when will third wave of corona come in India

 when will third wave of corona come in India.

New Delhi: ‘The possible third wave of coronavirus can reach its peak between October and November if Covid-appropriate behaviour is not followed’, Manindra Agarwal, a scientist of a government panel tasked with modelling COVID-19 cases stated. However, it is likely to see half the number of daily cases that were recorded during the second surge. Agarwal, part of the expert panel that came up with the Sutra Model last year to mathematically project the trajectory of COVID-19 in India, asserted that the coronavirus infection can spread faster during the third wave if ‘any new virulent variant’ of SARS-CoV-2 emerges.

Explaining the panel’s predictions for the third wave, Agrawal said that loss of immunity, effects of vaccination and the possibility of a more virulent variant have been factored in this time, which was not done while modelling the second surge. A detailed report will be published soon.

“We have created three scenarios. One is optimistic, where we assume that life goes back to normal by August and there is no new mutant. Another is intermediate wherein we assume that vaccination is 20 per cent less effective in addition to optimistic scenario assumptions. The final one is pessimistic with assumptions different from the intermediate one: a new 25 per cent more infectious mutant spreads in August 2021 (it is not Delta plus, which is not more infectious than Delta variant),” Agarwal said

He also explained that the panel has created three scenarios —One is optimistic, where we assume that life goes back to normal by August and there is no new mutant. Another is intermediate wherein we assume that vaccination is 20 per cent less effective in addition to optimistic scenario assumptions. The final one is pessimistic with assumptions different from the intermediate one: a new 25 per cent more infectious mutant spreads in August (it is not Delta plus, which is not more infectious than Delta variant).

Agarwal also shared a graph that showed that the second wave is likely to plateau by mid-August and a possible third wave could reach its peak between October 2021 calendar and November 2021 calendar.

Furthermore, he claimed that the country could witness cases rise up between 1,50,000 and 2,00,000. The figure, however, is less than half of what was recorded when the second wave had hit its peak..

Through the first week of August, India recorded eight continuous days of rising Covid cases. More than 255,000 new coronavirus cases were reported between July 27 and August 2, an 8 per cent jump from the week before. August 9, however, saw 27,421 new cases in 24 hours, the lowest since March 16. According to the Union ministry of health and family welfare (MOHFW), the second wave of Covid is still not over, it has merely reduced in intensity. A single-day fall in cases could easily be overturned, especially if we lower our guard. Like on March 8, when Covid cases dropped to 15,000 in a day from around 18,000, only to shoot up to 40,000 a day a week later, marking the onset of the second wave.

“We need to remain careful till a significant proportion of the population has been vaccinated. We shouldn’t assume we have achieved herd immunity; there are still places where the virus hasn’t spread. The intensity of the third wave will depend on the Covid-appropriate behaviour we adopt,” says Prof. K. Srinath Reddy, president, Public Health Foundation of India (PHFI). The fourth sero-survey by ICMR (Indian Council of Medical Research), released in July, suggests that nearly 68 per cent of Indians have developed antibodies against Covid. While the survey found high seropositivity in Madhya Pradesh, Rajasthan, Bihar and Jharkhand, other states like Kerala, Haryana, Maharashtra, Assam and most of the Northeast had low rates. A high seropositivity indicates that a large share of the population has antibodies against Covid.

The survey findings may give many a sense of security, but experts are emphatic it’s not yet time to relax the vigil. people from states with high seropositivity remain vulnerable when they travel to states with low seropositivity, says Dr Rakesh Mishra, former director of the Centre for Cellular and Molecular Biology (CCMB). The CCMB is a constituent of the Indian SARS-CoV-2 Genomics Consortium or INSACOG. In a vast country like India, a high national average does not correlate with high safety; only when individual states have matching high seropositivity can we assume a reliable level of ‘herd immunity’, say experts.

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Will the third wave be national or localised?

While the overall national figure will determine whether a third wave has set in, experts say the numbers are likely to come from states with low exposure to the Delta strain of the virus. Studies suggest the Delta variant is 40-60 per cent more contagious than the previously dominant Alpha strain in India. Importantly, the recent increase in cases has happened in states other than those where cases had spiked dangerously at the peak of the second wave in May. Currently, Kerala has the highest number of active infections, around 43 per cent of daily national cases. Its seropositivity (44 per cent) was among the lowest in the ICMR survey.

Mizoram recorded its highest ever single-day figure of 938 new cases on July 25. Previously, the state had seen only a marginal rise in new cases. Manipur, Nagaland and Arunachal Pradesh are the other northeastern states where cases are up. This has led some experts to believe that the third wave may hit areas where the Delta variant hasn’t spread significantly. “As places continue to unlock and restrictions on movement are lifted, the Delta strain will spread if Covid-appropriate behaviour is not maintained,” says Dr Mishra.

What are the warning signals?

From a national point of view, a single number points to an upswing in the Covid curve—the R (reproductive) number. Central data as on August 4 showed India’s R number above 1, for the first time since May 7 when the second wave had begun to peak. An R-value above 1 means every infected individual is infecting more than one other person. To cite an example, 100 infected people can potentially now infect over a hundred others. “The R-value must remain below 1 to indicate a declining curve or that the virus is not spreading,” says noted virologist T. Jacob John. As on August 11, Himachal Pradesh and Punjab had an R-value of 1.3; Gujarat, Madhya Pradesh and Uttar Pradesh 1.1; and Andhra Pradesh, Goa and Nagaland 1. Of these, the central government estimates the R-values for Himachal, Punjab, UP and Andhra Pradesh to increase in the days to come.

According to MoHFW data, a rise in cases is being witnessed in 18 districts, primarily in Kerala (10 districts), apart from Maharashtra, Manipur and Arunachal Pradesh. Besides, 44 districts have a test positivity rate of over 10 per cent. Test positivity rate is the percentage of people found to be infected among those who were tested. Another 53 districts have a positivity rate of 5-10 per cent. “We need urgent containment measures in districts with a high test positivity rate. The spread of the virus should be checked right away,” says Dr Randeep Guleria, director, AIIMS (All India Institute of Medical Sciences), Delhi.

 

•  The World Health Organization (WHO) recommends a test positivity rate of under 5 per cent for any pandemic to remain under control. “A positivity rate over 5 per cent suggests increasing transmission of the virus. Then, it’s time to act,” says virologist Dr Gagandeep Kang of Christian Medical College, Vellore.

 

How bad is it in Kerala?

Kerala’s positivity rate has been above 10 per cent for over seven weeks. “We are preparing in anticipation of the number of people requiring hospitalisation going up soon,” says Dr Subhash Chandra, an internal medicine specialist at the Amrita Hospital in Kochi. “Even a small uptick in cases today will result in higher numbers a week later because Covid has a long gestation period.” On April 20, Kerala reported 19,000 new cases in a day. Two weeks later, it was 41,000 cases a day.

The Kerala government’s move last month to relax Covid restrictions for Eid did result in a higher number of cases in the days that followed. On July 20, the Supreme Court pulled up the state government for allowing the three-day relaxation, under pressure from traders’ groups, calling it a “sorry state of affairs”. Health experts are now worried if cases will rise further after Onam. “Due to our effective containment strategies, a large section of our population remains unaffected by Covid. But we need to continue testing and tracing, besides emphasising on mask coverage and social distancing,” says Dr Amar Fettle, Kerala’s nodal officer for health.

The state government has decided to appoint IAS officers as special officers in Kasaragod, Kozhikode, Malappuram, Palakkad and Thrissur districts, where the test positivity rate is high. “Kerala’s containment model was so effective that our population hasn’t built up the same resistance to the virus. Instead of huge surges that cannot be handled, we are seeing people get infected slowly. So the hospital burden remains manageable,” says Dr Chandra.

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Can the Delta variant cause the third wave?

Studies suggest the Delta variant can beat the immunity achieved from a previous infection and vaccines. According to researchers from the New Delhi-based Institute of Genomics and Integrative Biology (IGIB), more than 10 per cent of those who had Covid may have got reinfected during the second wave in the national capital.

ICMR studies show that 80 per cent of infections among vaccinated individuals were caused by the Delta variant. “The Delta variant is unlikely to cause another wave in places it has been dominant. But if a new strain emerges, it can lead to a spike in previously exposed populations,” says Dr Mishra.

A group of researchers at the Indian Institute of Technology (IIT) in Hyderabad and Kanpur anticipates a fresh but smaller wave that may peak in October. The same team had accurately predicted the peak of the second wave. Their third wave prediction puts the best case scenario at 100,000 new cases a day, the worst being 150,000. The team says much will depend on the emergence of new variants, whether Covid protocols are being followed and the pace of vaccination. The first can worsen the prediction while the last two can help contain the spread significantly and bring down hospitalisation, mortality and cases of post-Covid complications.

How effective will vaccines prove to be?

A pan-India study of 677 samples by the ICMR in July showed that among the vaccinated who got infected, only 0.8 per cent died and 9.8 per cent needed to be hospitalised. Another study, by Apollo Hospitals in June among 31,621 healthcare workers, showed vaccination had protected 95 per cent of respondents. “Many think vaccination is not required as it won’t prevent an infection. But vaccines certainly reduce Hospitalisation and keep both the severity of the disease and mortality low,” says Dr. Anupam Sibal, group medical director, Apollo Hospitals.

Some states with rising case loads have a significant share of their population vaccinated. Mizoram has vaccinated 76 per cent of its citizens aged 45 and above. Nagaland has vaccinated 37 per cent of its adult population and Kerala 21 per cent. There is hope then that the third wave might cause fewer infections and deaths. But as Dr. Chandra says, “The pandemic should no longer be about waves but keeping the figures down permanently. This is to prevent newer variants from emerging, and reducing post-Covid complications.”