India Covid-19 curve beats US, set to surpass Brazil

India on Friday added the most cases of Covid-19 than any other country, surpassed, on average, the number of new infections in United States, and was set to overtake Brazil over the weekend to become the country with the worst outbreak in the world amid a raging second national wave that led to 92,961 new infections on Saturday — the highest since September 17.

In the seven days till Friday, India recorded 68,969 new cases a day on average. On the same day, the US recorded 65,753 while Brazil recorded 72,151 new cases a day over a week's period. In Brazil, the outbreak appears to be receding with the number dropping roughly 0.92% on average over the week. In US, cases are growing afresh but the expansion — 0.87% — is significantly slower than India's rate of 4.24%.

On Friday, India added 89,030 cases and an immediate daily comparison of Saturday's numbers with that of the US and Brazil was not possible due to the time difference. At the current pace, India could well surpass the record set by the first peak shortly, even breach the 100,000 daily cases mark.

This is not the first time India records the most number of cases for any country in the world – at the peak of its first wave, it recorded 99,181 cases on September 10. But this would eventually be eclipsed by the US, which recorded 308,941 cases at its worst on January 8. The highest Brazil has recorded is in the current wave, with a peak at 97,586 on March 25.

All India data is from the HT tracker. The US and Brazil data are from worldometers.info.

Experts say the trend reinforces the need for India to restrict activities and speed up the vaccination drive. The problem is particularly stark since the number of doses administered in India covers only 4.57% of the population, compared to Brazil's 7.57% and the US's 30.44%.

"I think there are going to be more cases this time around than during the first wave; the increase has also been very sharp as compared to the first wave. We can only hope that the case fatality remains the same," said Amit Singh, associate professor, Centre for Infectious Disease Research at the Indian Institute of Science, Bangalore.

"We are already in the middle of the second wave and we are not going to escape it. Having said that, partial lockdowns and aggressive enforcement of Covid-appropriate behaviours in public such as masking, social distancing, curbs on gatherings can help slow things down. What we really need to do is vaccinate everyone, and quickly," he said, adding that the government must open the vaccination drive for all.

The current surge of infections prompted the government to on Friday meet with health officials from states, particularly to highlight the situation in 11 "states of grave concern" that contributed 90% of Covid-19 cases and 90.5% of deaths in the previous 14 days.

At over 7% on Saturday, the country's overall test positivity rate – the proportion of samples that turn up positive – has also risen drastically, indicating that efforts to stay ahead of the virus could require more testing in order to minimise the number of positive cases being missed.

This necessity is also evident if absolute testing numbers are compared: the 1.02 million tests carried out across India on April 2 were slightly lower than the 1.05 million done on September 10, the day India recorded the peak of the first wave.

Government officials have identified the situation in Maharashtra (which accounted for 53.2% of the cases on Saturday), along with Punjab and Chhattisgarh, as particularly worrying. Following a meeting of the cabinet secretariat with the chief secretaries of all states on Friday.

At 9,108 cases, Maharashtra's capital Mumbai on Saturday breached the 9,000 threshold, the first for any city in India.

In the national capital, 3,567 new cases were recorded on Saturday — slightly lower than the 3,594 recorded on Friday — but the latest numbers corresponded to fewer tests. The positivity rate rose from 4.1% to 4.5%.

The government said more small towns are being hit in the current wave, which could spread infections among people who may not as readily have access to health infrastructure as people in larger cities do. "Another worrisome aspect pointed out was that Tier 2 and Tier 3 cities along with peri-urban areas have recorded the recent high rises in Covid cases; the spread of infection from these areas to the rural areas with weak health infrastructure would overwhelm the local administration was also highlighted," the government said on Friday, referring to the meeting with the states.

Experts have urged the government to consider accelerating the vaccine process, and open it up to all. "Now, there are several other vaccines with proven safety and efficacy across the world that should be brought in. For example, the Pfizer vaccine has now been shown to be safe and effective for children. Data for Covaxin or Covishield is not available in these age groups. Rather than waiting for it, the government should bring in what is already established," said Singh.

On Friday, India administered 3.6 million doses of coronavirus vaccines – the most it has done so far. But experts fear the pace is inadequate, particularly since the country has a large urban population and many of its cities have high population density, factors that aid the rapid transmission of Covid-19.