India Opens Up, But Threat of a Third COVID Wave Looms

Shoppers throng malls offering summer discounts in the Indian capital of New Delhi, tables at popular restaurants are nearly full, and the city’s roads are choked with traffic as a holiday weekend begins.

Nearly three months after the delta variant, the fittest and fastest version of the coronavirus so far, raced through the country’s densely packed cities and vast rural areas, places like Delhi and Mumbai, are humming -- markets are open, hawkers peddle their wares and public transport is back on streets.

As many countries scramble to contain the delta variant, India, where it was first identified, has had a respite, except in the southern state of Kerala, which is reporting nearly half the country’s daily infections.

However, threat of a third wave that might hit in the coming weeks looms over the country, although it will be less brutal, according to researchers who have made projections on the likely spread of the COVID-19 pandemic in India.

“As the country opens up, the numbers will rise slowly but not significantly, assuming that the delta variant remains the dominant one and we do not see an even more infectious variant,” said Manindra Agarwal, professor at the Indian Institute of Technology, Kanpur, one of the panel members.

“It will be more of a ripple really and certainly nothing as dramatic as the second wave.”

Much of the country has reopened in recent weeks as daily cases of COVID-19 dropped from a peak of more than 400,000 a day in May, to about 40,000 cases.

Optimism that a third wave may be milder, even though less than 10% of the country has been fully vaccinated, is based on the latest national seroprevalence survey that showed that 67.6% of the population has been exposed to the coronavirus.

“The susceptible population in the country has come down. Before the second wave hit, three-quarters of people in India were susceptible,” Chandrakant Lahariya, a New Delhi-based epidemiologist, said.

“Now we know through seroprevalence surveys that nearly 68% of the population has antibodies, so any future wave will be definitely smaller.”

The survey by the Indian Council of Medical Research tested 29,000 people across the country, including children older than 6, for antibodies.

Epidemiologists say that in cities like Delhi, where the second wave was the deadliest, the number of people who have antibodies could be even higher.

On the other hand, in Kerala state, which is still battling the delta variant, the survey showed that a smaller number of people had been exposed to the coronavirus.

Coronavirus cases have dipped dramatically in Delhi – the city of nearly 20 million has reported a record low of around 60 cases daily in recent weeks.

“Unlike other countries, which are now seeing the ferociousness of the delta variant, one positive thing that came out of the deadly second wave is that a large segment developed immunity. So, we do not expect cases to exceed about 70,000 a day unless a more infectious variant comes up during a potential third wave. Then it could go up to 150,000 at the peak which we expect around October,” Agarwal said.

As life resumes in India with most cities lifting restrictions, authorities, who were strongly criticized for complacency in the months and weeks before the deadly second wave are cautioning people to follow COVID-19 protocols such as wearing masks.

“We sometimes hear people saying that let us enjoy ourselves till the third wave – have parties, attend functions. That approach is not correct. That is inviting new infections,” Lav Agarwal, a senior health ministry official said at a news conference earlier this week. “We must remember that COVID-appropriate behavior should be the new normal. That is the only way to win this war.”

Many are not heeding that message – crowds in markets and unmasked people are a common sight.

Holiday destinations are again packed with people who are heading out from cities such as Delhi that have faced two strict lockdowns in the last 15 months. The visitors are good news for businesses that have struggled to survive the pandemic.

“The second lockdown hit us hard. But things have been looking up since we reopened in July,” said Tarun Sibal, owner of Titlie bar in Goa, a popular beach destination. “Early signs from the queries and calls we receive suggest that Goa should do a full revival, especially after a majority of the travelers coming will be vaccinated.”

Health experts however point to the slow pace of inoculations and say that the government's target to inoculate all adults by the end of the year is likely to be missed. Fewer than 9% of adults have been fully vaccinated so far as a shortage of vaccines continues to hobble the drive.

Epidemiologists also warn about the possibility new variants could upend present calculations -- pointing to countries like the United States and Israel that are seeing a surge despite high vaccination rates.

“There is nothing like being extra cautious in a pandemic,” said Lahariya.

“There are many things which we are still learning. A country can become susceptible with new variants, and these can once again severely challenge countries like India where public health services are very weak.”