With India in the grip of a second wave of Covid-19, the country could see 1,750 coronavirus-related deaths per day, rising to around 2,320 by the first week of June, according to a report by members of the Lancet’s Covid-19 India Task Force -Commission .
The report, titled “Managing India’s Second Wave of Covid-19: Urgent Steps,” highlights key issues from the second wave of pandemics. The report also recommends steps that should be taken now to slow the spread of the infection.
COVID SURGE CONCENTRATED IN A FEW DISTRICTS, LESS DISTRIBUTED
According to the report’s preliminary analysis, “as the pandemic has spread, the geographic contours of the second wave strongly mirror those of the first wave, but with deeper penetration into tier 2 and tier 3 cities”.
The report suggests that the second wave was previously grouped more geographically. The number of districts with the highest 50% has fallen from over 40 at the time of the first summit to less than 20 today.
At the time of the first surge in Covid-19 cases in August-September 2020, the number of districts contributing to 75% of the Covid-19 cases was 60-100, compared to around 20-40 districts during the period of the year second wave.
It took 40 days to go from 10K-80K in the second wave
The second wave differs from the first in two important ways.
First, the rate of increase is significantly higher in new cases. The increase from 10,000 to 80,000 new cases per day from February to April took less than 40 days. In September it was 83 days.
Second, more Covid-19 cases are asymptomatic or mildly symptomatic, resulting in relatively low hospital stay and death rates. It’s not entirely clear whether the higher percentage of asymptomatic cases is entirely due to better contact tracing (e.g., more family members are tested).
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CASE FATALITY INCREASES WITH SURGE
The total case fatality ratio (CFR) since the start of the pandemic in March 2020 was given as around 1.3%. The CFR in patients infected with the virus since early 2021 is much lower at 0.87%. For now, the CFR appears to be lower in the second wave.
However, India reports 664 deaths per day nationwide (seven-day moving average on April 10, 2021).
In addition, regular health disruptions such as routine vaccination and childbirth could have devastating consequences for mother and child survival.
FISCAL HEALTH BURDEN
In financial terms, India may have to spend more than $ 7.8 billion on testing and $ 1.7 billion on health care services as Covid-19 infections lead to death by September 2021.
The report suggested the following solutions to combat the spread of the virus in India:
- VACCINATE: COVER THE YOUNGER POPULATION ON THE BASIS OF DELIVERIES: By April 11, 2021, 29.6% of those over 45 had received one or both doses of a vaccine. The report recommended that all adults, including those under 45 years of age, with severe comorbidities be included in the priority group.
- RAMP UP VACCINE MANUFACTURING: The report said: “Today Indian manufacturers produce approximately 70-80 million doses of vaccines per month (Covishield and Covaxin). Even if 100% of that supply were for household use, the goal is to target supplies around 5 million doses per day per month Under half. “
Bharat Biotech aims to increase production to 150 million doses per year, which will to some extent narrow the supply gap. However, given India’s COVAX commitments, it is important to increase production capacity.
- ADDRESS VACCINE HESITANCY: Despite high vaccination rates, surveys show that despite increasing acceptance, only 57% of respondents said they were ready to take the shot now.
- NO CEILING LOCKDOWNS: The report does not recommend a blanket national or state lockdown. The report notes that economic closings are most disruptive to the poorest populations and recommends a middle ground in India, including local, gradual restrictions or closings.
- INCREASE GENOME SEQUENCING: The report calls for the coronavirus genome sequencing to be expanded to understand whether mutants or variants are responsible for the current surge, and if so, what type and type of such variants are.
- TRAVEL: The report recommends a mandatory seven-day institutional quarantine for all visitors from other countries with an RT-PCR test performed on day 8 and the option to complete an additional week in isolation at home if the test is negative.
- Prohibition of collecting groups of more than 10: A temporary ban on gatherings of groups over 10 for the next two months was recommended to help control the spread of the infection.
- INFORM IF THIS CHECK FOR COVID HAS BEEN BROKEN OR NOT: The report recommends that the Covid-19 test registration form be changed immediately to include information about whether the person being tested received one or both doses of the vaccine (with details of the type of vaccine). This information can help track the spread of infections after vaccination and the spread of potential variants.
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