COVID-19 Data Dispatch

Tag: India

  • The Delta variant is taking over the world

    The Delta variant is taking over the world

    The Delta variant is now dominant in the U.S., but our high vaccination rates still put us in a much better position than the rest of the world—which is facing the super-contagious variant largely unprotected.

    Let’s look at how the U.S.’s situation compares:

    U.S.: Delta now causes 52% of new cases, according to the latest Nowcast estimate from the CDC. (This estimate is pegged to July 3, so we can assume the true number is higher now.) It has outcompeted other concerning variants here, including Alpha/B.1.1.7 (now at 29%), Gamma/P.1 (now at 9%), and the New York City and California variants (all well under 5%). And Delta has taken hold in unvaccinated parts of the country, especially the Midwest and Mountain West.

    Israel and the U.K.: Both of these countries—lauded for their successful vaccination campaigns—are seeing Delta spikes. Research from Israel has shown that, while the mRNA vaccines are still very good at protecting against Delta-caused severe COVID-19, these vaccines are not as effective against Delta-caused infection. As a result, public health experts who previously said that 70% vaccination could confer herd immunity are now calling for higher goals.

    Japan: The Tokyo Olympics will no longer allow spectators after Japan declared a state of emergency. The country is seeing another spike in infections connected to the Delta variant, and just over a quarter of the population has received a dose of a COVID-19 vaccine. I argued in a recent CDD issue that, if spectators are allowed, the Olympics could turn into a superspreading event.

    Australia: Several major cities are on lockdown in the face of a new, Delta-caused surge following a party where every single unvaccinated attendee was infected. Unlike other large countries that faced significant outbreaks, Australia has successfully used lockdowns to keep COVID-19 out: the country has under 1,000 deaths total. But the lockdown strategy has diminished incentives for Australians to get vaccinated; under 5% of the population has received a shot. Will lockdowns work against Delta, or does Australia need more shots now?

    India: Delta was first identified in India, tied to a massive surge in the country earlier this spring. Now, India has also become the site of a Delta mutation, unofficially called “Delta Plus.” This new variant has an extra spike protein mutation; it may be even more transmissible and even better at invading people’s immune systems than the original Delta, though scientists are still investigating. India continues to see tens of thousands of new cases every day.

    Africa: Across this continent, countries are seeing their highest case numbers yet; more than 20 countries are experiencing third waves. Most African countries have fewer genetic sequencing resources than the U.S. and other wealthier nations, but the data we do have are shocking: former CDC Director Dr. Tom Frieden reported that, in Uganda, Delta was detected in 97% of case samples. Meanwhile, vaccine delivery to these countries is behind schedule—Nature reports that many people in African countries and other low-income nations will not get their shots until 2023. 

    South America: This continent is also under-vaccinated, and is facing threats from Delta as well as Lambda, a variant detected in Peru last year. While Lambda is not as fast-spreading as other variants, it has become the dominant variant in Peru and has been identified in at least 29 other countries. Peru has the highest COVID-19 death rate in the world, and scientists are concerned that Lambda may be more fatal than other variants. Studies on this variant are currently underway.

    In short: basically every region of the world right now is seeing COVID-19 spikes caused by Delta. More than 20 countries are experiencing exponential case growth, according to the WHO:

    We’ve already seen more COVID-19 deaths worldwide so far in 2021 than in the entirety of 2020. Without more widespread vaccination, treatments, and testing, the numbers will only get worse.

    More international reporting

    • In India’s COVID-19 catastrophe, figures are only part of the story

      In India’s COVID-19 catastrophe, figures are only part of the story

      By Payal Dhar

      India’s COVID-19 curve resembles a vertical line right now. An already fragile health infrastructure is on its knees, the government has shown itself to be incapable. There are no hospital beds to be had, no medicines, no oxygen, no emergency care; even the dead have to endure 20-hour queues for last rites. A nine-day streak of 300,000-plus new cases daily has ended with fresh infections crossing the 400,000 mark on May 1. More than 3,000 COVID-related deaths have been recorded daily for three consecutive days. Still, the worst, experts say, is yet to come.

      If one compares India’s cumulative figures with the U.S.’s, however, the numbers don’t seem to make sense. India’s 18.8 million confirmed cases, with 208,330 deaths, don’t seem anywhere near U.S. figures of 31.9 million and 568,836 respectively. India appears to record 1,360 cases and 15 deaths per 100,000 people, versus 9,684 cases and 172 deaths per 100,000 people in the U.S. Even accounting for the fact that India’s population (1.4 billion) is more than four times that of the U.S. (330 million), the scale of the devastation seen on the ground—patients three to a bed or being treated on the streets, people dying outside hospitals waiting for treatment, entire families being wiped out, and mass cremations taking place on pavements and car parks—appears disproportionate.

      The reasons are complicated and intersecting. For one, the official figures are highly likely to be vastly underestimated in India. Moreover, the country’s health infrastructure has always been fragile. There are only 5.3 beds per 10,000 population (versus 28.7 for the U.S.), and given the sheer numbers of COVID-19 infections, it’s simply a case of just-not-enough. Other reasons for the low numbers in India could, quite simply, be a lack of testing—only 1.74 daily tests per 1,000 people—as well as a purposeful obfuscation of actual figures.

      Experts say that COVID-19 deaths have been undercounted across the world for various reasons; testing methodologies and the recording of confirmed cases has not been uniform. “Every country reports those figures a little differently and, inevitably, misses undiagnosed infections and deaths,” Reuters’ COVID-19 Global Tracker states.

      It’s like looking at an iceberg, says one of India’s top epidemiologists, Dr. Jayaprakash Muliyil, chairperson of the Scientific Advisory Committee of the National Institute of Epidemiology, in a phone conversation. “The number of cases the system picks up is a fraction [of the actual number of infections],” he says. “A large number of cases are subclinical [not severe enough to present definite or readily observable symptoms].” This fraction depends on several factors—it is lower in smaller states with better infrastructure, like Pudducherry, and higher in others with greater population density, like Bihar.

      A recent study found a “severe under-ascertainment of COVID-19 cases” across U.S. states and countries worldwide. “In 25 out of the 50 countries, actual cumulative cases were estimated to be 5–20 times greater than the confirmed cases,” report authors Jungsik Noh and Gaudenz Danuser, adding that, “The estimation of the actual fraction of currently infected people is crucial for any definition of public health policies, which up to this point may have been misguided by the reliance on confirmed cases.”

      Serological surveys (using antibody tests) indicate that the actual number of infected people could be 30 times higher in India than what official figures show. COVID-related deaths could be anything between 2 to 5 times and 10 to 15 times than what is being reported.

      Modeling methods may be a headache, but pandemic curves always come down, and this one will too, says Dr. Muliyil. He is not a fan of lockdowns for a country like India—having said back in September that it had flattened the wrong curve, that of the economy. With newer mutations of the virus appearing to be more easily transmissible, he says that an infection rate of 70 to 75 percent might be required for herd immunity. Meanwhile, “natural protection to the virus is excellent.” He prescribes strategic vaccination—focusing on the 45-plus age group rather than younger people, and those who haven’t been infected— and “bring back the urge to mask up and avoid crowds.”

      Payal Dhar is a freelance journalist from India who writes on science, technology and society.

      Editor’s note: If you would like to contribute to help the situation in India, here are three recommendations from Payal:

      The COVID-19 Data Dispatch was able to compensate Payal for this piece thanks to the support of the COVID-19 Data Dispatch’s members. We hope to be able to feature more guest writers in the future—if you’d like to support this work, please consider a contribution.

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