How India could have averted 1.3 crore Covid-19 cases, 1.1 lakh deaths

Imposing even a moderate lockdown by mid-March would have helped India avert nearly 1.3 crore Covid-19 cases and 1.1 lakh deaths over the next two months during the second surge of the epidemic, says a new study.

Carried out by epidemiologist Bhramar Mukherjee at the University of Michigan and her collaborators, the study analyses the Covid-19 second surge in India and the possible role of government interventions using sophisticated computer models.

After a steady decline for about four months in the later parts of last year and early 2021, an uptick in cases was noted in three Indian states - Maharashtra, Punjab and Chhattisgarh - in February 2021 with the national effective reproduction number crossing the threshold of one on February 14.

Read more: India inoculating population size of Norway everyday, drive a marathon, not 100m sprint: Centre

Reproduction number or R measures a virus's ability to infect others. An R value of 1.9 would mean 10 Covid-19 affected persons would spread the infections to 19 others. For an epidemic to shrink, the R value would have to drop below one.

But despite the R value crossing the threshold, no strict control measures were reintroduced in the two months following the initial indications of a resurgence in transmission. Instead, there were large political rallies and religious gatherings, while social interactions continued unabated.

Also read: 'Dangerous period' with Delta variant, says WHO

The first comprehensive lockdown started only on April 14 in Maharashtra when India was already witnessing a staggering growth in infections.

“Had a lockdown been instituted in mid-to late-March of 2021, the case counts would have almost immediately started to decline, with the daily case count peaking around 20,000-49,000 respectively instead of the observed 414,280,” the researchers reported. The study is not yet peer-reviewed and appeared in a preprint.

It shows that under either of the two conditions – (a) a strict lockdown as imposed by the Centre last year or (b) a moderate lockdown as implemented by the Maharashtra government – nearly 13 million infections could have been averted had it began around March 15.

Read: Covid-19 vaccination drive a marathon, not a sprint: Centre

An end-of-April national lockdown would have been too late for any marked benefit because the second wave outbreak had already run its course. “This suggests that the timing of the intervention matters, and March 15-30 would have been the optimal time window for intervening,” they reported.

Similarly, a March 15 lockdown would have led to a 98.5% drop in Covid-19 deaths by May 15 in case of a strong lockdown. “Under the moderate intervention effect, our estimates show roughly 97K-109K deaths could have been avoided by May 15,” they said.

Until there is a sufficient supply of vaccines to inoculate most of the Indian population, non-pharmaceutical public health interventions will be key for India as the country designs its current lockdown exit strategy.

“Such measures are crucial for curbing deaths, infections, and subsequent viral mutation. Our analysis demonstrates that the earlier an intervention takes place, the better – timing matters,” the researchers concluded.