Fourth wave? COVID-19 cases rising in India as mask mandate lifted, schools reopen 

Rise in cases not yet an early sign of a new variant in circulation, say experts

By Taran Deol
Published: Friday 15 April 2022
Fourth wave? Cases on the rise in India as mask mandate lifted, schools reopen Photo: iStock

Several parts of the world have recorded a spurt in cases, primarily due to the BA.2 subvariant of omicron. This rise coincides with a decline in a majority of COVID-19-appropriate behavior, most importantly, following a mask mandate.

Less than a quarter of citizens are wearing masks — the lowest it has been since the organization began tracking it in April 2020, according to the latest projections by the Institute for Health Metrics and Evaluation (IHME), an independent population health research centre at University of Washington Medicine. 

Estimated daily COVID-19 infections, which include those who are not tested, can drop to 1.3 million if 80 per cent mask use is followed by the public, IHME predicted. In comparison, the current projection hovers around 3.5 million by June 2022. Estimated daily deaths record a similar difference — at 1,900 with current projections and 840 with 80 per cent mask usage. 

Testing — another critical tool in our fight against the pandemic — has also declined, with several countries and states now shifting to providing weekly COVID-19 data instead of daily. This could potentially skew our understanding of how the pandemic is progressing. IHME noted: 

The quality of data, the timeliness of data has changed, and that will impact our ability to track – not only us, but other groups who are doing similar projections, our ability to track the pandemic moving forward.

Parts of India, particularly urban areas, have also been witnessing a spike in cases over the last week. April 15, 2022 marks two weeks since several state governments lifted mask mandates for the first time since the beginning of the pandemic. Schools have also opened up after a long break, and have already emerged as key sources of fresh cases. 

In Gurugram, daily cases crossed the 100-mark after over a month on April 13. The positivity rate stands at 8.78 per cent. In the face of this, daily testing is set to increase from 1,500 to 3,000-4,000. 

Cases in Delhi have increased from below 100 in March-end to 325 on April 14, with a positivity rate of 2.39 per cent. Mumbai recorded 56 new COVID-19 cases and one death on April 14. On Wednesday, it recorded 73 fresh infections — the highest in a month. 

Union Health Secretary Rajesh Bhushan wrote to the governments of Maharashtra, Kerala, Mizoram, Delhi and Haryana — states that are recording a rise — to remain vigilant.

“It is essential that the state maintain a strict watch and take pre-emptive action if required in any areas of concern to control any emerging spread of infection. Testing and surveillance remain important to treat the virus, its spread and evolution,” he wrote. 

But should we be worried about a fourth wave?

Srinath Reddy, president of the Public Health Foundation of India (PHFI) does not find it surprising that with the opening up of society and virtually complete abandonment of all COVID-19-appropriate behavior, the virus is infecting more people.

“The BA.2 variant is still around and we also now have the recombinant virus entering India. But since all of them are part of the omicron family, we are likely protected against severe disease,” he told DTE. “It won't be a large spike and will be restricted to some areas. As immunity wanes, some serious cases may emerge. We need to wait and watch the behaviour of the recombinant variant till at least the end of the month,” he added. 

JP Muliyil, former head, department of community health, Christian Medical College, Vellore, Tamil Nadu concurred. He underlined how the omicron curve was much shorter than delta — the reason for which is under diagnosis. 

“For delta, cases were 25 times what was reported. For omicron, it’s at least 100, if not more. The government data is no way giving you an accurate picture,” he explained. 

“The fluctuation that you see is statistical noise of what is expected because of severe underreporting,” Muliyil said. This rise in cases is not an early sign of a new variant in circulation as yet, he added.

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