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Rise in COVID cases as expected

Rise in COVID cases as expected
Prof Gagandeep Kang (File)
New Delhi, Aug 22 (AGENCIES) | Publish Date: 8/22/2020 12:21:20 PM IST

One of India’s most highly regarded clinical scientists has warned against making projections of how many COVID-19 cases India could have in the next one month and two months or attempt to predict when the country will reach its peak, reports The  Wire.

Prof Gagandeep Kang, who won the Infosys Prize in 2016 and is the first Indian woman to be elected a fellow of Britain’s Royal Society in its 360 year history, said projections need to take onboard the impact of the different mitigation efforts that have been made and which needed sophisticated models to do this. She is working on such a model but it will be at least a couple of weeks before its ready and able to make reliable projections.

Kang said the 3 million total cases India has crossed today and the rate of increase, which is just short of 70,000 per day, is “completely expected”. Given India’s population of 1.38 billion “this is what the trajectory will be”. More importantly, she added “We should expect this to continue for a while”.

She said it’s hard to put a date or timeframe on when the country as a whole will reach its peak. This is because the disease is best seen in terms of the different locations, cities, regions where it’s happening and each of those has its own epidemic curve and each curve behaves differently depending upon the circumstances, the age profile, the mitigating factors, etc.

She also made a point of mentioning that antigen negative tests need to be followed up by a RT-PCR tests but this “is not being done”. She said health authorities were not making the requisite efforts to find out how much infection the antigen negative results are missing. As the ICMR itself accepts in its June 14 advisory, perhaps as many as 50% of antigen negative results could be incorrect.

On India’s mortality rate, which is 40 per million as of August 22, Kang said while it’s possible but under-reported. Kang said she did not accept it’s under-reported by a factor of 5.29 as an article in The Hindu by Hemant Shewade and Giridara Gopal Parameswaran suggested. 

However, she did accept that the quantum of under-reporting “could increase” as the incidence of the disease shifts from metropolises like Delhi, Mumbai and Chennai to tier 2 and tier 3 towns and then, further, into rural India.

On chances of being re-infected with COVID-19, she said while it was very unlikely for someone who has recovered from COVID-19 to be re-infected after 4-5 months; it was still unknown if it could happen after a year. 

Finally, Kang said there are several reasons, which are actually hypotheses, why India’s mortality rate (even if you believe its under-reported and multiply it by 2 or 3) is significantly lower than mortality rates in Europe and America. One reason/hypothesis is the age profile of the Indian population. 90% are under 60 and 83% under 50. The median age is 28-29. In Europe it’s in the mid or late 40s.

A second reason/hypothesis is that Indians have been subjected to more viruses and infections than people in Europe and America and, therefore, have acquired innate immunity. A third reason/hypotheses she mentioned is genetic. The virus reacts differently to different blood groups.

Finally, in response to a question about how long the immunity conferred by an infection will last, Kang said this is something that is being found out about every day. She said COVID-19 is a new disease and there’s a lot that remains to be known about it. One of the “don’t knows” is how long the immunity from infection will last. 

In response to a question, she said it’s possible that this could also have implications for the efficacy of a vaccine. It may only be effective for a limited period and, like the flu jab in Europe, it might be necessary to have it every year.

 

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