India is fast becoming the world’s new virus epicentre, setting a record for the biggest single-day rise in cases as experts predict that it will soon pass Brazil — and ultimately the US — as the worst outbreak globally.
As many as 78,512 new cases were added on Monday taking the total tally to over 3.6 million. On Sunday, India reported the highest ever one-day surge among all major countries. With 971 reported deaths, the Asian country pushed past Mexico for the third-highest number of deaths worldwide. At the present trajectory, India’s outbreak will eclipse Brazil’s in about a week, and the US in about two months.
And unlike the US and Brazil, India’s case growth is still accelerating seven months after the reporting of its first coronavirus case on January 30. The pathogen has only just penetrated the vast rural hinterland where the bulk of its 1.3 billion population lives, after racing through its dense mega-cities.
As the world’s second most-populous country, and one with a relatively poor public health system, it’s inevitable that India’s outbreak becomes the world’s biggest, said Naman Shah, an adjunct faculty member at the country’s National Institute of Epidemiology.
“It would not be surprising, regardless of what India does,” said Shah, a member of the Indian government’s COVID-19 taskforce.
From the Philippines to Peru, the novel coronavirus poses a unique problem to poor countries: the densely packed slums where millions of their citizens live present ideal conditions for the virus to spread, while their economic precariousness means that the shutdowns necessary to contain the pathogen are intolerable.
Across the developing world, economies have been forced to open up even with the virus still running rampant, quickly overwhelming underfunded hospitals.
The list of worst-affected countries globally has accordingly shifted from rich to poor as the pandemic races around the world. Where once countries like Italy, Spain and the UK had the biggest outbreaks and highest death tolls, now the US is the only advanced economy in the top ten, among other developing nations like Mexico, Peru and South Africa.
Nowhere has the developing world’s plight played out more viscerally than in India, where an ambitious national lockdown imposed in March was lifted after two months as joblessness, starvation and a mass migration of workers leaving cities on foot became too much to bear.
Prime Minister Narendra Modi’s government has since counselled the population to “live with the virus” while giving local officials freedom to impose restrictions on a state-by-state basis, which many have. The economy is projected to have contracted 18 per cent in the quarter to June from a year ago, more than any other major Asian country.
The Modi government has often pointed to India’s official mortality rate of around 1.8 per cent — among the lowest in the world — as evidence that it is managing the virus’ spread, even if not containing it.
But deaths are likely substantially under-reported, and skewed by the country’s disproportionately young population — 65 per cent are below the age of 35, the segment least in danger of dying from COVID-19. An age-adjusted analysis of India’s death rate by three economists at the National Bureau of Economic Research in Massachusetts found that India’s death rate was similar to the global average.
“What we’ve done is delayed infections, but we haven’t been able to curtail the transmission,” said CDDEP’s Laxminarayan. “And that was never going to be possible in a country the size of India and with the health infrastructure India has. What has played out is almost exactly what one should have expected.”
Ireland lifts COVID-19 lockdown, national picture still ‘uncertain’
Ireland lifted an extended local lockdown on Monday in the eastern county of Kildare ahead of schedule, but the whole country remains under some of Europe’s strictest COVID-19 restrictions.
Ireland closed or limited business on August 7 in three of its 26 counties — Kildare, Laois and Offaly — and their residents were barred from travelling outside their county.
Ten days later, an uptick in coronavirus cases prompted a significant tightening in measures nationwide. Authorities cut to six the number of visitors allowed in a home, banned fans from all sport events and urged people to avoid public transport where they could.
“While the situation in Kildare has improved, the national situation remains uncertain and the government continues to stress the importance of adhering to the public health advice and guidance to stop the spread of the virus,” the government said in a statement.
The local lockdowns had been due to run until September 6, but Prime Minister Micheal Martin said the numbers in Kildare were now similar to the rest of the country. He also urged vigilance ahead of a review of the nationwide restrictions on September 13.
Ireland has retained one of the strictest lockdown regimes in Europe and reopened its economy at a slower pace.
At 30.6, Ireland’s 14-day cumulative COVID cases per 100,000 people is higher than Britain, Germany and Sweden but below regional hotspots in Spain and France.
Ireland has reported 1777 COVID-related deaths in total but only 14 in August, despite the rise in cases.
Opening up without control is recipe for disaster, says WHO
Countries with significant active spread of coronavirus must prevent amplifying events, as opening up without the virus being under control would be a “recipe for disaster”, the World Health Organisation said on Monday.
WHO director-general Tedros Adhanom Ghebreyesus recognised that many people were getting tired of restrictions and wanted to return to normality eight months into the pandemic.
The WHO fully supported efforts to reopen economies and societies, he told a news conference, adding: “We want to see children returning to school and people returning to workplaces, but we want to see it done safely”.
“No country can just pretend the pandemic is over,” he said. “The reality is this virus spreads easily. Opening up without control is a recipe for disaster.”
“Explosive outbreaks” have been linked to gatherings of people at stadiums, nightclubs, places of worship and other crowds, where the respiratory virus can spread easily among clusters of people, Tedros said.
“Decisions about how and when to allow gatherings of people must be taken with a risk-based approach, in the local context,” he said.
Scientists see downsides to COVID-19 vaccines from Russia, China
High-profile COVID-19 vaccines developed in Russia and China share a potential shortcoming: They are based on a common cold virus that many people have been exposed to, potentially limiting their effectiveness, some experts say.
CanSino Biologics’ vaccine, approved for military use in China, is a modified form of adenovirus type 5, or Ad5. The company is in talks to get emergency approval in several countries before completing large-scale trials, the Wall Street Journal reported last week.
A vaccine developed by Moscow’s Gamaleya Institute, approved in Russia earlier this month despite limited testing, is based on Ad5 and a second less common adenovirus.
“The Ad5 concerns me just because a lot of people have immunity,” said Anna Durbin, a vaccine researcher at Johns Hopkins University.
“I’m not sure what their strategy is … maybe it won’t have 70 per cent efficacy. It might have 40 per cent efficacy, and that’s better than nothing, until something else comes along.”
Vaccines are seen as essential to ending the pandemic that has claimed over 845,000 lives worldwide. Gamaleya has said its two-virus approach will address Ad5 immunity issues.
Both developers have years of experience and approved Ebola vaccines based on Ad5. Neither CanSino nor Gamaleya responded to requests for comment.