In 106 days since the first laboratory-confirmed novel coronavirus case was reported on January 30, India surpassed China’s tally of 84,038. As on May 15, India had over 85,500 cases and the death toll stood at 2,752, as against 4,633 in China. There are only 10 other countries that have more cases than India. At the same time, the toll in the U.S. alone went past the total number of cases in China, while the total case load crossed 1.4 million. On March 18, when China reported zero fresh cases , India had just 162 cases and three deaths. Despite the country being under lockdown since almost end-March, the number of fresh cases and deaths reported each day has continued to rise steadily — on average, over 3,600 cases have been reported daily since May 8. This is of serious concern as contrary to the advice of WHO, India has not fully utilised the precious lockdown period to increase manifold the number of tests carried out daily while simultaneously tracing, isolating and treating COVID-19 patients. That even during the lockdown India has witnessed the shortest time, of 13 days, for cases to double compared with 14 other countries that have the most cases reported is testimony to the wide spread of the virus. A reason for this could be that cases in other countries, barring Russia and Brazil, have already peaked or are about to. Unfortunately, even as the number of cases has crossed 94,700, India is yet to begin investigating community transmission despite the strongly suggestive findings of sentinel surveillance among those hospitalised for severe acute respiratory infections. Given the high rate of asymptomatic transmission, high viral resurgence is inevitable when the lockdown is lifted.
With over 11,200 cases, Tamil Nadu has the second highest number of cases next to Maharashtra (over 33,000). But with over 4,000 tests per million, TN is testing nearly two times more than Maharashtra. It is not the States that report more cases that is a cause for concern, but those that have reported fewer. Active case finding and testing of most people with a travel history early during the lockdown could be one reason why Karnataka has reported fewer cases. Similarly, surveillance and case finding of those with a travel history early on have been good in Andhra Pradesh and could be a reason why it has reported fewer than 2,400 cases so far. Maharashtra, Gujarat, Madhya Pradesh and West Bengal have reported high case positivity. This could either be due to good surveillance, which is unlikely, or wider spread of the virus in the community, at least in specific regions. If the latter be the case, India can expect huge numbers to be reported in the coming weeks. No State, including Kerala, can thus be complacent.
