As COVID-19 cases rise in Delhi and Haryana, what this could mean for India?

After weeks of declining cases, Delhi reported 517 fresh cases of COVID-19 on Sunday. Meanwhile, in Haryana, the COVID-19 count has increased by four times until Sunday although the figure is less than that in the National Capital. Doctors and health experts are again worried as for the first time since the third week of January, active cases in the country have begun to rise again. Although the pattern of rising is still very small, the increasing trend continuing for days now is worrying.

Delhi has continued to report a significantly higher number of cases, over 100 per day on an average unlike other cities such as Mumbai, Bengaluru, Chennai, or Pune where the number of daily new cases dropped to the lower double-digits. On Tuesday, Delhi detected more than 200 new cases for the first time in a month. Since then, the number of cases has continued to rise every day. Similarly, on Saturday Haryana’s tally of 202 cases was the highest in five weeks. According to the statistics of the Health Ministry, Delhi and Haryana together contributed over half of India’s total cases on Saturday.

“There has been a sharp spike in the positivity rate of the contagious COVID-19 infection across the Capital and Haryana recently. Factoring in the new mutations of the virus, high infectivity or transferability rate, and declining sentiment of the public towards safeguards has culminated into a warning trigger. People are not proactively undertaking COVID-19 tests and are preferring home isolation for recuperation depending on the severity of the infection,” Dr. Om Parkash, Chief Medical Officer (SAG), South Delhi Municipal Corporation (SDMC) told Financial Express.com.

Dr. Om Prakash also suggested that people must not panic, as state governments’ are putting their efforts to bridge the gap for proper prevention of the potential fourth wave. “People must take cognisance of the social distancing protocols as sincerely as during the advent of the pandemic to curb the concerns of future cases surge,” he added.

What are the possible reasons?

Although the reasons for the rising numbers in Delhi and Haryana are not clear right now, the most plausible explanation is that it is being caused by the withdrawal of the mask mandate and removing almost all COVID-19 restrictions.

“As the cases of COVID-19 are rising in Delhi and NCR regions, it’s high time that we should keep our guard up, one cannot be casual at this time. We should continue to follow the COVID-appropriate behaviours. People, who are eligible for booster doses, should get their shot immediately. School kids, especially those below 12 years, should be extra careful as they haven’t taken any dose yet,” Dr. Shuchin Bajaj, Founder & Director, Ujala Cygnus Group of Hospitals, told Financial Express.com.

Dr. Bajaj also warned that parents should not delay their kids’ other essential pediatric vaccinations. Though the cases are rising, the symptoms are mild in freshly diagnosed patients.

Low COVID-19 figures in other parts of the country

Although there is a surge in COVID-19 cases in Delhi and Haryana, the numbers are not expected to go very high as there is no significant change in the emergence of a fast-transmitting variant and the availability of a large pool in a susceptible population. According to experts, the rise is likely to be temporary, and manageable.

While active cases at the national level have shown an increase in the last few days, the detection of new cases has remained at more or less the same level. The 1,150 new cases detected on Saturday were indeed significantly higher than the 949 and 975 cases on the two previous days. However, the seven-day moving average of new cases, which masks the daily fluctuations and presents a more consistent trend, is continuing to decline.

“With this virus, we are going to see ebbs and flow in infection, as new strains may develop, similar to the flu virus. Since the beginning of the pandemic, we have observed that masking has been effective in curbing the spread of the vaccine. With the rise in cases, I believe the mask mandate should be reintroduced – if not as a blanket policy, at least it should be enforced in crowded and enclosed areas. What we also need to focus on is enforcing vaccination including the precautionary dose, increased testing, and isolating if symptomatic,” Dr. Radhika Banka, Consultant Respiratory Physician at PD Hinduja Hospital and MRC, Mahim, Mumbai told Financial Express.com.

At present, over 10 states and union territories are reporting cases in single digits, many of which have zero COVID-19 cases. Meanwhile, the countrywide case numbers remain at the lowest level in the last two years and positivity rates are going down consistently.

Fears and speculations over the Fourth Wave

The surge in cases in Delhi and Haryana have renewed fear about the beginning of a fourth wave, especially among doctors and health experts. However, it is still too early to predict anything about a fresh wave of infections. According to experts, the majority of India’s population has already been infected with the Omicron variant and people would have attained a fair degree of immunity against this variant. Although reinfection by the same variant is not unknown, it is not frequent either. However, some maintain that the fourth wave has begun.

“The fourth wave has started, cases are increasing and will continue to increase over the next three weeks. We are moving steadily towards the fourth peak. My expectation is that the cases will increase, as they did in January, but they will not be as severe, and hospitalizations will also be limited. But yes, there will be a sharp increase in the cases. As always, we must stay vigilant,” Dr. Sushila Kataria, Senior Director, Internal Medicine, Medanta Hospital Gurgaon told Financial Express.com.

Meanwhile, it is still unclear how long the immunity gained from earlier infection is effective. Experts have maintained that immunity attained from the previous infection lasts for at least six to nine months. 

“Although the XE variant has gained prominence in the last few weeks the complete details for the new variant are yet unknown. As the number of cases spikes, the hospitalization rate still remains very low. So, there is no need to panic yet take all necessary precautions. Going by the current clinical scenario of the COVID-19 cases, it doesn’t seem to be as fulminant symptoms as delta strain though transmissibility might be higher than omicron,” Dr. Sachin Kandhari, Senior Neurosurgeon and Managing Director, IBS Hospital told Financial Express.com.