New Delhi: India is witnessing a sudden rise in Covid cases once again. On Friday morning, the country recorded over 40,000 fresh Covid cases, which was the worst Covid spike this year. Maharashtra, with over 20,000 daily Covid cases, is the highest contributor to this rise. Dr Randeep Guleria, Director of All India Institute of Medical Science, Delhi, said that this rise is worrying and could be the beginning of the second wave of Covid-19 pandemic in the country. Several doctors and experts told The Sunday Guardian that this surge could have resulted from people not following Covid protocols.

Dr Swapneil Parikh, Co-Founder, DIY.Health, told The Sunday Guardian: “As restrictions have been lowered and social contact has increased, susceptible hosts come into contact with infected individuals. We lifted restrictions too quickly and that gave the virus a chance to spread from one host to many. The rapid increase of cases in areas that had high seroprevalence makes me suspect this is variant related. Either we’re seeing a more transmissible variant or one that’s causing some reinfections or both. The interaction of host behaviour (increased social contact) and evolution of the virus may be causing such a rapid increase in cases.”

On the possibility of a situation similar to last year, Dr Parikh said: “I hope not. We’re better equipped today to respond. Our healthcare workers, the elderly, and those with high-risk conditions are being vaccinated. We have more tools than ever; testing is cheaper and more widely available, treatment is more refined, and high-quality masks are cheaper. There’s a lot of uncertainty about how severe this wave will be, but there’s complete certainty about how to stop it. We don’t know how bad it will get, but we know exactly how to stop it from ever getting there. There could be a more transmissible variant of SARS-CoV-2 causing a spike in cases, but we need to  sequence a much higher number of samples to understand this better. It’s too early to comment about a change in virulence or severity; unfortunately, that will be a late signal as there is a lag between infections occurring and hospitalizations and deaths.”

Several doctors and health experts The Sunday Guardian talked to maintained that the single most important step is to enhance the manufacturing and administration of vaccines. It’s very important to ensure everyone can get vaccinated, they said.

Dr Kirti Sabnis, Infectious Disease Specialist, Fortis Hospital, Kalyan, told The Sunday Guardian: “It is a must that India should do genotyping of at least 20% of the samples collected, to understand if there is a mutation of any kind that is causing the spike. Another thing is, people are not maintaining social distancing norms, therefore the rise. The best tool to tackle this situation is following Covid appropriate behaviour, maintaining social distancing and masking guidelines, more testing, and vaccination. Vaccination is instrumental to curb its severity, if not control it completely. We need at least 80% of our population to be vaccinated to see the effects of vaccine-induced immunity. This will take time. Until all of us get inoculated, the best possible tool is to keep our distance and stay protected.”

Dr Trupti Gilada, Infectious Disease Specialist, Masina Hospital, told The Sunday Guardian: “The situation in Maharashtra is already bad in terms of the number of cases. The only saving grace is that the critical cases and deaths are fewer, health preparedness and availability of drugs are maximized and there are very well laid out protocols. We may therefore not see the mortality like 2020; though the number of cases may match. States like Maharashtra, Punjab, Madhya Pradesh, Gujarat, and Tamil Nadu are worst affected. Yes, it will get worse because the increasing numbers haven’t encouraged people to follow masking and social distancing equally vigorously. The five states in election mode will see a surge due to increased public interactions. A newer strain with increased transmissibility remains a possibility either now or in the future. This reinforces the need to hasten the vaccination drive.”

Dr Jai Mullerpattan, Consultant Pulmonologist, PD Hinduja Hospital & MRC, told The Sunday Guardian: “To control the large spread, the nature of the virus shouldn’t be more infectious. And India, almost being the size of a continent, could have multiple strains in different areas, which we don’t know. Whether it could be the original strain or existing strains contributing to the spike, only accelerated studies about the virus will let us know. Some reports on the mutations that have picked up significantly in Maharashtra do not indicate if they contribute to the rise.”

“In the earlier pandemics, like the Spanish flu wave, the second wave was deadlier than the first wave with a more significant number of people getting infected, and the spread was faster. We shouldn’t be surprised if something like that happens here,” Dr Mullerpattan said.