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India sees record surges in cases due to coronavirus variants

Hindu woman performs prayer during the Navaratri festival at a temple in Amritsar, India

Narinder Nanu/AFP via Getty Images

Coronavirus cases are surging in many countries, with the highest number of new cases now being reported in Asia. India alone reported 161,736 new cases on 12 April. In the Indian city of Surat, parts of gas furnaces used for cremations melted after being used non-stop. Meanwhile, millions have been gathering for festivals across the country.

The surge appears to be driven mainly by the more transmissible B.1.1.7 variant from the UK, which is causing around 40 per cent of cases in Asia, according to pathogen-tracking project Nextstrain. Another 16 per cent of cases are due to the B.1.351 variant that evolved in South Africa.

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India’s daily case numbers are currently the highest in the world. Only the US has ever reported more daily cases, peaking at around 250,000 in January. However, India has a larger population. It is reporting around 100 cases per million people per day, which is lower than the rate declared by many other countries, including the US, Germany and Canada.

Then again, India may be detecting a much lower proportion of cases than Western countries. It has reported around 13 million cases in total, but antibody surveys and modelling suggest the actual figure could be more than 450 million, says Gautam Menon at Ashoka University in Sonepat.

Experts had been puzzled by India’s lack of a second wave. The reason why it is happening now isn’t entirely clear. Many first-wave restrictions have been relaxed and people may not be adhering as closely to those that remain. However, Menon says his models suggest this alone can’t explain the rapid rise in cases. He thinks new, more transmissible variants are mainly to blame. Another idea is that immunity acquired during the first wave is waning. All three factors could be involved.

“I don’t think cases will peak for at least another two or three weeks,” says Menon. He is also worried that numbers are rising across the entire country at once. “This may reflect the importance of reinfections,” he says. “Should that be the case, we may be in for an extended period in which cases will rise or stay at the same level.”

Because India does relatively little genetic sequencing of virus samples, it is hard to know what part new variants are playing in the rise. Sequencing does show a rapid increase in the B.1.1.7 variant, suggesting it is at least partly fuelling the resurgence.

There have also been alarming headlines about “India’s double mutant”, a variant now named B.1.617 that has also been seen in other countries, including the UK and US. Along with other mutations, B.1.617 has two in the part of the virus’s spike protein that binds to human cells, which may help it dodge antibodies. These mutations aren’t unique, though: variants with both mutations have evolved more than once.

B.1.617 has been reported by the Goa Chronicle to have caused a sudden increase of cases in the state of Maharashtra, but it has been present since September and still accounts for only a minority of cases. For comparison, B.1.1.7 was first detected in the UK in September and now accounts for 98 per cent of cases in the UK.

Cases are also surging in Bangladesh, from around 400 a day in February to 7201 on 12 April. Here, though, the B.1.351 variant appears to dominate.

In many countries, vaccination procurement has been difficult and roll-outs are proceeding too slowly to curb the rise in cases. India has given just 5 per cent of its population one dose of a vaccine. In other countries, including Bangladesh and Sri Lanka, less than 5 per cent of the population have received their first dose.

The standout in the region is Bhutan, where nearly all adults have received one dose of the Oxford/AstraZeneca vaccine.

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