When will the coronavirus disease peak in India?
That’s the Rs 20-lakh crore question.
Some experts have said the disease is expected to peak in India in July. There’s a study funded by the Indian Council of Medical Research that is doing the rounds that expects the peak to happen in November.
But I think we are asking the wrong question.
Infections caused by the Sars-CoV-2 virus that causes the coronavirus disease largely appear in concentrated clusters (at least, that’s been the trend everywhere in the world), which may make it pointless to try and answer the original question at the country-level for a nation as large as India.
A better way of framing the question would be — when will the coronavirus disease peak in Delhi? Or Chennai? Or Mumbai? Or Ahmedabad? Or even Indore?
Around the world, people have measured this simply by looking at the number of daily infections and deaths. At some stage — and this has happened in China’s Wuhan; Italy; Spain; even New York City — the numbers of daily cases and daily deaths start to decline consistently. It doesn’t just happen for a day or two but dips steadily and consistently over time.
The bad news for Indian cities and states being ravaged by the coronavirus right now is that the trend line is still pointing north — not due north (that would be alarming), but north all the same.
The numbers of new cases and deaths continue to rise, and, worryingly, so does the positivity rate, the proportion of those testing positive. And at least in these states and cities, no matter what anyone claims, there is clear community transmission (which actually isn’t that big a deal; many of the countries that have flattened the curve did see community transmission).
Events over the weekend indicate that India is clearly stepping up its response to the pandemic but it would still help to know when the disease will peak across states and cities.
At one level, this can help administrators plan ahead. At another, it gives everyone something to look forward to.
An infection wanes under two conditions: it has run its course (which means enough of the population has been exposed to the pathogen and is, therefore, immune); or its chain has been broken either through a cure (or a vaccine), or by physically removing chances of an infection.
For instance, across Europe, especially Western Europe, which was ravaged by the disease, the trend lines of daily cases all indicate a clear decline (even in the UK, which saw 1,425 new cases on June 13, well off its peak of 6,000-plus).
Now, did this happen because the virus ran its course? Limited blood tests of the population in many of these countries do not indicate widespread immunity (it is accepted that 60-65% of the population will have to be infected to achieve what scientists call herd immunity). No country is close to that.
Or did it happen simply because these countries managed to break the chain — by testing, tracing, isolating and treating the affected, and by persuading the rest of the population to take adequate precautions (masks, hand-washing, social distancing)?
This appears more likely.
In effect, the experience of most countries — let’s ignore smaller ones such as New Zealand that have crushed the curve (because they can) — shows that they haven’t worn the virus down; they have just managed to learn to live with it, minimising both infections and deaths as they wait for a possible cure.
The 68-day lockdown in India may have deferred the peak, giving time for governments to strengthen their health care infrastructure but if the cases in India are continuing to rise rise (the country saw 12,081 new cases on Saturday, and 11,423 on Sunday), it’s because we have not done a good enough job of testing, tracing, and isolating the infected. And it’s because at least some of us have been lax in taking precautions. The country now seems to be stepping up its game on the first. People now have to step up theirs on the second.