Covid virus is still here. Why aren’t more people falling ill?
It seems like a distant memory now, but just three years ago, India was in the midst of its worst phase of the Covid-19 pandemic. The month of May 2021 saw more than 1.2 lakh deaths — around 20% of all deaths attributed to Covid in the country so far. In the first three weeks of that month, more than 3 lakh positive cases were detected every day on average. Daily detections peaked exactly three years ago — on May 6, 2021 — when more than 4.14 lakh positive cases were reported.
The crisis continued for at least two more months, even though cases and deaths declined steadily. Unlike many other countries, India did not face any more deadly Covid-19 waves. The Omicron wave of January-February 2022 saw a massive surge in infections, but not too many severe cases or deaths. And although a few cases continue to be reported even now — there were 850 active cases as of Friday, according to the Health Ministry — the pandemic no longer presents a serious threat.
So, is the pandemic finally over?
On May 5, 2023, the World Health Organisation (WHO) announced that Covid-19 was no longer a global public health emergency. It was an acknowledgment that the uncontrolled spread of the virus was over, it was not leading to serious diseases, hospitalisations or deaths, and was no longer stretching public health systems in most parts of the world. The declaration was seen as a formal end to the pandemic.
India had withdrawn all Covid-19-related restrictions after March 31, 2022 — shortly after the Omicron wave had dissipated — and ceased the application of the provisions of the Disaster Management Act. Subsequently, state governments removed their mandates for compulsory wearing of masks in public spaces.
However, SARS-CoV-2, the virus that caused the Covid-19 disease, remains very much in circulation — and continues to cause infections and even some deaths. The dominant variant causing the most infections right now is JN.1, a distant descendant of Omicron. JN.1 is a little more efficient at infecting people than its sister variants, but, like all descendants of Omicron, does not cause severe disease.
WHO data show that in the four weeks leading up to April 14, more than 2.42 lakh positive cases were reported across the world, over two-thirds of which were in Russia and New Zealand. About 3,000 cases were reported in India. In this same period, about 3,400 deaths have been attributed to Covid-19 — about 2,400 in the United States, and 53 in India.
Despite very little testing, India is still reporting cases in double digits — 50 cases were detected on Thursday. There was even a death in Kerala. A few labs, including the National Institute of Virology in Pune, Centre for Cellular and Molecular Biology in Hyderabad, and Translational Health Science and Technology Institute in Faridabad, have been tracking the circulation of the virus, mainly through wastewater surveillance and samples from hospitals. Wastewater surveillance has revealed the presence of the JN.1 variant in India as well.
Why aren’t more people getting infected?
Detections may be low simply because very few people are getting tested.
Luck, or chance, has had a role to play in the way Covid-19 has ceased to be a major health risk in the last couple of years. The Omicron variant, which emerged at the end of 2021, had enhanced capability to spread and infect people, but it did not cause severe disease. A large proportion of the world’s population gained natural immunity after being infected with Omicron. By the end of 2021, more than half the global population had also received one or the other vaccine, which strengthened their immunity.
The decline in the number of people without immunity, either through natural infection or vaccination, meant that the virus had fewer opportunities to evolve rapidly into newer variants.
However, neither natural infection nor vaccines provide permanent immunity. The effect of vaccines taken in 2021 and 2022 is most likely over. Natural immunity also dissipates after some time. The only reason there is no uncontrolled surge is that people are continuing to get infected with relatively harmless variants, and getting their immunity renewed.
“That is exactly what seems to be happening. People are getting infected, possibly in large numbers. We don’t know because not many tests are being done. But in the process, their natural immunity is getting refreshed and extended,” Anurag Agarwal, Dean of Biosciences and Health Research at Trivedi School of Biosciences at Ashoka University, said.
Meanwhile, the fact that the virus has not mutated into a more dangerous variant, has been very helpful. How long this situation will continue is anyone’s guess. However, the virus is no longer new to scientists and public health experts, who now have a much better understanding of it, and know what to expect and how to deal with its spread. But the circulating strains need to be constantly monitored and tracked, so that timely interventions can be made.
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