“There are no easy answers,” say epidemiologists and mathematicians tracking the coronavirus’ rapid surge in 2021. There are no clear indications of a plateau yet in the state- or national-level data, experts say as India added over 2.16 lakh fresh cases in the last 24 hours.
According to mathematical modeling carried out by professors at IIT Kanpur, the peak appears to be between 20 and 25 April but given the high rate of infections, the real value and date of the peak are yet to be determined.
Dr Murad Banaji, a mathematician at Middlesex University with an interest in disease modelling, has observed that while some of the early hit states and districts appear to have peaked, none of the states are yet seeing a steady decline in cases.
Experts have also cautioned that the peak of the second wave can well be decided by human behaviour and the kind of interventions put in place.
The R-value, which tells us approximately how many people one infected individual will infect, shows that every state currently has a value above 1. This means that one person will still at least infect another person. In some cases, the R-value is still above 2.
“Looking at the R values, we can see that the epidemic is growing across all parts of the country, but that the speed of growth varies,” Dr Banaji told The Quint.
No Plateau Visible Yet at National Level
According to Dr Banaji, there are not any clear plateaus in state-level data yet, although Punjab comes closest.
“When we look at district-level data from Maharashtra, we see that some districts appear to have peaked, while others are still seeing rising daily cases,” Dr Banaji told The Quint.
“Mumbai is showing signs of passing a peak in cases, but it is too early to be absolutely sure. So, the picture is too complicated even at the state level to draw firm conclusions yet,” he further added.
The big question is, when will the situation stabilise nationally?
Banaji, who has been studying the R-values at the national, state, and district levels says there are no easy answers.
“This surge has been particularly rapid and all the signs are that it will be hard to bring under control,” he said.
Experts say while it is possible that the rapid rise is at least partly because there are variants in circulation which are more transmissible, or which can evade prior immunity. According to Dr Banaji, there certainly should be regular genomic sequencing to examine this question.
To get an idea of how this wave will evolve, we need to watch what happens in those regions hit first – Maharashtra, Punjab and Chandigarh.
“Once we see convincing declines in these regions, then this will provide some hope for other states, and some insight into what control measures work,” he told The Quint.
Human Behaviour to Decide Peak of Current Wave
Experts have also pointed out in near unison that human intervention and actions could determine how prolonged the wave is and when it peaks. According to Ramanan Laxminarayan, Director of the Washington, DC-based Center for Disease Dynamics, Economics and Policy, “The peak of this second wave, like with the first, will be determined largely by human behaviour.”
This is evident also from the modelling carried out by the faculty at IIT Kanpur. A peak of about 1.70 lakh cases that was predicted for 15-20 April has now moved forward to 20-25 April. India surpassed the projection by reporting over two lakh cases on 16 April.
“The date of turning (of the curve) will decide the value of peak,” said Manindra Agrawal, Professor of Computer Science at IIT Kanpur, in a tweet on 14 April.
Laxminarayan added as a cautionary note, “If there continue to be mass gatherings and poor compliance with distancing and masking, things could get worse than it already is. But a change in behaviour could quickly bring it under control.”
With no visible plateau or a steady decline in sight just yet, what do insights from mathematical models suggest?
“Right now, in the context of overwhelmed hospitals, the priority must be to slow down the spread as much as possible – and accelerate vaccination, focussing on the most vulnerable,” Banaji said.
Experts say, if the spread is not slowed as a matter of urgency, then there will be an increasing number of preventable deaths, both from COVID and other causes, as healthcare systems collapse.
Banaji adds it’s important to “recognise that a huge mistake during the last lockdown was treating the control of COVID as a law-and-order issue, instead of prioritising education about risk.”
Laxminarayan adds it is important to consistently spread the message that COVID-19 is a serious disease.
“It does not help to communicate that case fatality rates are low (they are not when calculated correctly after adjusting for age and comorbidities), and that things are under control but also expect people to wear masks and inconvenience themselves.”
Experts agree that governments should avoid pointless measures which could actually increase risks. While shutting outdoor spaces should be monitored for overcrowding instead of shutdowns, they say people need to continue being educated as well about outdoor behaviour.
“And crucially, governments need to recognise that people have to survive: those in non-essential jobs who cannot work from home but still need to earn a living must be supported financially until the crisis has passed. Create an atmosphere of empathy, not of fear,” Banaji said.
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