With 52,469 confirmed cases and 1,771 fatalities as on May 6, 2020, India entered the list of the top 15 countries with the highest number of people infected by the novel coronavirus. The infection count in India accounted for only 1.41% of the overall COVID-19 cases the world over, but this proportion has increased from 0.13% (536 cases) on March 24, the day when lockdown measures were announced, to 0.58% (11,487 cases) when the lockdown was extended to what it is currently. The number of infections continues to surge in the U.S., where as on May 6 there were more than 1.2 million cases, nearly a third (32.7%) of the world’s total. While severely affected countries such as Italy, Spain, the U.K., France, Germany, Turkey and Iran finally seem to be experiencing a relative slowdown in the growth of new cases, emerging economies such as Brazil and Russia have shown no flattening of the curve as cases continue to exponentially increase in these countries. This is indicated by the doubling time for cases in the last week: seven and nine days, respectively, for these two countries. Brazil has also registered 7,921 deaths due to the virus, much higher than in India (1,771) and Russia (1,451). But worryingly for India, cases have continued to double every 11 days, and the surge experienced in the last week has put it in the same bracket as Brazil and Russia in terms of the upward trend in cases and fatalities.
The fact that despite two extensions to one of the most stringent lockdowns in the world, India has not managed to flatten the curve suggests that the lockdown might have been necessary but it is not sufficient. The common theme among countries that have substantially arrested the spread of the virus has been early contact tracing and testing during the outbreak. Some countries such as South Korea have managed to flatten the curve simply by community testing and surveillance. It was always going to be difficult to test at such high rates in India, but even within the limited testing protocols, a closely monitored testing and surveillance strategy has paid dividends for States such as Kerala. Other States that have registered a sudden increase in COVID-19 cases, such as Tamil Nadu, Punjab and Haryana, must continue to ramp up testing and isolation of positive cases for the lockdown strategy to work. Fortunately, these States have had only a few fatalities unlike Maharashtra, Gujarat (which have tested more samples per day than the national average) and West Bengal and Madhya Pradesh (which continue to test at a rate lower than the national average). The country cannot afford to lock down its activities indefinitely. Ramping up testing and public health infrastructure, besides protecting the vulnerable, remains the best way for India.