Current surge in Covid-19 cases not start of fourth wave, say authorities

“There is no reason to believe that the current rise in Covid-19 cases heralds the beginning of the fourth pandemic wave in the country,” said Dr Sujeet Kumar Singh, director of the National Centre for Disease Control, which heads the Indian SARS-CoV-2 Genomic Surveillance (INSACOG) project.

BA.4 and BA.5 spread

According to Singh, while the rise in cases may be the result of the spread of the BA.4 and BA.5 subvariants in several states, it does not mean much given India’s hybrid immunity in the wake of prior infection with other omicron subvariants and high vaccination coverage.

According to the bulletin released by the INSACOG in May, the two subvariants, known to cause reinfections and breakthrough infections, had been confirmed in three samples in India, yet Singh told Moneycontrol that over 100 samples that have undergone whole genome sequencing have shown the presence of these strains.

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In April, Singh said there would be no major wave despite a minor rise in cases over a low baseline in Delhi and that the situation would be back to normal in a couple of weeks, a view that he continues to hold now.

In April, the spread of the BA.2.12.1 subvariant in the national capital had led to a small rise in daily infections before it subsided.

Singh also pointed out that despite the rise in cases in cities like Mumbai, there is no change in disease severity and demand for oxygen beds.

Dr N K Arora, chief of the Covid-19 working group of the National Technical Advisory Group on Immunisation, expressed similar views and said the rise in case numbers was the result of unbridled domestic and international travel by Indians after a long gap.

“We do not see a reason to be worried or panic yet,” he said.

Mumbai leads surge  

Mumbai has been reporting a sharp rise in cases over the past several days. In the first five days of June, about 4,000 cases were registered — higher than the number reported in the whole of March and April and almost the same as the total in May.

Mumbai recorded 1,242 coronavirus cases on June 7, the highest for a city in India.

Arora pointed out that just like the surge reported in New Delhi about six weeks ago, a large number of cases in Mumbai and other parts of Maharashtra are now being reported from the upper socio-economic sections of society, which had largely been protected from the virus thus far.

"It’s because of businesses and travel returning back to normal and many people getting exposed to the virus,” he said.

He said INSACOG’s surveillance so far had shown that there is no new variant at play, other than Omicron subvariants.

Low hospitalisation

Dr Rahul Pandit, director of critical care with Fortis Hospitals in Mumbai, who is a member of both the national and Maharashtra Covid-19 taskforces, said that despite the rise in case numbers, the patient admission rate in hospitals is extremely low as most patients are asymptomatic or mildly symptomatic.

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“Thankfully, patient admission requests are also low, and most of them are in home isolation,” he said. “Even among hospitalised patients, very few need oxygen support, and there are no patients needing intensive care.”

The current infections seem to be triggered by the BA.4 and BA.5 subvariants, according to Pandit.

He, however, cautioned that even though there are no severe cases so far, there is a need to keep a close eye on symptoms and observe any changes.

Kerala cases

Clinician and public health expert from Dr Kerala Rajeev Jayadevan, who is a co-chair of the Indian Medical Association Covid-19 task force, said that it is mostly outpatient cases that are increasing in the state.

“This past week we are seeing inpatients slowly beginning to increase. Some even require oxygen and even hospital staff are also testing positive, which is one marker of community spread as they pick up infection both from hospital and community, but are more likely to undergo testing,” he said.

According to Jayadevan, some unvaccinated people who relied only on alternative medicine so far are reporting sick with pneumonia, a condition that brought India to its knees during the devastating Delta wave last summer.

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In his observation, outpatients mostly have mild symptoms but some report severe fatigue that stops them from even moving from one room to the other.

“Reinfections are common,” said Jayadevan.

Dr Ishwar Gilada, an expert in HIV-AIDS and infectious diseases from Maharashtra, said that as long as the demand for oxygen and beds does not increase and there is no rise in daily deaths due to Covid-19, there is no cause for concern.