Will COVID pose more problems for India in 2022?

India's devastating second wave of COVID-19 earlier this year brought the nation's health care system to its knees.     

At the height of the wave in April and May, the daily number of new infections often exceeded 400,000, overwhelming the country's health care infrastructure, which struggled with acute shortages of hospital beds, critical medicines and equipment.

Many patients died outside hospitals because of the lack of beds and medical oxygen.

"It was almost like Dante's inferno. A numbed population watched in horror for more than a month at the shortage of hospital beds, the fires of crematoria burning day and night, doctors begging for oxygen, patients suffocating outside hospital gates, and decomposing bodies floating in the River Ganges," Aman Lal, a crematorium caretaker, told DW.

Rising concerns over omicron

Over the past couple of weeks, concerns over the prospect of a third wave of infections have grown, with the detection and spread of the new omicron variant worldwide.

India has so far recorded about 200 omicron cases across 12 states, mostly in the western state of Maharashtra and the nation's capital New Delhi, the Health Ministry said on Tuesday.

The country's tally of omicron cases has nearly doubled within a week, but there have been no deaths reported so far. In less than 40% of cases, patients either fully recovered or were discharged, the data showed.

Virologists and scientists say there will be an increase in infections in India over the coming weeks and months. Nevertheless, they believe the new variant could be less lethal than the last delta wave because of widespread previous infections and vaccinations in the South Asian nation.

No room for complacency

Vineeta Bal, an immunologist at the Pune-based Indian Institute of Science Education and Research, believes another serious COVID-related crisis may not come India's way even though infections could go up.

"Vaccination, some improvements in health infrastructure, partial but continued use of masking and omicron as a possibly more infectious but less virulent strain will contribute to a less devastating situation than what we saw in 2021," Bal told DW.

Still, experts warn that there is no room for complacency. "A small percentage of a large number can be huge. However, the pre-existing immunity due to vaccination and prior infection should help reduce the impact. Unvaccinated and older people could still be affected more severely," Soumya Swaminathan, the World Health Organization's chief scientist, told DW.

"What we should be looking towards is making this another manageable respiratory infection which does not disrupt our lives," she added.

"Rather than focusing on the absolute number of cases reported daily, we need to track severe cases, hospitalizations and deaths closely. And we need to analyze breakthrough infections by age and by vaccination status to look for waning immunity," Swaminathan underlined.

Mask-wearing declines as infections drop

The number of new infections recorded in India has been on the decline over the past few weeks.

The South Asian country registered 5,326 new COVID-19 infections in the past 24 hours, the lowest such tally in the country in more than one and a half years.

Overall, the country has reported 34.75 million cases, the second-highest in the world after the United States.

Government surveys have estimated that nearly 70% of Indians had been naturally infected by July, following a record rise in infections and deaths in April and May.

With the drop in new infections, mask-wearing in public has fallen to levels last seen in March, before the second wave of cases, data from the Institute of Health Metrics and Evaluation shows.

Current mask-wearing is estimated at 59%, nearly the same as in March, having peaked at 81% in May.

But amid growing fears of potential surges in infections, health authorities have been urging people to use face coverings in public.

No booster shots yet

Authorities have also been accelerating the vaccination campaign, with at least one vaccine shot given to about 87% of the nation's eligible 944 million adults while around 58% have received two doses.

India has not considered authorizing booster doses yet, as many in the country have been naturally infected and the government believes two vaccine doses offer sufficient protection for now, Reuters news agency reported late last month.

"A booster protects a person further from symptomatic infection. While we await local data, let us not delay preparing for boosters and vaccinating children as global data shows that people with prior infection with other variants have minimal capacity to neutralize omicron," virologist Shahid Jameel told DW.

India better prepared now than during the second wave?

Gautam Menon, a professor of physics and biology at Ashoka University, believes India is better prepared overall to face a new wave of infections, in terms of knowing where its deficiencies lie and what to address first.

"The positive is that, compared to the second wave, any third wave will hit a population that is expected to have substantial hybrid immunity, from infections during the delta wave and vaccinations," Menon said.

The expert added that the government should make the relevant epidemiological data available widely, particularly with regard to testing, disease severity and patients' prior medical conditions, among other things.

"Data is a public good and measures can be made faster and better if more integrated data is made available. We will be flying blind into the storm otherwise," Menon said.

Edited by: Srinivas Mazumdaru