Covid 19 and India

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Contents

An overview

2020

December 25, 2020: The Times of India

Covid 19 in India, Jan to Dec 23, 2020, a state-wise overview
From: December 25, 2020: The Times of India

11 months of ups and downs in India’s battle against Covid

The peaks of 90,000+ daily cases appear far behind now, but as the new year beckons, India has a wary eye open for a new strain. Atul Thakur charts the course of the virus since the first case in January

India reported its first Covid-19 case on January 30 when an Indian student in Wuhan tested positive upon her return to Kerala. Through February, though, India added only two more cases, taking the country's cumulative total to three cases and zero deaths.

The coronavirus’ real onslaught began in March — within the first 10 days, many large states began reporting cases. Delhi, Rajasthan and Telangana reported their first cases on March 2, followed by Haryana and Uttar Pradesh on March 4. Separated by thousands of kilometres both Tamil Nadu and Ladakh reported their first case on March 7. On March 9, Jammu & Kashmir, Karnataka, Maharashtra and Punjab reported positive cases. By March-end, 27 of the 36 states and UTs had reported positive cases. India also saw its first Covid-19 deaths on March 13, when both Delhi and Karnataka reported their first fatalities. By the end of the month, 13 states had witnessed Covid deaths.

Indians spent most of April under one of the world’s strictest lockdowns, but cases kept crawling up. From little over a thousand, India’s cumulative Covid case count went up to over 33,000 by April-end. The death toll also crossed the 1,000-mark in April. By the end of the month, Sikkim, Nagaland, Dadra and Nagar Haveli, Daman and Diu and Lakshadweep were the only ones yet to report cases.

Cases breached the one-lakh threshold in May. The month also saw cumulative deaths cross the 5,000-mark. But even by the end of the month, 12 states and UTs, including Ladakh, Tripura, Puducherry, Goa, Arunachal Pradesh, Nagaland, Sikkim, Manipur and Mizoram were yet to report their first deaths.

But Covid unleashed its full force during the first phase of unlocking in June and cases raced from 1.8 lakh to 5.6 lakh over the course of the month. Cumulative deaths, too, rose from 5,164 on May 31 to 16,893 on June 30. The rapid increase in both cases and deaths continued in July and August. From over 5 lakh by June-end, cases rose to more than 35 lakh by the end of August.

The silver lining was that the otherwise grim months of July and August showed a glimpse of what lay beyond the peak of cases. Tamil Nadu was the first state to peak. The daily average of new cases touched 6,803 on July 30 and hasn’t crossed that mark again. Bihar also saw its highest daily case tally on August 15.

Eighteen states and UTs reported their maximum daily average of cases in September. Among the larger states, Andhra Pradesh saw its peak at 10,500 cases on September 2. Other major states like Maharashtra (22,149), UP (6,581), Odisha (4,272), Chhattisgarh (3,282), Assam (2,875), Telangana (2,718), Punjab (2,639), Haryana (2,566), and MP (2,523) reached their peak daily cases in September. India reached its peak on September 17, when the daily average touched 93,199 cases.

There has been a steady decline in daily cases since September, and by October-end it appeared that 29 states and UTs were past their peaks.

The daily average of cases is over 5,000 for Kerala and more than 2,000 for Maharashtra and West Bengal now. The average ranges between 1,000 and 2,000 for Chhattisgarh, UP, Delhi, Karnataka, Tamil Nadu, MP, Gujarat and Rajasthan. Judging from the overall trends since September, it seems that the worst is over.

A timeline

Shuja Asrar, January 1, 2021: The Times of India

September recorded the highest number of cases, February- December 2020
From: Shuja Asrar, January 1, 2021: The Times of India

Coronavirus calendar: How the Covid pandemic unfolded across India in 2020

NEW DELHI: More than 82 million cases, over 1.8 million deaths, a record slump in the economy, loss of livelihoods of millions, lockdown that confined billions of people inside their houses — the coronavirus pandemic has exposed vulnerabilities and tested resilience of humans in 2020.

In India, the virus has so far infected 10.2 million people and claimed the lives of over 148,000 people. The month of September witnessed the most catastrophic phase of the pandemic when over 2.6 million cases were confirmed.

We look at how the pandemic spread across the country since the detection of the first case on January 30.


January (cases:1 | deaths:0)

30 First case confirmed in Kerala's Thrissur

31 WHO declares the coronavirus a Global Emergency of International Concern


February (cases:3 | deaths:0)

2 Second case reported in Kerala's Alappuzha

3 Third case reported in Kerala's Kasaragod

11 WHO names new coronavirus SARS-CoV-2 and disease caused by it Covid-19

27 A total 759 Indians and 43 foreigners airlifted from Wuhan


March (cases:1,397 | deaths:35)

6 Screening of international arrivals in India

11 WHO declared Covid-19 a pandemic

12 First confirmed death in India. Stock markets crash — BSE SENSEX dropped 8.18%,NIFTY dropped 9%

14 Indian scientists isolated a strain of the novel coronavirus

17 Govt allowed private pathology labs to test for Covid-19

22 One-day janta curfew imposed. Passenger air and train travel suspended

23 Hydroxychloroquine recommended for the treatment of high-risk cases.

25 Lockdown imposed till March 25. All domestic flights suspended

26 Exodus of migrants begin. The government announced an economic relief package of ₹1.7 lakh crore

28 1,000 confirmed cases. PM CARES Fund set up


April (cases:34,863 | deaths:1,154)

14 10,000 cases confirmed. Nationwide lockdown extended till May 3.

16 IPL suspended indefinitely

20 First recovery through plasma therapy


May (cases:190,609 | deaths:5408)

1 Nationwide lockdown extended till May 17

3 5,000 deaths confirmed

4 Liquor shops reopen across the country

7 Phase 1 of Vande Bharat mission begins. 50,000 confirmed cases reported in India.

9 ICMR announces tie up with Bharat Biotech to develop indigenous vaccine for Covid-19

12 PM Narendra Modi announces Rs 20 lakh crore Atmanirbhar package

17 Nationwide lockdown extended till May 31

19 100,000 cases confirmed


June (cases:585,481 | deaths: 17,400)

1 Govt announced guidelines for Unlock 1

10 Recoveries exceed active cases for the first time

12 India overtook UK to become 4th worst-hit coronavirus country


July (cases:1,695,988 | deaths:36511)

1 Govt announces guidelines for Unlock 2.0

6 India overtakes Russia to become third worst-hit country

15 Phase-1 clinical trials of India’s first indigenous Covid-19 vaccine, Covaxin

25 BCCI announces IPL to be held in UAE from September 19

29 Govt announces guidelines for Unlock 3.0


August (cases:3,691,166 | deaths:65,288)

3 Serum Institute of India got approval from DCGI for trial phases II & III

26 Serum Institute of India starts India trials of Covishield

29 Centre issues Unlock 4.0 guidelines

31 India's GDP contracts 23.9% in April-June quarter


September (cases:6,312,584 | deaths:98,678)

7 India became second worst-affected country after the US

22 India reported over 1 lakh coronavirus recoveries in a single-day for the first time

28 Global death count crossed one million

30 Government issued Unlock 5.0 guidelines


October (cases:8,184,082 | deaths:122,111)

5 Govt said 20-25 cr people to be vaccinated by July 25

26 Govt asked state to prepare 3-tier system for vaccine rollout

28 Voting for phase 1 of Bihar assembly elections


November (cases:9,462,809 | deaths:137,621)

5 Govt said 20-25 cr people to be vaccinated by July 25

26 Govt asked state to prepare 3-tier system for vaccine rollout

28 Voting for phase 1 of Bihar assembly elections

9 Pfizer and BioNtech said vaccine candidate more than 90% effective

10 Delhi in midst of third wave

28 Vaccine trial paricipant demand Rs 5 cr in damages


December (cases:10,244,852 | deaths:148,439)

1 Farmers protests erupt across country

21 India bans flights from UK

29 Six arrivals from UK tested positive for new strain

30 Several cities impose night curfew

2021: The second wave

Chennai: 2020, Jan-May 2021

Komal Gautham, June 8, 2021: The Times of India

Daily fresh cases of COVID-19,
April 12- November 15, 2020; Infections month-wise, January- December 2020,
Infections per month, January- June 9, 2021
From: Komal Gautham, June 8, 2021: The Times of India

CHENNAI: The city had more cases, more deaths during the second wave of the viral infection that began on April 11 compared to the first wave in May 2020.

While several factors including a highly infectious strain of the virus played a crucial rule in expediting transmission, epidemiologists say efforts taken by Greater Chennai Corporation dragged the curve down quicker this year.

On June 30, 2020, with 2,392 new cases, Chennai reported the highest number of cases for the first wave.

It took 30 days for the city to reach the peak from May 31 (prepeak period) when it was reporting around 800 cases.

In the second wave, on May 12, Chennai reported 7,564 cases – it’s peak during the second wave – 30 days after 2,105 cases on April 12, 2021.

“In 2020, it took 16 weeks for the city to report a pre-peak number of 800 cases a day. In 2021, Chennai did that in a fortnight,” said P Ganeshkumar, epidemiologist, National Institute of Epidemiology.

How did the erstwhile hotspot manage this? Timely lockdown played a crucial role. But public health experts say five key decisions by GCC helped the city. First, besides ramping up testing, the state asked scan centres to share CT reports of patients suspected for Covid-19. Since Covid-19 is a notifiable disease, many patients evaded RTPCR tests and opted for CT scans.

“This was one of the first leaks we plugged,” said joint commissioner V Alby John. Last year, while there were similar measures, the data from private labs was shared to members of the public directly. This year, it was the civic body that delivered the test results along with the medical kits.

Second, to stop those tested positive from spreading the infection, the civic agency initiated a slew of measures. It arranged for tele consultations and car ambulances that would pick them up from doorsteps to screening centres and hospitals.

Those advised home isolation were given medical kits and were monitored by a special team, including medicos appointed by GCC.

“Early isolation and therapy reduced the number of cases and deaths,” said Dr Ganeshkumar.

The city also tested more than 30,000 people per day in May 2021. “With high and targeted testing, we were able to identify more cases. Test positivity rate also dropped below 10% eventually in a shorter period of time. Last year, it took about a month in comparison to less than 20 days this year due to higher number of tests,” he said.

Despite all these measures, as active cases in the city crossed 49,000 the pressure on the healthcare system was overwhelming.

“The progression of the disease was rapid and unpredictable. And more women and younger people suffered badly, recalls infectious diseases expert Dr S Subramanian. Oxygen and drugs such as remdesivir were scarce.

The city corporation worked with the state health department to ensure timely supply of life saving oxygen gas and drugs at different hospitals.

“After several brainstorming sessions, we tightened the existing system and filled some gaps. We took vaccines at people’s doorsteps to ensure vulnerable people are quickly covered,” says GCC commissioner Gangandeep Singh Bedi.

“Almost all the measures worked. We know we still have a long way to go to stop the virus,” he said.


The death toll

2020, 2021: WHO vis-à-vis Govt of India

Amitabh Sinha, May 7, 2022: ’’The Indian Express

The Table shows Covid death claims in states
From: Amitabh Sinha, May 7, 2022: The Indian Express
Government's death data, 2018-20
From: Amitabh Sinha, May 7, 2022: The Indian Express

The WHO’s estimate of 47.4 lakh Covid-related deaths in India in 2020 and 2021 flies in the face of overall death data, historical trends in death reporting, and Covid death compensation claims from states.

While there is little doubt that India’s official Covid-19 death toll is an undercount, as is the case with probably most other countries, the “excess mortality” figures released by the World Health Organisation Thursday raise several questions.

The WHO’s estimate of 47.4 lakh Covid-related deaths in India in 2020 and 2021 flies in the face of overall death data, historical trends in death reporting, and Covid death compensation claims from states.

If, indeed, the WHO numbers are taken at face value, that would imply India missed 90 per cent of all Covid-19 deaths in the first two years of the pandemic – and possibly millions of deaths were not even recorded.

Significantly past data shows that India records over 90 per cent of all its deaths. Several population scientists The Indian Express has spoken to in the last few weeks said missing such a large number of deaths was “extremely unlikely”.

According to WHO, 8.3 lakh Covid-19 deaths happened in 2020 – the official Covid-19 toll for India for that year is 1.49 lakh. The government Thursday said that an estimated 81.2 lakh people died in the country that year due to all causes. This is consistent with past data that shows that, on an average, about 83.5 lakh people die in the country every year in the last decade and a half.

In 2019, India recorded 92 per cent of these deaths. The level of death registrations has seen a sharp rise in the last few years, from 79 per cent in 2017, to 86 per cent in 2018, to 92 per cent in 2019. In its statement, the government also claimed that 99.95 per cent of all deaths were recorded in 2020.

If 8.3 lakh of the 81.2 lakh deaths were caused by Covid-19, as the WHO says, non-Covid deaths in the year 2020 were only around 73 lakh. India’s total death toll for a year has never been below 80 lakh since 2007 till when data is available. WHO estimates say that 39.1 lakh Covid-19 deaths happened in 2021. This is at least 4 lakh more than what the entire world, put together, reported that year.

India’s official Covid-19 death toll for 2021 is 3.32 lakh. That would mean that India missed almost 92 per cent of the Covid-19 deaths in that year. At a time when government is offering mandatory cash compensation for every Covid-19 death, there is an added incentive for people to get the deaths registered.

In fact, compensation claims offers fresh light on the debate over the actual number of Covid-19 deaths in the country.

Data from 11 states, which together account for 75 per cent of the country’s death burden, shows that the total number of applications made for compensation is less than twice the combined death toll in these states. In Gujarat, the number of applications is over 10 times the death tally but in Kerala the applications are less than the recorded deaths.

The fact that even in Bihar, applications are less than the total deaths shows that compensation claims might not be a foolproof way to assess the actual number of deaths. Apart from the fact that the affluent sections might not be filing these claims to get Rs 50,000 compensation, issues related to accessibility of government agencies and services could also be barriers to people filing these applications. At the same time, however, there is also the possibility of people filing fake applications. The Supreme Court has already warned people against filing fake claims, and a state like Maharashtra has rejected over 60,000 applications that were found fake. The bottom-line, however, is that the application numbers are not anywhere near the WHO’s numbers.

The WHO numbers would also imply that the Covid-19 deaths per million population in India is 3,448, instead of 384 according to the official death toll. The global average for deaths per million is about 804. In India, Kerala has the highest deaths per million population right now, barring Goa. About 1,950 people per million population died in Kerala, which is supposed to be one of the best states in keeping records.

Assuming that Kerala has counted 100 per cent of its deaths (which it has not because it is still reporting back-dated deaths almost every day), some experts argue that even if its death per million number is extrapolated to the entire country – as an academic exercise — that would mean about 26.5 lakh Covid-linked deaths, still just over half of WHO’s numbers.

Population scientists say that the actual death count would not be a matter of speculation, or a modelling exercise, once the data from the Sample Registration Survey (SRS) is out. SRS is a survey-based sampling exercise that estimates the number of births and deaths every year. It is through this exercise that we know that about 83.5 lakh people die in the country every year, on an average.

They also say that states will continue to add backdated deaths to the tally after verification. Kerala is doing that on a daily basis, while other states do it periodically. Recently, Assam added over 1,300 deaths to its tally after a data reconciliation exercise. A couple of months ago, Maharashtra added 4,000 deaths to its tally.

Economy, impact on

2020, impact on Indian economy

The impact of Covid-19 on the economy in 2020
From: January 12, 2021: The Times of India

See graphic:

The impact of Covid-19 on the economy in 2020

2020: India and the world

Quarterly real GDP growth (YoY %), 2020: India and the world
From: February 3, 2021: The Times of India

See graphic:

Quarterly real GDP growth (YoY %), 2020: India and the world

The stock market/ Sensex, Mar 20-Feb 21

February 16, 2021: The Times of India

Covid and The Indian stock market/ Sensex, Mar 20-Feb 21
From: February 16, 2021: The Times of India

The Budget-led rally on Dalal Street continued for the third straight week as unabated buying led by foreign funds took the sensex past the 52k milestone on Monday. The index opened the session at 51,908 points, rallied to a new life high at 52,236 and settled 610 points higher at 52,154, also a new closing high. Banks and FIs were among the top contributors to the day’s gains. The market cap is now at a record Rs 205 lakh crore (about $2.8 trillion), higher than the country’s GDP.

Analysts believe the Budget could lead to investmentled growth while the proposal for an AMC for banks’ bad assets would release funds for lenders to concentrate on their core business. A stable rupee, with India’s forex reserve nearing $600 billion, is also giving confidence to foreign funds to buy Indian stocks, market players said.


Banking, finance stocks lead surge past 52k pts

The rally since February 1 has also made investors richer by over Rs 19 lakh crore with BSE’s market capitalisation now at an all-time high at Rs 205 lakh crore or about $2.8 trillion. This also lifted India’s market cap above the country’s GDP, making it one of a handful of countries to have a market cap-to-GDP ratio of more than 1.

The gains were led by foreign fund buying who net pumped in over Rs 20,100 crore, or about $2.8 billion. In contrast, domestic funds have net sold stocks worth about Rs 8,960 crore, data from CDSL and BSE showed. The rally in the domestic market was also helped by a global rally but ignored the rising crude oil prices and also the chance of a double-dip recession in the Eurozone.

According to Deepak Jasani, head of retail research, HDFC Securities, global shares rose for the 11th consecutive day to hit a fresh peak on optimism about the rollout of Covid-19 vaccines and new fiscal aid from Washington, while tensions in the Middle East drove oil to a 13-month high. “A recent Reuters poll found the euro zone economy was in a double-dip recession and that economists now expect GDP to contract 0.8% in the first quarter, reversing an earlier forecast for growth of 0.6%,” Jasani wrote in a post-market note.

In Monday’s market, the gains came mainly on the back of buying in banking and financial stocks with ICICI Bank, HDFC Bank, HDFC and Axis Bank contributing over 80% of the sensex’s gain. Selling in TCS, RIL and HUL, however, limited the gains to some extent.

Unemployment

April-June 2020

March 12, 2021: The Times of India

In 1st 3 months of lockdown, urban joblessness hit 20.9%

Had Shot Up From 9.1% In The Previous Quarter, Reveals Govt Data

New Delhi:

The urban unemployment rate in the country shot up to 20.9% in April-June 2020, the period of the lockdown imposed to prevent the spread of the Covid-19 pandemic, latest official data showed.

The quarterly periodic labour survey (PLFS) showed the unemployment rate rose in the three months to June last year from 9.1% in the previous quarter (January-March quarter) and 8.9% recorded in the April-June period of 2019. The government had imposed one of the strictest lockdowns to stop the spread of the infection which hurt economic activity and led to job losses in key sectors such as hospitality, airlines, tourism and other segments of the services sector.

The PLFS was launched by the National Statistical Office in April, 2017, to estimate the employment and unemployment indicators (worker population ratio, labour force participation rate, unemployment rate) in the short time interval of three months for urban areas only in the current weekly status. Under CWS, a person is considered as unemployed in a week if he/she did not work even for one hour on any day during the reference week but was available for work at least for one hour on any day during the reference week, according to the PLFS.

The survey showed that the unemployment rate among males at the all India level for all ages was at 20.8% in the April-June 2020 period, higher than the previous quarter’s 8.7% and above the 8.3% rate in April-June 2019. Among females, it was at 21.2%, higher than the January-March quarter’s 10.5% and above the 11.3% recorded in April-June 2019.

The unemployment rate among those in the 15-29 years of age at the all India level was 34.7%, higher than the previous quarter’s 21.1% and above the 21.6% in April-June 2019.

The survey showed the labour force participation rate slowed to 35.9% in the April-June quarter of 2020, lower than the previous quarter’s 37.5% and below the 36.2% recorded in April-June 2019. Among males, the rate slowed to 55.5%, lower than the 56.7% in the January-March quarter and below the 56.3% in the April-June quarter of 2019. Among females, it slowed to 15.5% in the three months to June 2020, below the 17.3% in the January-March quarter of 2019. The rate was at 15% in April-June 2019. Labour Force Participation Rate (LFPR) is defined as the percentage of population in the labour force.

Maharashtra had the highest urban unemployment rate at 35.6%, followed by Jharkhand 32% and MP at 28.9%. All states recorded double digit urban unemployment rate in the April-June quarter.

Covid: impact on the India economy, 2020-22

Briefly

Sidhartha & Surojit Gupta, January 25, 2024: The Times of India

Average annual household income in Rs Lakh, 2011-12 prices, FY16- FY23- Pre-covid, Covid year, Post-covid periods
From: Sidhartha & Surojit Gupta, January 25, 2024: The Times of India

Incomes up since Covid, but poorest 20% still below FY16 level: Study

Sidhartha & Surojit Gupta, TNN

New Delhi : Average household income in India has increased around 12% since the Covid pandemic-induced fall, with the poorest seeing an over 75% jump, a new survey has estimated.


While average annual household income increased to over Rs 3.6 lakh in 2022-23, for the poorest it rose to Rs 1,14,000. That was 16% below the 2015-16 level of Rs 1,37,000 (see chart). Post-pandemic, the poorest 20% households saw income levels shrink 52% from 2015-16 level. These are findings of the latest round of ICE 360 Degree Survey by private economic think tank People Research on India's Consumer Economy (PRICE) that were shared exclusively with TOI.


During 2020-21, average household income levels had dropped below 2015-16 level in the bottom three income groups. By 2022-23, incomes of all five groups had recovered strongly in the wake of strong economic growth during last three financial years.

‘Covid forced occupation shift’

Income levels in what PRICE classifies as upper-middle and rich segments not only did not fall due to Covid, but actually increased — pointing out how lower income segments are more vulnerable to such shocks, necessitating government intervention. The pandemic also resulted in the gap between the richest and the poorest 20% widening from 3.8 times in 2015-16 to 11 times in 2020-21 before narrowing to 7 times during the last financial year.


The numbers also showed that household in come in rural India has climbed 16.6% to over Rs 3.1 lakh annually, as against a 7% expansion in urban areas to a little under Rs 4.5lakh.


The latest survey also revealed a shift in occupation trends due to Covid as the lockdown forced many workers to return home and seek work as agriculture and non-agriculture labour.


With the economy opening up and their return to large cities, there has been a 39% jump in salaried households from 72 million in 2020-21 to 124 million last year [2022-23?]. In contrast, households that were classified under the farm labour category shrunk by almost a third to 26 million, while non-farm labour households saw a 53% fall to 28 million. The rise in the number of salaried households the average household income in this category is estimated to have declined 27% to just under Rs 4.6 lakh in FY23.


“Hit by lockdowns and the loss of work, the urban poor in Tier I and Tier II cities, who are made up largely of casual labour, petty traders (hawkers, street vendors), artisans, and domestic workers, felt the greatest impact of the downward spiral in income,” said PRICE MD and CEO Rajesh Shukla.

Government finances: impact on

Capex 2020

The impact of the pandemic on state Government finances, capex: 2020
From: March 23, 2021: The Times of India


See graphic:

The impact of the pandemic on state Government finances, capex: 2020

Debt: GSDP ratio

The impact of the pandemic on state Government finances: Debt: GSDP ratio, 2020
From: March 30, 2021: The Times of India

See graphic:

The impact of the pandemic on state Government finances: Debt: GSDP ratio, 2020

India vis-à-vis other countries

2020-mid Jan 2021

Armaan Bhatnagar, January 14, 2021: The Times of India

India witnessed just one COVID peak compared to US and UK
From: Armaan Bhatnagar, January 14, 2021: The Times of India

See graphic:

India witnessed just one COVID peak compared to US and UK


Covid-19: Why India is different among worst-hit nations

NEW DELHI: Once leading the world in daily case count, India has shown a marked improvement in its coronavirus situation over the last few weeks. From hitting a peak of over 97,000 new cases in a single day last September, the country is now consistently reporting under 20,000 daily cases on an average. And while its battle against coronavirus is far from over, India's Covid-19 graph does stand out when compared to some other badly-hit nations around the world.

The United States leads the world when it comes to coronavirus infections and deaths. It has been reporting over 2 lakh cases daily for the last few weeks, with the average case count perilously close to its peak of nearly 3 lakh infections.

Similarly, the situation is also grim in UK, Brazil and Spain, all of which are reporting fresh infections that are close to the peak number.

The percent of the peak a country currently reports gives an idea of how far it is from containing the spread of the virus relative to the worst days of its outbreak.

In comparison, India's current average daily case count stands at just 18% of its peak. If the declining trend holds, the percentage is expected to go down further.

Lesser deaths, more recoveries

India's current recovery rate is at 96.5%, which is among the highest in the world.

When it comes to deaths, India has among the lowest case fatality ratio (CFR) vis-a-vis the worst-hit nations. The case fatality ratio is the percentage of deaths compared to the total number of cases.

India's CFR currently stands at 1.4%. Meanwhile, Mexico has the highest CFR at 8.7%, way above others.

Lowest cases per million

India's Covid-19 situation can also be understood through its average case count per million.

Despite being a densely populated nation, India has been reporting just over 7,500 cases per million people. The number is almost 1/10th compared to the US, which is averaging over 71,000 cases per million people.

And while India's overall testing rate is lower compared to other nations, there has not been a major decline in testing since the peak in September. India was testing an average of 1 million people in the months of September and October, and the figures have now come down to 8 lakh per day. However, the proportionate fall in cases is much higher, indicating that the situation has been brought under control.


No more peaks?

For long, experts were divided over whether India would witness another Covid wave after September.

But in December last year, several experts suggested that India may not witness another peak at all. They said that even if India does hit a new peak, it won't be as bad as the first one.

This is evident from the constant decline in the cases, or the flattening of the curve, over the last few months.

Meanwhile, countries like the UK and US continue to report record highs, with each peak worse than the previous one.

Both countries have already hit their third peak, with the virus showing no signs of abating.

Impact of ‘Lockdown’ and govt policies

The Impact of the Covid ‘Lockdown’ of 2020 and govt policies, in India and the world.
From: January 30, 2021: The Times of India

See graphic:

The Impact of the Covid ‘Lockdown’ of 2020 and govt policies, in India and the world.

Legislatures, impact on

Ordinances, 2020-21

Vishwa Mohan, June 4, 2021: The Times of India


Kerala promulgated the highest number (81) of ordinances followed by Karnataka (24), Uttar Pradesh (23), Maharashtra (21) and Andhra Pradesh (16) during Covid-hit 2020 when assemblies in most of the states had sat for far fewer days compared to their average sittings during 2016-19.

Data of 19 state legislatures, including UT of Delhi, analysed by not-for-profit organisation PRS Legislative, show that on average, they issued 14 ordinances over the last year. This number was, however, skewed by Kerala with 81 ordinances.

“Nearly half of these 81 ordinances were ones that were re-promulgated, i.e. the same ordinance was issued again after an intervening session,” said PRS in its report on ‘annual review of state laws’, analysing available data on states that account for 90% of India’s population.

An ordinance is promulgated when the assembly or Parliament is not in session and immediate action is required. It is in force until six weeks after the next meeting of the legislature. The government can go for its repromulgation if it’s not enacted during the session. Though all governments take the ordinance route to make laws, the decision is invariably criticised by the opposition as it is seen as bypassing the legislature and scrutiny of elected representatives.

The PRS Legislative noted that states on average had last year enacted 20 laws (excluding appropriation laws). While Karnataka passed the highest number of laws (55), followed by Andhra Pradesh (41), Kerala, which had enacted a yearly average of 23 laws in the preceding three years, used the ordinance route for making laws and only legislated three laws in 2020. The report analysed passing of bills and time taken by state assemblies in the process, and found that state legislatures had passed “most bills without detailed scrutiny”.

Spread in India, Asia

Neutrophil elastase deficiency helped

Yogita Rao, February 9, 2021: The Times of India


Protein behind corona’s slow Asia spread: Study

MUMBAI: Deficiency in a particular human protein, which is more common in Europe and the United States than in Asia, could explain why coronavirus is not spreading as fast in Asian countries. A team of scientists from the National Institute of Biomedical Genomics in Kalyani, West Bengal, have found a biological reason for the slower spread of a mutant of coronavirus in Asia compared to the West. The team has explained how higher levels of a human protein — neutrophil elastase — helps the virus to enter the human cell, multiply and also spread faster from infected individuals.

However, this protein is kept in check by the biological system, which produces another protein called alpha-1 antitrypsin (AAT). AAT deficiency leads to higher levels of neutrophil elastase in the cells, which in turn helps in faster spread of the virus. This deficiency is known to be much higher in Europe and America than among Asians. The study has been published in the journal, Infection, Genetics and Evolution.

The team of scientists led by Nidhan Biswas and Partha Majumder observed that the rate of the spread of the mutant virus — D614G — has been non-uniform across geographical regions. The researchers say that, “…in order to reach 50% relative frequency, the 614G subtype took significantly longer time in East Asia (5.5 months) compared to Europe (2.15 months) as well as North-America (2.83 months).”

“Many were speculating why coronavirus spreads differentially across geographies. The most popular speculation was the higher temperature in Asia was not congenial to the spread of the coronavirus. We believed the cause had to be biological, rather than physical or social,” said Majumder.

The researchers linked the differential spread to an additional cleavage site created by the D614G mutant virus, for entry into the human cell.

“However, some naturally-occurring mutations in the AAT-producing gene results in deficiency of the AAT protein. This deficiency is known to be much higher in the Caucasians of Europe and America than among Asians,” said Majumder. “While we used AAT deficiency data from East Asia, along with North America and Europe, for the study, considering the pace at which the coronavirus is spreading, the numbers are representative of other Asian regions too, including India.”

As per their data, AAT deficiency is the least in East Asian countries — 8 per 1,000 individuals in Malaysia, 5.4 per 1,000 in South Korea, 2.5 in Singapore. On the other hand, 67.3 in per 1,000 individuals in Spain are AAT deficient, 34.6 in the UK and 51.9 in France and in the US it is prevalent in 29 individuals among 1,000.

The researchers emphasized that this finding along with other social factors may explain the differential geographical/ethnic spread of the mutant virus.

Vaccines

2022, Nasal vaccine

Ramya Kannan, Sep 10, 2022: The Hindu


The story so far: On September 6, Union Health Minister Mansukh Mandaviya tweeted that the Central Drugs Standard Control Organisation had approved Bharat Biotech’s nasal vaccine for primary immunisation against COVID-19 in the 18-plus age group for restricted use in an emergency situation. It is hoped that Bharat Biotech’s ChAd36-SARS-CoV-S recombinant vaccine, to be administered nasally and developed in association with the University of Washington, will prove a powerful tool in the battle against the virus by preventing infections, something the other vaccines have not been able to do.

What does the vaccine do?

A nasal vaccine is delivered through the nose or mouth and it is expected to work on the mucosal lining, prompting an immune response at the entry points of the virus in the human body. It likely prevents the infection right there, thereby also blocking its spread. Scientists have called this sterilising immunity, where the virus is prevented from causing infection in the host effectively.

Early studies at Washington University, according to a report published on the varsity’s website, “showed that nasal delivery of this vaccine creates a strong immune response throughout the body, especially in the nose and respiratory tract. In animal studies, the nasal vaccine prevented infection from taking hold in the body.”

Emily Waltz explains in an article in Nature, that the COVID-19 vaccines currently in use do a good job of reducing disease severity and preventing hospitalisation, but don’t block mild illness or transmission that well. The reason for that is that they are injected into the muscle. “Intramuscular shots prompt an immune response that includes T cells, which destroy infected cells, and B cells, which produce antibodies that ‘neutralise’ pathogens — binding to them to stop them entering healthy cells. These cells and antibodies circulate through the bloodstream. But they aren’t present at high enough levels in the nose and lungs to provide rapid protection. In the time it takes for them to journey there from the bloodstream, the virus spreads, and the infected person gets ill.”

Is a nasal vaccine the best defence against COVID-19 so far?

“Exactly how successful these vaccines will be is unclear. Expecting a vaccine to stop transmission of a virus or prevent even mild illness — achieving what is called sterilising immunity — is a high bar. Bharat [Biotech] and CanSino [Chinese vaccine maker that has secured a licence to use another nasal vaccine] won’t know whether their vaccines can achieve this until they have conducted further efficacy studies,” explains Ms. Waltz Both Bharat Biotech and CanSino have announced that their trials have been successful but have not released data. She points to two other nasal vaccines that have reportedly been deployed in populations, one in Iran and the other, an intra-nasal version of Sputnik V in Russia, but says scant data is available from either of them.

In a release, Bharat Biotech said: “The product — iNCOVACC — is stable at 2-8°C for easy storage and distribution. The reactogenic events and adverse events that were documented during the trial were highly comparable to the published data from other COVID-19 vaccines. Product development data will be submitted to peer-reviewed journals and will be made available in the public domain.”

The University of Washington article indicated that two clinical trials of the nasal vaccine were conducted in India. “A phase 3 trial involving about 3,100 previously unvaccinated people who received two doses of the nasal vaccine, and a booster trial with about 875 people who received a single dose of the nasal vaccine after two doses of another COVID-19 vaccine. These trials, which concluded in August, indicated that the vaccine is safe and effective at eliciting a strong immune response in people when used either as a primary vaccine or as a booster.”

What next?

Early publication of trial data and a speedy rollout of a nasal vaccine would be ideal. By avoiding the jab, the nasal vaccine might be more appealing to people not yet vaccinated. It can be an option for children too, for whom it has not been authorised for use yet.

Also, though two vaccines were authorised for use in the 5-12 and 6-12 age groups in April, there is no sign of a rollout for these candidates.

Vaccine diplomacy, India’s

As on Jan 31, 2021

February 1, 2021: The Times of India

The export of Covid vaccines made in India, As on Jan 31, 2021
From: February 1, 2021: The Times of India

India-made Covishield part of Pak jab drive under vax alliance

Govt’s Vaccine Diplomacy Gathers Pace

New Delhi:

India’s vaccine diplomacy took further wing with 1 lakh anti-Covid shots being sent to Oman, a close partner in the Gulf, after having supplied the jabs to immediate neighbours. Later this week, India is scheduled to send over 5 lakh doses to Afghanistan. India will also send 2 lakh doses to Nicaragua, 1 lakh to Barbados, 70,000 to Dominica and 1.5 lakh to Mongolia, though dates are yet to be finalised.

Egypt, Algeria, UAE and Kuwait have all purchased vaccines and are on the commercial export list. Apart from the gifts, Mongolia (10 lakh) Nicaragua (3 lakh), Saudi Arabia (30 lakh), Myanmar and Bangladesh are among those who have contracted to purchase vaccines from India.

7m made-in-India vax doses to be part of Pak’s inoculation drive

The purchases are made commercially, but need export clearance from the Indian government. Meanwhile, around seven million made-in-India doses of AstraZeneca’s Covishield vaccine will be part of Pakistan’s free Covid-19 vaccination drive starting next week under the global Covax alliance, PM Imran Khan’s special assistant on health Dr Faisal Sultan said.

As a special Pakistani plane departed for China to fetch the first batch of Sinopharm’s Covid-19 vaccine, Dr Sultan announced that around seven million out of the 17 million committed doses of Covishield would reach the country by March.

“Though AstraZeneca is being prepared in India, it will come through Covax, an international alliance which has announced free vaccines for 20% of Pakistan’s population. DRAP (Drug Regulatory Authority of Pakistan) has already registered both Sinopharm and AstraZeneca,” Dr Sultan said.

The UN Covax initiative will see India selling about 100 lakh doses of vaccines.

In addition, the UN will be buying about 4 lakh doses for its own workers all over the world. India’s vaccination drive is attracting attention, with Indian ambassador to the Philippines Shambu Kumaran tweeting on Sunday that the Asean nation was examining India's rollout of inoculations, pointing to reports in the local media there.

India and the world: Vaccine exports, till 2021 May

India and the world: Covid vaccine exports, till 2021 May
From: June 17, 2021: The Times of India


See graphic:

India and the world: Covid vaccine exports, till 2021 May

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