How has India managed to avoid a second wave of infection until now?

[35B]

Such serious policies should have a prober debate in parliament, with public disclosure of the evidence. Rather than the autocratic decisions made at the behest of Grima Wormtongue Chris Whitty in opposition to epidemiological best practices.

I agree that the legislative framework has had inadequate discussion in Parliament, but executive powers have always existed and been used under primary legislation - and this is precisely where that is appropriate

 

[Bantamzen]

So we have a policy that is based on limiting transmission, which applies restrictions to travel from countries that represent a high risk of transmitting Covid, and we kneecap that policy by saying it can't be used quickly when required? My own reaction on hearing it was for Friday was to wonder why the delay.

That's not about the policy itself - I suggest we agree to disagree on the merits of it - but the ability to implement it.

I think the decision was in some way pragmatic. Slam the borders shut to India leaving a lot of UK residents stranded there was a recipe for chaos. Just as with holiday destinations, some time is needed to allow at least some controlled repatriation. If not, and particularly with India people would take different routes home. What would be more difficult to control additional flights arriving from India where you can test / get trace details immediately and send them home, or have dribs and drabs arriving from various other destinations having gone there on an indirect route. Its particularly relevant from countries like India where indirect flights can be sourced far more cheaply than in Europe.

 

[Yew]

I agree that the legislative framework has had inadequate discussion in Parliament, but executive powers have always existed and been used under primary legislation - and this is precisely where that is appropriate

At least the dictators of Rome had a tenure of 6 months.

 

[35B]

I think the decision was in some way pragmatic. Slam the borders shut to India leaving a lot of UK residents stranded there was a recipe for chaos. Just as with holiday destinations, some time is needed to allow at least some controlled repatriation. If not, and particularly with India people would take different routes home. What would be more difficult to control additional flights arriving from India where you can test / get trace details immediately and send them home, or have dribs and drabs arriving from various other destinations having gone there on an indirect route. Its particularly relevant from countries like India where indirect flights can be sourced far more cheaply than in Europe.

That sounds like a reasonable hypothesis - though quarantine obligations apply whichever route you take and an observant passport clerk would rapidly clock someone had been there.

At least the dictators of Rome had a tenure of 6 months.

And these government powers are time limited.

 

[Bantamzen]

That sounds like a reasonable hypothesis - though quarantine obligations apply whichever route you take and an observant passport clerk would rapidly clock someone had been there.

Given how many countries don't stamp passports, a rapid determination isn't quite so easy. Passport officers often have to spend quite some time asking questions & checks to determine a route someone has taken. It is far easier to slip through the net than you might imagine.

 

[Bayum]

Considering their Coronavirus VOC, there's clearly been a high level of transmission between citizens for a double mutation to occur. Significantly, many of those who have indeed tested positive could potentially be a minority due to the lack of widespread testing. Indeed, many have written about 'questionable methods' in working out the true number of those who have been infected. Right now, we're seeing masses of corpses being cremated. Many won't have had chance to have even seen a doctor, let alone a death certificate or diagnosis.

Questionable Testing Belies India’s Drop in Covid Infections

India’s daily coronavirus infections have been cut in half since a peak of more than 97,000 in mid-September, but the significant drop has raised fresh questions over the South Asian nation’s testing regime and whether it reflects the true state of its epidemic.

www.bloomberg.com

 

[yorkie]

Considering their Coronavirus VOC, there's clearly been a high level of transmission between citizens for a double mutation to occur.

Who have you been listening to?

As I said above, the "UK variant" has 17 mutations. Mutations are absolutely inevitable, are occurring independently in multiple lineages, as the virus adapts to humans. There is no way to avoid this.

Significantly, many of those who have indeed tested positive could potentially be a minority due to the lack of widespread testing. Indeed, many have written about 'questionable methods' in working out the true number of those who have been infected.

The number of people infected with Sars-CoV-2 will be massively higher than the numbers of positive tests; even in the UK, with mass testing, I suspect that the number of people infected is in the order of 5 times higher than the official figures. For India, you can multiply it by an even higher (much higher!) factor.

 

[brad465]

Who have you been listening to?

As I said above, the "UK variant" has 17 mutations. Mutations are absolutely inevitable, are occurring independently in multiple lineages, as the virus adapts to humans. There is no way to avoid this.

The number of people infected with Sars-CoV-2 will be massively higher than the numbers of positive tests; even in the UK, with mass testing, I suspect that the number of people infected is in the order of 5 times higher than the official figures. For India, you can multiply it by an even higher (much higher!) factor.

Reports I was reading suggested daily new infections in India are around 5-10x higher than what testing is picking up. Therefore, yesterdays 314k figure suggests new infections yesterday were around 1.57-3.14 million. Even at the upper estimate it would take more than a calendar year to infect the whole population, even if that value was uniform every day (which never happens in reality).

 

[Bayum]

Who have you been listening to?

As I said above, the "UK variant" has 17 mutations. Mutations are absolutely inevitable, are occurring independently in multiple lineages, as the virus adapts to humans. There is no way to avoid this.

Remind me how many of those 17 mutations are variants of concern?

 

[Domh245]

Remind me how many of those 17 mutations are variants of concern?

I think you've got something confused there.

Each variant of the virus has (one or) multiple mutations to their genetic material - the mutations themselves are what cause the different variants. In this case, the UK variant has 17 mutations compared to the original (wild-type) sequence of SARS-CoV-2 - many of these mutations are common to different variants. E484K as an example is a mutation which has been observed in pretty much all the main variants - UK (B.1.1.7), South African (501.V2), and Brazil (P.2)

Also worth noting as well that in the UK the Indian variant is only a Variant under Investigation, not yet a variant of concern.

 

[yorkie]

Remind me how many of those 17 mutations are variants of concern?

This is parody, right?

(If not, well by that logic I ask you how many arms and legs of football supporters are super league football clubs in Manchester?)

I think you've got something confused there.

Each variant of the virus has (one or) multiple mutations to their genetic material - the mutations themselves are what cause the different variants. In this case, the UK variant has 17 mutations compared to the original (wild-type) sequence of SARS-CoV-2 - many of these mutations are common to different variants. E484K as an example is a mutation which has been observed in pretty much all the main variants - UK (B.1.1.7), South African (501.V2), and Brazil (P.2)

Also worth noting as well that in the UK the Indian variant is only a Variant under Investigation, not yet a variant of concern.

Agreed except B.1.1.7 doesn't have E484K; you probably mean N501Y?

That said, some cases of B.1.1.7 with additional E484K mutation have been found but I am not sure if this has been reclassified.

Let's be honest, mutations such as N501Y, E484K are repeatedly being naturally selected for independently in multiple lineages globally; the idea this natural selection process can somehow be halted is pure fantasy on the part of lockdown fanatics who have no clue about viruses.

 

[brad465]

The record high of 314k cases in India on Wednesday was a well reported headline, for yesterday, to be reported potentially in the morning, it was a further 332k. If the peak doesn't come soon they look set to have heavy media coverage for a long time, especially as today they go on the red list for us.

 

[Bantamzen]

The record high of 314k cases in India on Wednesday was a well reported headline, for yesterday, to be reported potentially in the morning, it was a further 332k. If the peak doesn't come soon they look set to have heavy media coverage for a long time, especially as today they go on the red list for us.

Its interesting to watch how elements of the media have latched onto India. The good old Beeb for example is focusing on how India now has world record rates. What they fail to mention is that at an estimated 1.38 billion souls, India is second only to China as the most populated country on the planet. So its really not a surprise to see India up there.

 

[Domh245]

Agreed except B.1.1.7 doesn't have E484K; you probably mean N501Y?

That said, some cases of B.1.1.7 with additional E484K mutation have been found but I am not sure if this has been reclassified.

Let's be honest, mutations such as N501Y, E484K are repeatedly being naturally selected for independently in multiple lineages globally; the idea this natural selection process can somehow be halted is pure fantasy on the part of lockdown fanatics who have no clue about viruses.

Clunkily worded on my half. 'Main' B.1.1.7 doesn't have E484K, but I was referring to those small number of cases which did have the E484K (VOC 202102/02), mostly just to highlight how common the mutations are.

Agreed that trying to halt the mutation process is impossible (though I've not seen anyone here calling for it!) - at least without eradication which is also effectively impossible.

 

[brad465]

Its interesting to watch how elements of the media have latched onto India. The good old Beeb for example is focusing on how India now has world record rates. What they fail to mention is that at an estimated 1.38 billion souls, India is second only to China as the most populated country on the planet. So its really not a surprise to see India up there.

Yes I mentioned further upthread that if a rate of 3 million infections a day was maintained for as long as it would take to infect the entire Indian population (assuming actual infections are an order of magnitude higher than what's reported), it would take over a year.

 

[Ediswan]

The current per 100,000 figures for India, both cases and deaths, are significantly lower than some European countries e.g. France and Germany. The differences with India are:

* Much larger population
* Lower provision of healthcare infrastructure per head
* The rates are still rising (appears to be exponential)

 

[nlogax]

The current per 100,000 figures for India, both cases and deaths, are significantly lower than some European countries e.g. France and Germany. The differences with India are:

* Much larger population
* Lower provision of healthcare infrastructure per head
* The rates are still rising (appears to be exponential)

Healthcare in India was really not prepared for what’s happening there now. Last year’s relatively low impact provided a somewhat false sense of security. It’s hard to say when this exponential growth will start to slow down.

One of my colleagues had to fly out there this week to see his father who has been struck down with this and is in a critical condition. Regardless of thoughts about the complexities of mutations and variants and what the UK is or isn’t exposed to, you have to feel for those in India who are faced with spiralling case numbers and insufficient hospital facilities in multiple regions.

 

[ainsworth74]

It does seem to be getting pretty grim in India from Reuters a few days ago:

Gas and firewood furnaces at a crematorium in the western Indian state of Gujarat have been running so long without a break during the COVID-19 pandemic that metal parts have begun to melt.

"We are working around the clock at 100% capacity to cremate bodies on time," Kamlesh Sailor, the president of the trust that runs the crematorium in the diamond-polishing city of Surat, told Reuters.

And with hospitals full and oxygen and medicines in short supply in an already creaky health system, several major cities are reporting far larger numbers of cremations and burials under coronavirus protocols than official COVID-19 death tolls, according to crematorium and cemetery workers, media and a review of government data.

India on Monday registered a record 273,810 new daily infections and 1,619 deaths. Its total number of cases now stands at more than 15 million, second only to the United States.


Reliable data is at the heart of any government response to the pandemic, without which planning for hospital vacancies, oxygen and medicine becomes difficult, experts say.

Government officials say the mismatch in death tallies may be caused by several factors, including over-caution.

A senior state health official said the increase in numbers of cremations had been due to bodies being cremated using COVID protocols "even if there is 0.1% probability of the person being positive".

"In many cases, patients come to hospital in an extremely critical condition and die before they are tested, and there are instances where patients are brought dead to hospital, and we do not know if they are positive or not," the official said.

'VERY IRKSOME'

But Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, said many parts of India were in "data denial".

"Everything is so muddy," she said. "It feels like nobody understands the situation very clearly, and that's very irksome."

In Surat, Gujarat's second largest city, Sailor's Kurukshetra crematorium and a second crematorium known as Umra have cremated more than 100 bodies a day under COVID protocols over the last week, far in excess of the city's official daily COVID death toll of around 25, according to interviews with workers.

Prashant Kabrawala, trustee of Narayan Trust, which manages a third city crematorium called Ashwinikumar, declined to provide the number of bodies received under COVID protocols, but said cremations there had tripled in recent weeks.

"I have been regularly going to the crematorium since 1987, and been involved in its day-to-day functioning since 2005, but I haven't seen so many dead bodies coming for cremation in all these years," even during an outbreak of the bubonic plague in 1994 and floods in 2006.

Government spokesmen in Gujarat did not respond to requests for comment.

India is not the only country to have its coronavirus statistics questioned. But the testimony of workers and a growing body of academic literature suggest deaths in India are being underreported compared to other countries.

Mukherjee's research of India's first wave concludes that there were 11 times more infections than were reported, in line with estimates from studies in other countries. There were also between two and five times as many deaths than were reported, far in excess of global averages.

WORKING DAY AND NIGHT

In Lucknow, capital of the populous northern state of Uttar Pradesh, data from the largest COVID-only crematorium, Baikunthdham, shows double the number of bodies arriving on six different days in April than government data on COVID deaths for the entire city.

The figures do not take into account a second COVID-only crematorium in the city, or burials in the Muslim community that makes up a quarter of the city's population.

Crematorium head Azad, who goes by only one name, said the number of cremations under COVID protocols had risen five-fold in recent weeks.

"We are working day and night," he said. "The incinerators are running full time but still many people have to wait with the bodies for the last rites."

A spokesman for the Uttar Pradesh government did not respond to a request for comment.

Elsewhere, India Today reported two crematoriums in Bhopal, the capital of the central state of Madhya Pradesh, 187 bodies were cremated following COVID protocols in four days this month, while the official COVID death toll stood at five.

Last week Sandesh, a Gujarati newspaper, counted 63 bodies leaving a single COVID-only hospital for burial in the state's largest city, Ahmedabad, on a day where government data showed 20 coronavirus deaths.

The Lancet medical journal noted last year that four Indian states making up 65% of COVID fatalities nationally each registered 100% of their coronavirus deaths.

But fewer than a quarter of deaths in India are medically certified, particularly in rural areas, meaning the true COVID death rate in many of India's 24 other states may never be known.

"Most of the deaths are not registered so it's impossible to do a validation calculation," Mukherjee said.

Non-stop cremations cast doubt on India's counting of COVID dead

Gas and firewood furnaces at a crematorium in the western Indian state of Gujarat have been running so long without a break during the COVID-19 pandemic that metal parts have begun to melt.

www.reuters.com

Looking at the numbers that they do have (for whatever those might be worth) things seem to be growing on an exponential basis with no end in site with potentially fairly awful consequences for a lot of people in India. There was a report on the BBC this morning of one family who had had to travel five hours to try and find a canister of oxygen for a critically ill relative and were likely going to need to travel five hours again the next day to find another canister and so on. It's going to get a whole lot worse I fear before it gets better.

Regardless of thoughts about the complexities of mutations and variants and what the UK is or isn’t exposed to, you have to feel for those in India who are faced with spiralling case numbers and insufficient hospital facilities in multiple regions.

Yes I certainly agree with you there. I also personally find the unfolding humanitarian disaster in India to be of far more concern than the suggestions that the UK media are trying to spin it so as to keep us all afraid.

 

[kristiang85]

It is an unbearably hot time of year in India right now, so I wonder if everybody staying inside in the shade is part of it? (like the effect of winter here)

 

[brad465]

It is an unbearably hot time of year in India right now, so I wonder if everybody staying inside in the shade is part of it? (like the effect of winter here)

Yes their seasons are different to ours in the sense of how behaviour changes. During our winter, they are also in their coolest part of the year, but temperatures will be comfortable for many (average high in New Delhi is 20C in January), whereas in our spring they get high 30s-low 40s often, which was certainly tough when I was there 5 years ago, while nights are not much of a relief either. The monsoon period after is cooler but being very wet wouldn't be surprised if being indoors remained commonplace, and their first wave peaked during this period, with late September-December drier and cooling down so a return to more comfortable conditions.

 

[kristiang85]

Yes their seasons are different to ours in the sense of how behaviour changes. During our winter, they are also in their coolest part of the year, but temperatures will be comfortable for many (average high in New Delhi is 20C in January), whereas in our spring they get high 30s-low 40s often, which was certainly tough when I was there 5 years ago, while nights are not much of a relief either. The monsoon period after is cooler but being very wet wouldn't be surprised if being indoors remained commonplace, and their first wave peaked during this period, with late September-December drier and cooling down so a return to more comfortable conditions.

Yeah I went for a workshop in April one year, and it was nudging 48 one day and our air con failed. Two of our participants passed out, it was awful.

 

[HSTEd]

There is a reason the colonial administration decamped from Delhi during the summer!

Indeed I have to question what on earth they were doing there in the first place

 

[35B]

Given how many countries don't stamp passports, a rapid determination isn't quite so easy. Passport officers often have to spend quite some time asking questions & checks to determine a route someone has taken. It is far easier to slip through the net than you might imagine.

When I've been to India, their border staff have been very robust in their use of the stamp. Red country monitoring may be tricky for some countries, but a brief look at a passport will show whether someone has recently been in India.

It does seem to be getting pretty grim in India from Reuters a few days ago:

Yes I certainly agree with you there. I also personally find the unfolding humanitarian disaster in India to be of far more concern than the suggestions that the UK media are trying to spin it so as to keep us all afraid.

It is an unbearably hot time of year in India right now, so I wonder if everybody staying inside in the shade is part of it? (like the effect of winter here)

Colleagues in a variety of cities in India (Mumbai and Delhi in particular) are getting scared now - and these are people who live in the good parts of town, with good jobs with multi nationals. I've heard more stories in the last week about colleagues who are either ill with Covid themselves, or who have family members suffering, than I have in the preceding year, and sadly that includes deaths in all age groups.

What's interesting, when talking to them, is that they aren't mentioning changes in the weather as a factor - they complain that it's hot now, but all rely heavily on air conditioning etc. throughout the year. The monsoons haven't started yet - colleagues in Mumbai are quick to complain like hell when they do.

On the other hand, what's obvious is that despite work from home rules, people have been mixing much more generally than here; I have a number of work group WhatsApp pictures that show events where distancing was not a thing. The vaccination programme also has a long way to go yet.

 

[Bantamzen]

When I've been to India, their border staff have been very robust in their use of the stamp. Red country monitoring may be tricky for some countries, but a brief look at a passport will show whether someone has recently been in India.



Colleagues in a variety of cities in India (Mumbai and Delhi in particular) are getting scared now - and these are people who live in the good parts of town, with good jobs with multi nationals. I've heard more stories in the last week about colleagues who are either ill with Covid themselves, or who have family members suffering, than I have in the preceding year, and sadly that includes deaths in all age groups.

What's interesting, when talking to them, is that they aren't mentioning changes in the weather as a factor - they complain that it's hot now, but all rely heavily on air conditioning etc. throughout the year. The monsoons haven't started yet - colleagues in Mumbai are quick to complain like hell when they do.

On the other hand, what's obvious is that despite work from home rules, people have been mixing much more generally than here; I have a number of work group WhatsApp pictures that show events where distancing was not a thing. The vaccination programme also has a long way to go yet.

India may be robust, but as I said someone travelling back via another country isn't necessarily going to have their passport as robustly checked on return to the UK. You can have all the stamps in the world, but if you arrive back and the border officer doesn't check, or the traveller uses e-gates it means nothing.

 

[class321]

As someone who is from India, I could say Narendra Modi simply did not care about coronavirus and reacted too late. I am supposed to go to my uncles wedding in December, looking at the situation there, that doesn't look like its going to happen. Also, they are under reporting coronavirus cases. My dad was speaking to family members in a village in India, I don't know if this is true but most of the people in the village had corona already, but none had reported.

 

[35B]

India may be robust, but as I said someone travelling back via another country isn't necessarily going to have their passport as robustly checked on return to the UK. You can have all the stamps in the world, but if you arrive back and the border officer doesn't check, or the traveller uses e-gates it means nothing.

Which is why Heathrow queues are so long, as travellers’ papers are being checked. Thoroughly, and the eGates are closed.

 

[class321]

It is an unbearably hot time of year in India right now, so I wonder if everybody staying inside in the shade is part of it? (like the effect of winter here)

Most people are out in the evening.

 

[Yew]

Which is why Heathrow queues are so long, as travellers’ papers are being checked. Thoroughly, and the eGates are closed.

Sounds like the perfect place for a virus to spread, a queue of travellers of unknown provenance.

 

[Bantamzen]

Which is why Heathrow queues are so long, as travellers’ papers are being checked. Thoroughly, and the eGates are closed.

Heathrow isn't the only international port of entry. And reading some of the reports it seems that a lack of staffing is as much an issue as enhanced checks.

 

[Cdd89]

Sounds like the perfect place for a virus to spread, a queue of travellers of unknown provenance.

And believe me (from experience) that there is zero social distancing in the Heathrow immigration hall - or at least there wasn’t in late Feb. The switchback queues also ensure you are in close proximity to as many different people as possible!

When I've been to India, their border staff have been very robust in their use of the stamp. Red country monitoring may be tricky for some countries, but a brief look at a passport will show whether someone has recently been in India.

Two thoughts...

1. The group of people currently likely to want to travel between India and the U.K. are more likely than average to be dual passport holders — the passport with the India stamp need never be seen.
2. If it were so easy to identify those fraudulently completing a passenger locator form, we wouldn’t need to be issuing “deterrent” threats (such as 10 years in prison) for doing so.