Increase in number of COVID-19 cases during the second wave
Sai Krishna Muthyanolla
April 9, 2021
India has been averaging more than one lakh new COVID-19 cases every day for the last few days. We crossed the earlier peak of 97000 odd daily cases reported in September 2020. It took a mere 25 days to cross the number compared to over 70 days during the first wave. However, it is still early to conclude on the severity or the direction of this wave.
As per the daily update on 08 April 2021 provided by the Ministry of Health & Family Welfare (MoHFW), there were a total of 1,26,789 new COVID-19 positive cases that were reported across India in a single day. This is the highest number of cases recorded in a single day in India since the pandemic broke out in the country last year. In fact, over the last four days, more than one lakh new cases were reported each day for three days. As per the update on 05 April 2021, 1.03 lakh new cases were reported in a day, the first such instance of more than 1 lakh daily cases ever since the pandemic broke out in India.
The earlier daily highest number of new cases was on 16 September 2020 with 97.8 thousand new cases were reported. Since then, the numbers have gradually fallen to around 10-12 thousand cases per day during January 2021 up until Mid-February 2021. However, starting from the last week of February 2021, there has been a gradual increase in the total number of new daily cases being reported, which further intensified during March 2021, indicating a Second wave of COVID-19 spread in the country.
The rate of increase in COVID-19 cases during the 2nd wave more than twice during the 1st
During the first wave of COVID-19 spread in the country, the number of new daily cases peaked during mid-September. As noted earlier, the highest number of cases in a single day was on 16 September 2020.
The time taken to reach this peak was a long drawn one when compared to many other countries. After the first COVID-19 case was reported in India at the end of January 2020, it was not until June 2020 that the number of new daily cases crossed the 10 thousand mark.
The progression described above is based on when the first instance a milestone i.e., 20 thousand cases, thirty thousand cases, etc. was crossed. Note that there could be instances of minor rise & fall in the numbers of new daily cases in between.
However, comparatively, the growth in the number of cases during the current wave (2 wave) is much quicker.
Case Positivity rate has nearly quadrupled in the last one month
The information analysed so far does indicate a more rapid increase in the new cases of COVID-19 during the current second wave, when compared to the first wave. Apart from the spread of the infection, one of the reasons cited for the increase in the number of COVID-19 cases during the latter part of 2020 was the ramping up of the testing facilities. The increase in the number of COVID-19 tests has enabled the identification of a greater number of COVID-19 positive cases.
In this context, Case Positive Rate (CPR) provides a better perspective. It indicates the number of cases identified as positive per every 100 tests conducted.
We have observed in an earlier story, that there were early indications in the fall of CPR, with the number of tests remaining constant along with the decreasing number of new COVID-19 positive cases. To ensure consistency in the numbers and remove any extremities, we took a 7-day moving average for calculating the CPR instead of a daily CPR.
Recent trends show a slight increase in the number of tests being conducted on a daily basis. It is to be seen if the increase in the number of tests would have an impact on CPR, or it would continue to grow as seen over the last month.
While there is a slight fall in Fatality Rate, the recovery rate fell owing to more new cases
One of the significant aspects of the spread of COVID-19 in India has been its lower fatality rate when compared to other countries. During the peak period of first-wave i.e., around mid-September’2020, the fatality rate was around 1.65% i.e., 1.65 deaths per 100 total confirmed COVID-19 positive cases (7-day moving average).
In fact, while the COVID-19 numbers were increasing towards the peak, it coincided with a fall in the fatality rates. The fall in fatality rate further continued.  Even during the last month, which has seen a significant increase in the number of COVID-19 positive cases and the CPR, the declining trend of fatality rate continued. The fatality rate is currently around 1.3%.
Analysing the Fatality rate as a standalone indicator does not offer a complete picture. The fatality rate could take some time to stabilize as we are in the phase of a quick increase in cases. However, it also has to be noted that there is no documented evidence of the second wave or any different variant being more fatal than the first. Experts argue that with the improvement in healthcare facilities coupled with treatment protocols and vaccination efforts, the fatality rates could further fall. However, it is still early days to come to any definitive conclusion.
On the other hand, the recovery rate is the no. of COVID-19 positive cases that have reported as recovered. Since the beginning of the pandemic in the country, the recovery rate has shown a consistent increase. During the peak period of the first phase, the recovery rate was around 80%, which further increased in the ensuing months. By the end of February 2021, the recovery rate was at its highest at 97%.  However, since then, there has been a fall in the recovery date which is currently at around 93 %. One of the primary reasons for this is the increase in rapid increase in the new cases who are either asymptomatic or undergoing treatment and yet to be reported as recovered. These numbers are yet ambiguous, and the rates will stabilize only when the trend in cases stabilizes in the next few weeks.
Earlier timelines indicate that it is still early days of Second Phase
Among the countries with significantly higher COVID-19 numbers, the USA and Brazil had a protracted first wave similar to that of India. Meanwhile, European countries had a shorter burst of increase in COVID-19 numbers and followed by a fall. Comparatively, the second wave has been longer in these countries. Apart from that, the caseload has been way higher during the 2nd wave with almost a 10-fold increase in the daily number of cases reported in these countries. While the USA seems to have recently exited the second wave after a prolonged period than the first wave, Brazil is still reporting higher numbers.
These trends could be indicative of the trends in India as well.  As for the timeline, going by the experience of the first wave, and the longer duration of the second wave in other countries, we might have just entered a longer phase of the second wave even in India. However, the one crucial difference is that India entered the second wave when the vaccination efforts have taken off with more than 7 crore people already vaccinated. While a steeper peak and rapid increase in the number of cases in India in the coming weeks cannot be ruled out, it is still early days to come to any such conclusion.
The exponential increase in the positive cases in the second wave observed in other countries could indicate that India might be looking at much larger numbers by the time second wave peaks. For comparison, the peak for the USA during the first wave was around 80 thousand cases, while during the second wave it is around 3 lakh cases.
While the higher recovery rates & lower fatality rate, have been a positive for India during the first wave, it is to be seen if the country would be able to maintain the same even during the current second wave. A lot might depend on the severity of cases coupled with the readiness of the system to deal with a rapid increase in caseload.
Featured Image: Second wave of COVID-19