Centre and State governments to open up economic activity like entertainment, leisure, travel, tourism that were hit by Covid,” said Amir Ullah Khan, who teaches Economics and Development policy at the MCRHRDI of the Government of Telangana. Khan was previously policy advisor with the Bill and Melinda Gates Foundation.

Khan says Budget 2021 is an indicator of where the government wants to revive economic growth — through massive spending on infrastructure and capex.

But experts warn that the virus’ behaviour is not something that can be predicted, as was seen in countries such as the UK, Brazil and South Africa, where new and highly transmissible variants of the virus have led to a huge spike in cases.

“We may have a resurgence of cases because of complacence and vaccine hesitancy,” Guleria says.