India to face wave of Covid-19 peaks as virus spreads at different rates

The body of a Covid-19 victim outside a crematorium in Delhi.
The body of a Covid-19 victim outside a crematorium in Delhi. © Murali Krishnan

India is likely to see a wave of peaks in the number of Covid-19 cases across the country instead of one single high, because the virus is spreading at different rates across states, according to health officials.   


For the past month, four of the five states of southern India have been major coronavirus hotspots. The epidemic is rapidly extending its footprint in this region which now accounts for over 200,000 cases – almost 27 percent of the country’s total number of coronavirus cases.

Virus flaring up across India

Similarly, the northern states of Uttar Pradesh and Bihar, along with West Bengal in the east, are also witnessing a steady and disturbing upward trend in infections.

“The daily rise in cases is worrisome. We are going to see different peaks in different parts of the country,” said G V S Murthy, director of the Indian Institute of Public Health.

“Each state will have its own trajectory based on when people there were exposed to the infection.”

Worryingly, the trajectory of deaths is still rising at a fast pace. Unlike the curves of some other badly-hit countries, India’s trajectory has yet to peak or stabilise.

Health ministry data shows that 86 percent of Covid-19 cases come from just 10 states, making for an uneven spread.

Looking at India-wide numbers makes little sense given that the growth in case numbers is dominated by a handful of states, say epidemiologists.

Experts point out one major reason for the exponential rise in so many regions is because there is proof that full-blown community transmission is happening in India, a fact the government is reluctant to admit.

Did central government get it wrong?

An admission of community infection could be read as an indication that the Delhi government’s contact tracing, testing and isolation efforts, and even perhaps the harsh lockdown measures, have not had the desired impact.

According to the WHO’s guidelines, community transmission is evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases.

“Rates of infection are rapidly going up in every state and this is certainly happening. The rising cases support this,” says Arvind Kumar, a chest specialist in the capital.

Community infections

The governments of Kerala, West Bengal and Assam have said that there is community transmission in certain areas in their respective states.

Coronavirus cases in India stood at over 1.43 million with a daily increase of nearly 50,000 on Monday while the death toll was 32,771.

India, the third worst-hit country in the global coronavirus tally after US and Brazil, has gradually ramped-up its Covid-19 testing capacity and has conducted over 420,000 tests in a day.

The government has advised all state governments to keep up the strategy of 'test, track and treat' with aggressive testing which may lead to higher number of daily positive case.

“This will eventually achieve a decline as has been demonstrated after the central government's targeted efforts in the National Capital Territory of Delhi," the ministry said in a statement.

Though India hit the million infections mark on 17 July, a large number of those infected are asymptomatic and it is difficult to estimate the number of ‘true infections’, especially without the serological survey data.

Serological tests look for disease-specific antibodies in an individual and are carried out to estimate the spread of the disease in a population group.

The Indian Institute of Science has predicted that the country may have as many as 3.5 million Covid-19 cases by 1 September. This is because, as cases increase rapidly, isolation and quarantine would have limited effectiveness.

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