The annual flu season has begun in Delhi, north-west India, and the northern plains. Several in the HT newsroom have come down with flu in the past week — not the coronavirus disease (Covid-19; they tested negative), but the seasonal flu that makes its presence felt around this time of the year. Some of its symptoms are similar to that of the coronavirus disease, adding to the confusion, and the fear — but it is just the flu.
Temperatures in the north and northwestern parts of the country are expected to start falling significantly by the end of September, and while no one in India seems particularly worried about it right now, health administrators in much of the northern hemisphere are wondering what the onset of cooler weather will mean for the Sars-CoV2 virus (which is anyway winter’s child). Will it mean a further spike in cases, which are already surging in parts of Europe as a direct result of countries opening up?
Not too long ago, in spring, many of us (including this writer) were hoping that warm weather would prove unfavourable for the spread of the virus. We were wrong. It even thrived in the Indian summer. Now, based on what is known of the Spanish Flu of 1918-19, researchers and health administrators are worried about fall and winter — the second wave of the Spanish Flu, which started in the fall of 1918, was far more virulent and fatal than the first (or the third).
It is likely that India and the rest of the world will see a fall (fine, India doesn’t really have the season but you know what I mean) and winter with more cases of Covid-19, but fewer deaths. Several medicines have been approved for emergency use by drug regulators, including in India, and this writer’s own sense is that the use of antivirals such as remdesivir, steroids, monoclonal antibodies, and interferons to manage infections serious enough to require hospitalisation may end up saving lives. India’s health administrators can’t be faulted at least in this aspect. Still, the increase in cases, which will mean a consequent increase in hospitalisations, will stretch health systems again.
India’s daily numbers — the country ended Sunday with 5,485,390 new cases — have seen that rare thing, a dip, in the past few days, with its seven-day average actually dipping between Wednesday and Saturday (I remember this happening only once before in recent months). The trailing seven-day averages for each of the six days between Monday and Saturday were: 93,180, 93,334, 93,617, 93,278, 92,589, and 92,308. The only thing that can explain this is a dip in testing. India tested 1.16 million people on September 10, a day when it recorded 99,181 cases. It tested fewer than that on the eight days that followed. Only on Saturday, September 19, did it test more — 1.2 million people, which is also a record in terms of number of tests. As I’ve pointed out previously, there isn’t a direct daily correspondence between tests and cases, although anyone looking at numbers around the world assumes there is (and it is easier from the analytical perspective to do so; all analysis by the HT newsroom also assumes this; otherwise calculating key metrics such as positivity rates will become difficult). The 99,181 cases number on September 10 came on the back of 1.13 million tests on September 9 and 1.15 million tests on September 8.
The drop in testing after September 10 wasn’t sharp —the difference exceeded 100,000 only on three days (of which it exceeded 200,000 on one day) — but it still seems to have been enough to prevent the number of new cases in India exceeding six-digits. That reprieve may be temporary. If India continues to test with the same intensity it did on September 19, it will cross the 100,000 number for new daily cases very soon.