COVID-19 in India: What changed in the coronavirus second wave as compared to the first wave?

Asymptomatic cases were also higher in this wave, but the mortality rate did not differ between the two waves.

Coronavirus second wave in India: The second wave of coronavirus that hit India this year was significantly different from the first spike of cases that we saw in 2020. The second wave differed in terms of the infectiousness, the symptoms as well as the severity. According to a report in IE, experts are also concerned about long COVID syndrome, which refers to the persistence of COVID-19 long after the initial infection. Here’s a look at what was new during the second wave as compared to the first one.

COVID-19 symptoms in first and second waves

The report said that while some symptoms like breathing issues and dry cough remained the same in both the waves, the second wave also saw additional symptoms like loose motion, eye infection and hearing problems. Apart from this, the second wave also saw an increase in the number of secondary infections and black fungus infections, the report cited St Stephen’s Hospital’s Dr Abha Mangal as saying.

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Meanwhile, COVID-19 technical advisor to Maharashtra government Dr Subhash Salunkhe said that while the first wave included symptoms that were more flu-like, the symptoms seen during the second wave, like those involving the gastrointestinal tract, did not fit into any criteria.

In a recent correspondence in The Lancet Respiratory Medicine, experts speaking about the implications of India’s second COVID-19 wave said that during this year’s wave, severe consequences were seen, like reduced supplies of essential treatments, increase in deaths especially among the younger population, and spiralling cases.

Second wave and the younger population

Experts, including Dr Mangal, have said that at large, the demographic profile of coronavirus cases in both the waves has somewhat been similar, but there have been some differences. The mortality continued to remain higher among elderly people and those having comorbidities, but young adults saw more mortality in this wave than the first one. As per a report by ICMR, the average age of cases in the second wave declined to 49 years, compared with 50 years in the first one. Asymptomatic cases were also higher in this wave, but the mortality rate did not differ between the two waves.

Increased severity

A large study conducted in north India showed that the disease severity at admission and mortality rates were overall higher in the second wave, and this was especially the case in younger patients, the report cited Delhi-based Max Super Speciality Hospital’s Dr Sandeep Budhiraja. Meanwhile, long Covid protracted was witnessed during the second wave, which was mainly characterised by fatigue, neuromuscular complications and brain fog, as per Maharashtra COVID task force member Dr Shashank Joshi. Dr Joshi said that while the period for post-Covid vigilance had been about two weeks in the first wave, this time was up to 100 days in the second wave.

The second wave also witnessed an increase in unusual bacterial, fungal and viral infections, along with a spike in cases of black fungus, and this has been the case even without diabetes and steroid therapy.

Apart from this, anecdotal cases of thrombosis, which led to infarction of legs and also amputation, were also being witnessed, as per National COVID task force expert Dr Sanjay Pujari.

As far as the spread of the virus is concerned, in the first case, while 75% of the cases had been reported from a total of about 100 districts, 40 districts combined made up this figure in the second wave, indicating that the variant – the Delta variant – was more infectious in the second wave.