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Following more than a week of steady decline in the detection of new COVID-19 cases across the country, the test positivity rate has started to fall too. This is the first time in over a month where the weekly positivity rate has started dipping. According to experts, these falling numbers indicate that the third wave of COVID-19 in India could well be nearing its end.

India reported 1.67 lakh new Covid-19 cases as on February 1, sharply down from 2.34 lakh infections on January 30. The new daily cases dropped below the 2-lakh mark for the first time since January 12. The active case load now stands at 18,31,268 while the recovery rate marginally rose to 94.37 per cent.  Meanwhile, the country’s daily Covid-19 deaths climbed to 1,192 in the 24 hours ending 8 AM on February 1, taking the total death toll at 496,242.

Positivity rate is the proportion of people who test positive out of the total number of people tested. The weekly positivity rate saw a dip from 16.84 per cent on January 27 to 15.63 per cent on January 30 and 11.69 percent on January 31. Positivity rate is a good indicator of how quickly the disease is spreading in the population, or how prevalent it is. The weekly positivity rate in India had fallen below half a percent in the third week of December, 2021 before it began to rise with an increasing number of infections caused by the highly virulent Omicron variant. It continued to rise exponentially after, till the last week, when a dip was observed for the first time ever since.

Despite the fall, a positivity rate higher than 10 per cent is still quite high, making it difficult to ascertain whether it signals the end of the pandemic. Even as some cities or states in India may be beginning to see plateauing and declining COVID-19 cases, the risk persists and the focus must be on reducing transmission, experts believe. According to data from the Union Ministry of Health and Family Welfare, 388 out of 734 districts continue to have a weekly positivity rate higher than 10 per cent. Another 144 have positivity rates between 5 and 10 per cent and 202 districts have less than five per cent positivity rate.

Current regional prevalence

While most major cities in India seem to have peaked, with a near steady decline in cases over the past week to 10 days, the highest positivity rates are in Kerala right now, where most of the districts have been reporting over 40 per cent positivity. One district each in Himachal Pradesh, Assam and Haryana, and three in Arunachal Pradesh also have more than 50 per cent positivity.

Kerala has been reporting more than 50,000 new cases for the last five days now, its contribution to the national case count now exceeding 20 per cent. Amongst the major states, it is the only one which is not yet showing any signs of decline in the daily case numbers.

Andhra Pradesh is also not seeing a decline, but there the case count is around 12,000. Karnataka and Tamil Nadu, two other states reporting over 25,000 cases every day, seem to have reached their peaks in the third wave and are on their downward journey now.

Omicron and the likelihood of endemicity

The Indian SARS-CoV-2 Genomics Consortium (INSACOG) stated last week that Omicron is in community transmission in India and has become dominant in multiple metros. An ICMR study has demonstrated that individuals infected with Omicron, the variant that seems to fuelled the third wave in the country, have significant immune response which could neutralise not only the Omicron, but also other variants of concern, including the most prevalent Delta variant. It suggests that the immune response induced by the Omicron could effectively neutralise the Delta variant, making the re-infection with Delta variant less likely, thereby displacing the Delta as dominant strain. The study emphasised upon the need for Omicron-specific vaccine strategy.

Many experts believe that COVID-19 is on its way to becoming an endemic disease. However, what this actually means is not immediately clear. In epidemiology, an infection is said to be endemic in a population when that infection is constantly maintained at a baseline level in a geographic area without external inputs. The expectation that COVID-19 will become endemic essentially means that the pandemic will not end with the virus disappearing; instead, the view is that enough people will gain immune protection from vaccination and from natural infection such that there will be less transmission and much less COVID-19-related hospitalization and death, even as the virus continues to circulate.

Some European countries such as Spain have started making tentative plans for when they might start treating Covid-19 as an endemic disease, like seasonal flu. But, World Health Organization (WHO) experts and other officials say that’s premature with a warning that the world is nowhere close to declaring the pandemic as over. Moreover, endemic would not mean the problem is over– the reason being that many serious diseases, including tuberculosis and HIV, are considered endemic in parts of the world and yet they continue to kill hundreds of thousands of people every year.

Vaccination and COVID appropriate behaviour continue to be best way forward

India’s COVID-19 vaccination coverage has crossed 166.59 crore. About 90 per cent of India’s adult population has received the first dose of Covid-19 vaccine whereas over 70 per cent have been administered both the doses.

Despite the immunity conferred by the Omicron variant in a sizeable proportion of the population, vaccines still seem to remain highly effective at protecting people against serious illness, hospitalization, and death. Vaccines, face masking, and hand hygiene remain effective methods to reduce the likelihood of severe disease.

Photo Credits: The Indian Express

References:

https://indianexpress.com/article/explained/explained-covid-19-positivity-rate-ebb-of-third-wave-7748190/

https://www.dnaindia.com/india/report-is-the-covid-19-pandemic-entering-in-endemic-stages-who-says-this-2931001

https://www.hsph.harvard.edu/news/features/what-will-it-be-like-when-covid-19-becomes-endemic/

https://indianexpress.com/article/india/coronavirus-omicron-india-live-news-third-wave-health-ministry-covid-delhi-mumbai-7740153/

https://www.indiatoday.in/coronavirus-outbreak/story/explainer-covid-pandemic-endemic-who-deaths-infections-1902613-2022-01-21

https://www.thehindu.com/news/national/omicron-in-community-transmission-stage-in-india-dominant-in-multiple-metros-insacog/article38313131.ece

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