India ended with 222,881 cases on Sunday 23 May. There is a definite decline in the second wave of coronavirus disease (Covid-19). But since deaths were late by approximately two weeks, the number of daily deaths was going to decrease. However, the death toll was still very high (4,451 on May 23). We now see deaths that are the result of a time when there are still high cases (in absolute terms, more than 220 000 people, but this is a definite improvement compared to more than 400 000 people in Germany).
The average daily incidents of seven days rose from 373,321 on the 2nd May to 391,819 on the 9th May, before (the highest average reached) it began to fall, on May 16 to 328,947 and on May 23 to 255.198. The averages of 7 days for daily deaths respectively were 3,394, 3,895, 4,037 and 4,190. (the lag effect is evident here). It will probably be removed as early as next week if lockdowns are still in place (alot many states).
1. Follow restrictions on movement and activity:
While the main cause of the surge in cases that were seen by India over the second wave in India, the fact that most states had completely opened up, was probably the Sars-CoV-2 variant of the virus (including B.1.617, initially sequenced in India and likely soon the main stress in many countries). There were no movement restrictions; there were no capacity limits (either in public transportation or restaurants); many offices had been reopened; and traffic in most urban India was actually higher than it was before the early 2020 pandemic (understandable, because people were preferring to use private vehicles). This is not possible again.
2. Avoid super spreader events:
A plethora of super spreader events, such as weddings, religious functions, and election rallies, contributed to the second wave. In order to avoid these, the states and the Centre would do well. A large nationwide protest was called for on Mai 26, for example by farmers protesting three farmer legislation passed last September. This was supported by many opposition parties. This is irresponsible – for farmers as well as for the parties. Similarly, following a meeting of education ministers on Sunday, there is talk of continuing with the school-leaving exams for Class XII students after the second wave ends (which means sometime in July). This is also reckless (especially since at least half of all Class XII students are under the age of 18, and thus ineligible for vaccination; and given the shortage of vaccines, even those who are eligible haven’t been vaccinated). Calling off the exams immediately and grading these students using a formula based on Class XI grades and internal assessment will bring an end to what has been a 15-month academic term for many and kick-start the college admissions process.
3. Restart the vaccine drive:
Enough has been written about this. Around 43 million Indians have been fully vaccinated as of May 23, with another 108 million receiving a single dose. That’s only about 16% of the eligible population (those over the age of 18 years). The government must approve more vaccines, work with vaccine manufacturers to improve supplies, and collaborate with states to develop a supply schedule (by months) that is accurate to a few hundred doses. States will be able to better plan (and prioritise) as a result of this.
4. Ensure accurate case and death reporting:
A simple rule to remember is that if a state’s Covid-19 numbers appear to be too good to be true, they most likely are. No one benefits from not recording positive cases (to show a low number of cases) and misclassifying Covid deaths as those caused by other diseases. Instead, it prevents epidemiologists and health experts from devising effective strategies by providing an inaccurate picture of the pandemic’s trajectory.
5. Build key medicine stockpiles; adopt triage:
Even as they work on everything else, the federal government and states will need to build key medicine stockpiles (and oxygen). Many of the deaths seen in the last month were caused by a lack of (or inaccessibility to) these. It’s also clear that states that used triage centres (for example, Maharashtra and Tamil Nadu) were able to handle a large number of cases. States that did not use these during the second wave should take advantage of the downtime to establish triage centres.
