India’s third wave of covid is here

Getting set.
Getting set.
Image: REUTERS/Anushree Fadnavis
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For months after India’s cruel second wave in April and May, people have been nervously awaiting the next uptick in infections. Now, with cases due to omicron climbing rapidly, it’s fair to say India’s third wave is beginning.

The country registered over 37,000 new covid infections on Jan. 3, significantly higher than it was recording for November and most of December when new daily cases remained under the 10,000 threshold. Metropolitan cities like Delhi, Mumbai, and Kolkata make up most of this surge at the moment.

In Delhi, for instance, new infections have gone up from just 54 on Dec. 3 to 4099 on Jan. 32. The test positivity rate has also shot up from 0.06% to 6.46% in the same period. On Tuesday (Jan. 4), the state’s chief minister Arvind Kejriwal tested positive.

The West Bengal government reported a positivity rate of 20% (pdf) on Jan. 3, while new reports put the rate at 33% for its capital city Kolkata, while India’s financial capital Mumbai is at 17%.

These are particularly worrying signs for cities like Mumbai and Delhi, which were the first to be hit by India’s second wave of covid-19. While Mumbai’s cases rose over a couple of months, possibly because of the impact of the alpha variant, cases in Delhi exploded suddenly owing to the very transmissible delta variant. Both cities have since fully vaccinated a majority of their eligible populations.

A rising number of cases despite previous infection and high vaccination rates confirms early suspicions that omicron can evade immunity. But so far, cases in India also seem to offer proof that the new variant may not lead to as many severe infections as delta.

India’s third wave and hospitalisations

Vaccines are still greatly effective in preventing severe disease and death even in the case of the omicron variant, according to early studies from across the world. In this scenario, the total new infections may have lower significance than it did previously, when most people had not been vaccinated. While it is too early to extend that conclusion to India, and the vaccines in use here, hospitalisation is one indicator that offers some hope.

According to data released by Mumbai’s civic body, nearly 90% of the new covid-19 infections in the city on Jan. 3 were asymptomatic. While the city recorded over 8,000 infections, hospitalisations rose by 574 on the same day, and 71 of those needed oxygen support. So far, about 12% of the total covid bed capacity has been used in the city. But beds may fill up soon.

The Delhi government has also begun giving out similar hospitalisation data. On Jan. 3, with nearly 4,100 infections, there were 420 hospital beds occupied in Delhi. Of these, 124 were on oxygen support and seven needed ventilators.

Still, while the situation at the moment may seem different from the delta variant wave, which completely overwhelmed the healthcare infrastructure in India, that can swiftly change during a period of high infections. Even if a small proportion of exponentially rising infections need beds, these can still overburden hospitals, especially in the context of India’s already insufficient healthcare capacity.

A big worry also is infections among doctors and healthcare workers, who will only begin receiving booster shots this month.

Things may already be looking grim in Kolkata.

In Delhi, too, 23 resident doctors have tested positive over the past week at Safdarjung Hospital.

The next few weeks will be crucial for India to keep up its tests, track and isolate patients, and also offer transparent data on hospitalisations to understand the impact of omicron, and estimate when its cases might peak (right now, it’s too soon to say).

But while local governments prepare for a covid-19 wave, some of India’s largest political parties are readying for the electoral battlefield.

Crowded political rallies continue

Much like India’s second wave of covid, the ongoing third wave coincides with a hectic election season.

The state of Uttar Pradesh, among the largest and most populous in the country, will go to the polls in February. In the run-up to the hotly contested election, Narendra Modi’s Bharatiya Janata Party, Congress, and Samajwadi Party have begun hosting mega campaign rallies in the state. Over the first weekend of January, all three parties shared images of massive crowds at campaign events in the state.

These rallies are a painful reminder of the elections of the summer of 2021, when prime minister Modi led a massive campaign in West Bengal, inundated with pictures of a maskless crowd, despite an explosion of infections in the country. After the election rallies, the test positivity rate in Kolkata, the capital of the state, rose to nearly 50%.

Currently, all political parties in Uttar Pradesh have expressed the desire to stay on schedule for the election despite fears of the omicron variant.

Elections are also due in the states of Punjab, Goa, Manipur, and Uttarakhand either in February or March. Modi led BJP’s rallies in Punjab, while Delhi chief minister campaigned for his Aam Aadmi Party in Punjab, Uttarakhand, and Uttar Pradesh.

But the question of a lockdown still persists.

Will there be lockdowns?

India avoided a nationwide lockdown even during the peak of the previous wave, so a blanket shutdown may not be on the cards. At the time, India’s health ministry advised states to follow a “localised lockdown” strategy, which may be the case with the third wave, too.

In Delhi, for instance, the government formulated a colour-coded lockdown strategy in August. Different levels of restrictions will be triggered under the graded response action plan, based on total new cases, test positivity rates, and hospitalisations.

For now, a yellow alert, the first level of this plan, has been sounded in Delhi. The cut off for this level is a test positivity rate of 0.5% for two days. But Delhi has held back on escalating restrictions based on positivity rate alone because the need for hospital beds hasn’t risen sharply.

Chief minister Kejriwal has said that the government will strengthen its home isolation protocol this time. His government’s covid war room was largely missing during the worst of infections in Delhi in April, leading residents to look for hospital beds, oxygen cylinders and medication on their own.

Other states like Maharashtra and Karnataka have night curfews in place, besides restrictions on large public gatherings. Mumbai’s civic body has said it will go into a full lockdown if new daily cases cross 20,000.

The question of a lockdown also key if India has to regain lost ground in terms of the economy. The country was the biggest contributor to global poverty in the two years of the pandemic, and its GDP growth rate, when adjusted for the losses of the pandemic, has slowed down from pre-pandemic years.

Modi is keen to keep India’s economy on track, and lockdowns will only slow down the process. “We have to further accelerate the pace of development. Corona poses challenges, but it cannot stall the growth process,” he said at a recent government event.