Some months into the COVID-19 outbreak, what was once an exponential graph of the number of positive cases seemed to be calming down with the numerous vaccines being discovered and approved, and a hope of returning to normalcy bloomed among the masses seeing the statistics showing a significant drop in the cases from the previous peak in September till mid February, and the virus seemed to die out.
Fast forward to two months, i.e., April. India was amidst its second wave and the cases were shooting up, reaching an average of 3 lakh cases per day. It seemed that the virus was in no mood to stop.
Today, India is currently experiencing the worst health crisis and the healthcare system is collapsing.
First Wave
Hospitalisations and mortality were lower during the period of the first wave of the COVID-19 outbreak, which lends support to the argument that cases were indeed declining in India.
There are multiple hypotheses but no concrete evidence of why India was actually experiencing a low number of daily new cases.
Non-pharmacological intervention (NPI) could provide some of the explanation. Certainly, a mask mandate and social distancing could have a positive effect on reducing the number of daily cases. India’s testing capacity had increased in a very short span of time and there was greater awareness for people to follow NPIs. But on the other hand, India is a densely populated country with around 1,200 people per square mile. Social distancing is extremely difficult to follow under such circumstances.
There is also speculation on favourable environmental factors such as the hot and humid climate of India which had proved to be favourable in controlling the spread of the virus in the first wave. But this is questionable, as other countries such as Brazil and Mexico did not seem to benefit with the similar weather.
There are also suggestions that a proportion of the Indian population had developed innate immunity from exposure to other related infections in their lives, which boosted their immune response to the novel coronavirus.
India also had one distinct advantage over the European countries, which is its relatively younger population, who generally show more resistance to the virus.
Daily cases had dropped from almost 1 lakh per day to a minimum of 15,000 per day. This was the time when India was recovering and calming down, hoping for a ‘V’ shaped economic bounce back; and the focus had now shifted to ramping up vaccine production and the process of vaccination. [1]
But this changed completely in the month of February where cases significantly rose once again, breaking record numbers everyday and once again sending the country into absolute chaos.
Second Wave Chaos
The second wave of the COVID-19 outbreak had struck India by the end of February, and the cases shot up exponentially.
There are many reasons and speculations behind this sudden exponential rise in cases; however, we’ll only look at some important scientific reasons behind it
1) SARS-CoV-2, the virus behind the COVID-19 pandemic, has RNA as the genetic material. RNA is unstable compared to DNA, and this instability leads to mutations leading to a change in the structure and function. Although the majority of mutations are inconsequential, they do not alter the way a virus behaves, but some trigger changes in spike protein could lead to new variants that could potentially cause more infectious, severe diseases, and evade vaccines.
2) Some variants responsible are kent variant or U.K. variant B.1.1.7 having E484k genetic mutation that allows the virus to evade human immune system, and spread easily and rapidly. It presents with symptoms like persistent cough, tiredness, muscle ache, sore throat, fever, etc. Currently, this variant dominates new cases in Punjab.
3) Another one is the fast spreading “double mutant,” so called as it has double mutations E484Q and L452R leading to immune escape, and is labelled as B.1.617. This variant has been found in some parts of Maharashtra, the worst hit state in India.
4) New variants yet to be discovered might also be present in different parts of the country.
Dr Shuchin Bajaj, Founder and Director of the Ujala Cygnus Group of Hospitals spoke about the new variant of COVID-19 and said, “The new variant spreads easily and quicker than any other variant. All mutations or variants may not be transmissible or cause infection, and there is still no clarity on which strain causes which symptoms. Nowadays, we are seeing new covid strain, and some newer symptoms are found in patients like fever, pain in muscles, dry and persistent cough, and loss of smell and taste. In addition to conjunctivitis, sore throat, headache, rashes, upset stomach, and discolouration of fingers and toes.” [2]
Conclusion
By this, we can understand that any one reason cannot lead us to a conclusion. There were also many other factors and incidents which acted as super spreaders, such as the endless election campaign in three odd states and the Kumbh festival congregation without any prior safety arrangements. This is the overall viewpoint of origin and reasons for the second wave in, especially, with respect to the context of India. The only way out for us from this chaos is complete vaccination of the general population, as suggested by medical experts, which is what our government and the private players are working on.
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