File image: People scramble to board a bus amid the spread of COVID-19 in Mumbai, India on February 25, 2021. (Image: Reuters/Francis Mascarenhas)

India on March 21 saw 43,846 cases and 197 deaths. The numbers are surging at a fast clip. Maharashtra is leading the way with 30,535 cases, but other states such as Punjab (2,644), Kerala (1,875), Karnataka (1,715), Gujarat (1,580), and Madhya Pradesh (1,322) are also adding more cases. These six states now account for 80 percent of the cases. The deaths too have surged to 212.

Since the pandemic began early last year, India saw 1.16 crore cases and about 1,60,000 deaths. The country's total active caseload has reached 3,34,646.

We are at the beginning of a second wave.

How did we get here?

The latest upsurge is blamed on super spreading events that have led to community spillover and the subsequent lack of testing, tracking and tracing. Also maybe due to fatigue of pandemic or sheer complacency, most people have become lax in adherence to COVID-19 appropriate behaviour like wearing masks, hand hygiene and social distance. The governments eased restrictions on public transport, educational institutions, business establishments, entertainment and religious places, allowing mobility and crowding of people even as enforcement took a backseat.

COVID-19 Vaccine

Frequently Asked Questions

How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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The government's genomic sequencing efforts are yet to provide any evidence to suggest that new variants are possibly behind the spike in cases, but experts say that there is a possibility of emergence of new variants that may have higher transmissability. Around 400 COVID-19 cases linked to the UK, South African and Brazilian strains of the coronavirus have been detected in India, according to Health Ministry last week. The government maintained that there was no case of re-infection by mutant variants of SARS-CoV-2 virus. The UK, South Africa and Brazil variants not only have high transmissibility but can affect the efficacy of the COVID-19 vaccine. To sequence the viral genome of the virus, the government has set up Indian SARS-CoV-2 Genomics Consortium (INSACOG) Labs. For general surveillance - the government randomly collects samples of 5 percent of positive COVID-19 cases across India. Samples from metro cities, COVID clusters and new clinical symptoms are given priority for sequencing.

Positivity and fatality rates

The daily positivity rate on the basis of the seven-day moving average has increased from 2 percent on March 1 to 3.70 percent on March 21. States with high positivity rate include Maharashtra (18.35 percent), Punjab (7.44 percent), Goa (5.93 percent), Madhya Pradesh (5.05 percent) and Gujarat (4.81 percent). India is conducting about 8.8 lakh COVID-19 tests.

As far as the COVID-19 case fatality rate (CFR) or death rate is concerned, India is seeing some improvement. The country hit peak CFR at 1.75 percent in September, and now it stands at 1.37 percent. Vaccination of high-risk people and better treatment protocols could be the reason behind low CFR compared to last year.

Testing

Testing is key to identify and isolate COVID-19 cases. India is much better prepared in terms of COVID-19 testing infrastructure particularly RT-PCR testing. In March 2020, India was testing just 4,000 samples per day, now it is testing about 9 lakh per day. There are about 2,425 laboratories in the country that conduct COVID-19 testing. The RT-PCR test, which is the gold standard for COVID-19 diagnoses, is now available at less than Rs 1,000 per test, compared to Rs 4,500 per test last year.

Please read here on four ways to control COVID-19 spike

Vaccination, how far have we reached?

The availability of COVID-19 vaccines is one significant difference in reducing the mortality rate. COVID-19 vaccines may not prevent human-to-human transmission, but will avert hospitalisation and death. The government is inoculating high-risk people such as healthcare and frontline workers, elderly people of age 60 and above, and people aged 45 years and above with comorbidities.

The government is vaccinating an average 18-20 lakh people on a daily basis, but on holidays and weekends the figure drops drastically. India is targeting to complete 30 crore inoculations by August, a stiff target. India so far administered 4.51 crore doses of COVID-19 vaccine. About 75 lakh people have got both doses of the vaccine.

COVID-19 spike | Why cases increase, is it a second wave and other key questions answered

Since the pandemic began early last year, India saw 1.16 crore cases and about 1,60,000 deaths.

File image: People scramble to board a bus amid the spread of COVID-19 in Mumbai, India on February 25, 2021. (Image: Reuters/Francis Mascarenhas)

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