India’s coronavirus infection tally was on track to overtake the United States. Then the numbers suddenly dropped

It was only a few weeks ago that a macabre prediction was looming for India: Experts said the country was set to overtake the United States for coronavirus infections. 

Key points: 

• After peaking at 100,000 COVID-19 cases a day, India’s infection tally has fallen 
• Some cities, including the capital New Delhi, are still experiencing outbreaks 
• Experts are cautiously optimistic but say the virus could spike again 

The country was long expected to peak somewhere in November, and experience high daily numbers and possibly several peaks due to its large population. 

But then, suddenly, something strange happened. The number of cases started to drop. 

Ever since India was plunged into a nationwide lockdown in March, the country experienced an unrelenting increase in coronavirus cases, hitting a peak of almost 100,000 cases a day in early September. 

But its daily tally and death toll is now less than half of what it was, while the United States is now recording close to 100,000 cases a day. 

A Government-appointed panel has declared the peak had passed. 

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Values shown are 14-day averages. 

Professor Shamika Ravi from the Brookings Institute has been crunching the numbers throughout the pandemic and said the decline seemed “credible”. 

“The test positivity rate, which means the percentage of tests that come out positive, have been declining quite steadily,” she said. 

“The Government has ramped up testing in almost every state now.” 

Professor Ravi said the overall number of cases did not mean that each and every state was in the same position, given India’s huge population. In fact, some states are still experiencing rising cases, such as West Bengal and Delhi. 

But the fact the number of infections dropped in some of the worst-hit states has meant the aggregate number has come down as well. 

“The decline did not start at the same time, and at the same place,” she said. 

The state of Maharashtra and its capital Mumbai have long been India’s epicentre of the pandemic, accounting for around a fifth of the nation’s tally and more than a third of deaths. 

It was one of the big states whose coronavirus turnaround helped usher in the end of the peak. 

Dr Shruti Tandan said her ICU ward in Mumbai now regularly has spare beds. 

Dr Shruti Tandan manages 26 intensive care beds for confirmed and suspected coronavirus patients in a Mumbai private hospital. 

After the city had endured weeks of skyrocketing cases, she spoke about sleepless nights after having to refuse critically ill patients because the hospital had hit capacity. 

But now there are often spare beds. 

“Maybe three out of four days a week we do have spare beds,” Dr Tandan said. 

But while the rate of infection elsewhere in India has plummeted, the capital New Delhi has entered its third wave, after a recent festival. 

A series of serological surveys, which detect the presence of coronavirus antibodies, also suggest the actual rate of infection is much higher than the official data. 

There is also concern at the wide use of rapid antigen tests, which are less reliable than the “gold standard” polymerase chain reaction (PCR) test. 

Stories of tragedy and heroism emerge from hotspots 

Ambulance driver Aarif Khan was so worried about catching coronavirus and spreading it to his family, he spent months sleeping at work as the number of cases exploded in the Indian capital. 

New Delhi ambulance driver Aarif Khan was so worried about catching coronavirus and spreading it to his family that he slept at work. He died from COVID-19 in October. 

He and his colleagues had been providing a free service to Delhi residents, transporting coronavirus patients, moving bodies of COVID-19 victims and even providing last rites and cremations. 

Despite taking an abundance of caution, the veteran driver contracted the virus. 

The 48-year-old died in October, leaving his wife and children without an income or government support. 

“We asked him to stop doing this work during this pandemic,” his son Mohammad Aasif told about this. 

“But he did not listen to us. He told us that he would continue his community service.” 

Mohammad Aasif says he begged his dad to stop working as an ambulance driver during the pandemic. 

Delhi has been one of India’s worst-hit cities with more than 370,000 recorded infections and its daily infections have passed 5,000. 

Since March, the organisation Mr Khan worked for, Shaheed Bhagat Singh Sewa Dal, has transported more than 500 bodies for cremation, 700 patients to hospitals, and performed last rites on 70 patients whose family were in quarantine. 

This is in addition to the non-coronavirus patients the ambulance drivers continue to serve. 

The organisation’s founder, Jitendra Shunty, has also contracted the virus in the line of duty. 

“Our morale is down because of [Mr Khan’s] death,” Mr Shunty said. 

Jitendra Shunty says his ambulance drivers who are helping people in New Delhi are “warriors”. 

“My colleagues and warriors are shattered but I know his sacrifice will not be in vain as our spirit and dedication to serve humanity remains high. 

“This is [the] ultimate sacrifice for humanity.” 

India is not out of the woods yet 

Experts and health workers say they are relieved the outbreak in cases in India has slowed for the first time since the pandemic began. 

But no-one is willing to relax just yet. 

Dr Tandan said while the number of patients has dropped, the symptoms they were experiencing had worsened. 

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This includes the increased prevalence of lung fibrosis, which causes the lung tissue to harden and scar. 

“Some of the patients come back with repeated fall in oxygenation,” she said. 

“When we scan, we realise COVID-19 has left scars on their lungs, which makes you think this disease is quite unforgiving,” she said. 

There are also several warnings that states may endure more waves of infections in coming weeks. 

Delhi’s pollution typically skyrockets in November and December, and doctors are warning the toxic air will likely worsen the rate and severity of infections. 

The cool winter weather in the northern states is also a concern as it means people will probably be spending more time indoors. 

“The literature coming out does tell us falling temperatures makes the virus particularly infectious,” Professor Ravi said. 

There are also several upcoming festivals, including Diwali, which is the biggest festival on the Hindu calendar. 

Doctors fear people will let their guard down due to the drop in infections. 

“It’s a huge worry,” Dr Tandan said. 

But Professor Ravi said the states had responded to important lessons. 

“All this time the testing has only improved,” she said. 

“The reason I keep talking about testing is it’s sort of a proxy for everything else that the state is doing. There is a lot of tracing effort. People are very cautious.” 

Whatever the challenges ahead, the ambulance drivers in Delhi are committed to keep fighting the virus. 

Jitendra Singh Shunty says he will continue shuttling COVID-19 patients around New Delhi to help save lives. 

“We have seen several peak days in the past months,” Jitendra Singh Shunty said. 

“I am glad and content that we are able to serve our nation in the time of need.”