After reporting over 97,650 novel coronavirus cases on September 11, the largest number ever reported on a single day by any country till then (the U.S. registered 99,780 cases on October 30), India has been witnessing a steady fall in daily fresh cases reported since mid-September. Since October 25, there have been fewer than 50,000 new cases every day, except on one. More importantly, the reduction in daily cases has continued despite no appreciable drop in overall testing numbers, a trend quite pronounced in States that bore the brunt of the pandemic — Maharashtra, Andhra Pradesh, and Tamil Nadu. It is quite clear that the pandemic has peaked by spreading through the major densely populated cities, leaving lakhs infected and thousands dead, but there is a definite slowing down in these areas. Since August, cases had already started to pile up beyond urban areas in rural districts. It is unclear whether the drop in daily cases and deaths registered in the urban areas is playing itself out similarly in rural areas as well, as unlike urban areas, the protocols for testing, treatment, isolation are not as diligently followed because of gaps in the rural health infrastructure across States. This is something State Health Departments need to follow up on.
There is evidence from other disease surveillance in the past that States with better primary health and sentinel infrastructure across topographies, urban or rural, have recorded diseases better. For example, the reporting of HIV cases in Maharashtra and the southern States resulted in the recording of more cases while Uttar Pradesh, Bihar and a few other north Indian States reported fewer cases. The absence of evidence is, after all, not the evidence of absence and Uttar Pradesh, Bihar and others must not become complacent about the drop in cases, and must continue to increase their respective testing rates to keep pace with the rest of India. While peaking and a reduction in cases is a good sign that could ease the strain on the health infrastructure, the danger the virus poses is still real. The dip in cases may turn out to be just a statistical blip, with a second surge and heightened spread waiting to happen in the winter, particularly as people partake in the festive season. States have started to ease restrictions on schooling, commercial activities and have even allowed theatres and malls to open to spur the consumption economy severely affected by the lockdowns. The easing was unavoidable as the economic strain was becoming as much of a problem for people as COVID-19 was to their health. Citizens must not get complacent about the drop in cases and should continue to observe norms of social distancing, mask wearing and hand hygiene till vaccines made available prove their efficacy.
