India on Thursday added 99,181 cases of the coronavirus disease (Covid-19) as it continued to set new global records for daily cases, inching closer to the sombre threshold of 100,000 cases in a day.
The total number of cases in the country touched 4,559,710, data compiled by HT from across the states on Thursday night showed.
The virus’ spread has been accelerating in the world’s second-most populous country, with worrying trends emerging, particularly due to the persistently rising number of active cases. At 945,771 on Thursday night, this number inched towards the million mark — a level breached only by the United States that continues to lead in terms of total infections seen till date.
Earlier in the day, the global death toll crossed 900,000. Of this, 76,303 are in India, even though the country has logged a relatively lower case fatality rate (CFR) of 1.7% – the proportion of those who died among confirmed cases – compared to the global average of 3.2%.
In the seven-day period between September 3 and September 10, India reported 90,195 new Covid-19 cases every day on average. Two months ago (for the week ending July 10), this number was 24,566 cases a day, and it was 58,742 daily infections a month ago for the week ending August 10.
In contrast, even when the pandemic was at its peak in the United States (end of July), this number never crossed 70,000 cases a day. US is the worst-hit country in the world with over 6.5 million cases.
The national doubling rate – the number of days it takes for a given number of infections to double – has not improved in the last two weeks and has hovered around 32 days.
One of the key reasons for the continuously rising daily cases is that the pandemic has shown no signs of relenting even in the country’s worst-hit regions. States such as Maharashtra, Andhra Pradesh and Karnataka (at the 1st, 2nd and 4th spot with 990,795; 537,687; and 430,947 cases respectively) continue to drive the number of daily cases. A little under half (45%) of all infections in India in the last week have come from just these three states. In fact, three out of every four infections in the country in the last week have come from 10 states.
Daily cases have also hit a new peak in the last two weeks in Delhi, which was one of the only major hot spot states to have brought the outbreak under control. The capital reported 4,308 new cases on Wednesday, albeit on the back of a record number of tests: 58,340.
Higher testing has also been one of the key reasons for this rapid rise in cases throughout the country. On average, the country has tested more than a million samples a day through the past two weeks, and this trend is continuously increasing.
However, despite the increase in testing, many major states continue to have high positivity rates, a factor that experts said was alarming. The positivity rate shows how widespread the virus is in a region. Nearly a quarter (24%) of all tests in Maharashtra have been positive for Covid-19 in the last week, in Andhra Pradesh more than 15% of all tests have come back positive and for Karnataka this number was around 13%. The high positivity rates in these states indicate that infection numbers there may not be dropping soon, and that they are still not testing adequately.
The majority of the cases has been coming from rural areas in the last month where health care challenges, from testing to treatment, are much more significant, HT reported on August 26. The trend is very different from what was seen in the initial months of the pandemic, when the cases were largely in the urban areas.
Experts said that the larger focus of the governments, despite the rapid increase in cases, has to remain on keeping the mortality as low as possible.
“It is not surprising that the number of cases is increasing day by day. The infection has now spread to most parts of the country and we cannot contain it any longer. The cases will keep going up till a peak is reached. However, this peak will be different for different places. Now, many cases are being reported from smaller cities and rural areas that had not been affected previously. The important thing is to focus on reducing the mortality,” said Dr Puneet Mishra, professor in the department of community medicine at All India Institute of Medical Sciences (AIIMS).
“India has a three-tier health care system, with most rural areas having access to a primary health care centre, wellness centre, or a sub-centre. These centres are usually run by paramedical staff and not doctors. And while 80% of Covid-19 patients require no medical attention at all, the remaining need high attention with proper monitoring or ICU (intensive care unit) admission. This cannot be done at primary health care centre. Plus, 70% of our healthcare is provided by private hospitals concentrated in larger cities. So, I expect the mortality to increase a little with the disease affecting rural areas,” he added.
(With inputs from Anonna Dutt)