Cases Drop, Recovery Rate Rises in India, Where Omicron Has Yet to Dominate

India has documented a slight decrease in the number of confirmed Chinese coronavirus cases between the end of last week and Monday as well as increasing recovery rates, a peculiar trend compared to the rapid spread of the omicron variant of the disease almost everywhere else.

While still a significant minority compared to confirmed cases of delta variant infection, the number of identified omicron cases is growing exponentially, resulting in local governments implementing social distancing and lockdown protocols despite the number of cases actually dropping. Experts believe that India has yet to enter the surge phase of omicron infection now present in places like the northeastern United States and Europe.

India is the origin country of the delta variant, a mutated version of the virus originating in Wuhan, China, in late 2019. The initial surge of delta cases early this year resulted in large numbers of cases and deaths in the country and has since yielded some of the highest percentages of populations testing positive for coronavirus antibodies, suggesting high levels of exposure to the pathogen.

India reported 6,358 Chinese coronavirus cases between Monday and Tuesday, according to the country’s Health Ministry. In comparison, on December 19, India reported 13,600 cases. That day was a Sunday and somewhat anomalous to the days surrounding it, suggesting a weekend-related delay in test results. The number of cases hovered around 7,000, however, for much of the next week, increasing slightly to 7,189 on Saturday.

India’s World Is One News (WION) noted on Tuesday that the number of new cases on December 26 was 6,531, significantly lower than the Saturday before it. By Monday, that number had dropped by another 300 cases.

“India has recorded nearly 46,000 total cases from December 20 to 26. However, this number has seen a decline from 49,000 that India observed in the week before December 20,” WION reported.

The outlet also observed that the current recovery rate from coronavirus infections was at 98.40 percent, “the highest since March 2020.”

The Times of India additionally reported on Tuesday, “Active cases in India account for less than one percent of total cases, currently at 0.22 percent, the lowest since March 2020.”

Despite the wave of apparent good news, local Indian authorities have begun instituting mobility restrictions in anticipation of a wave of omicron variant cases. The Health Ministry documented 135 cases of omicron between Monday and Tuesday, several of them in two states that had previously not documented any. Delhi is leading the pack in infections with 142 confirmed omicron cases.

Delhi officials announced a “yellow alert” on Tuesday that shuts down all schools, imposes a 10 p.m. curfew, and bans religious and political gatherings, despite the small number of omicron cases compared to delta. The “yellow alert,” the Hindustan Times reported, automatically goes into effect “when the positivity rate for two consecutive days rises to more than 0.5 percent or if the cumulative single-day positive cases for a duration of seven days go beyond 1,500.”

The Indian Ministry of Home Affairs is also threatening to impose lockdowns on the country despite the positive trend in cases this week.

“State governments should ensure that the health systems in the states are strengthened to meet any challenge posed by the new variant,” Home Secretary Ajay Bhalla wrote in a letter to state leaders on Monday. “Further, the state governments/UT administrations should ensure that oxygen supply equipment are installed and are fully functional and the buffer stock of essential drugs should also be maintained,” stated Bhalla.”

“In a letter sent to the chief secretaries of all states and administrators of Union territories, home secretary Ajay Bhalla said that while the country has witnessed overall decline in active cases,” the Times of India reported, “Omicron variant is reported to be at least 3 times more transmissible than the Delta variant and is posing a new challenge for the fight against [Chinese coronavirus].”

The Times of India reported that the vast majority of omicron cases in Delhi are mild, reflecting a pattern seen globally.

“Dr Suresh Kumar, medical director of Delhi’s LNJP hospital, which is the capital’s largest facility for treatment for [Chinese coronavirus] patients, said that 85-90 percent of the patients are asymptomatic while others have very mild symptoms,” the newspaper relayed.

Studies from South Africa, the first country to alert the World Health Organization (W.H.O.) to the existence of the omicron variant, have found a dramatic dip in the need for hospitalizing omicron patients compared to delta patients. The W.H.O. itself has also stated that omicron appears to cause “milder” infections than delta.

Even prior to omicron, however, Indians appeared to be protected from coronavirus infection at higher rates than other populations. A national survey taken in July found that as many as 67.6 percent of Indians nationally possessed antibodies against coronavirus; at the time, only about a fourth of Indians had been vaccinated, suggesting the majority of those with antibodies had been infected.

In Delhi, the study found a staggering 97 percent of people possessed coronavirus antibodies by October.

The first waves of coronavirus infection severely affected India. By July, India had documented 414,000 deaths attributable to coronavirus infection. A Harvard University study published that month, however, found that the number could be ten times smaller than the actual coronavirus death toll due to poor documentation of cases and treatment in remote parts of the country.

“True deaths are likely to be in the several millions, not hundreds of thousands,” according to the study, which monitored “excess mortality” in the country, meaning the number of deaths documented during a time frame that is above the annual average for that time. Comparing the much higher number of deaths between January 2020 and the end of June 2021 to the average for similar timeframes, the researchers concluded that between 3 and 4.7 million people had died of coronavirus infection throughout the pandemic in India.

Following the initial case surges, however, Indian cases fell. The Indian government took several unorthodox measures that elicited both international interest and confusion, among them the approval of homemade coronavirus vaccine products and the government promotion of the use of hydroxychloroquine, a drug often used to treat malaria, and the antiparasitic ivermectin. Prime Minister Narendra Modi posted photos of himself in March allegedly receiving a dose of “Covaxin,” the homemade vaccine product by Bharat Biotech, and Indian health authorities approved the use of the other two drugs in clinical guidelines. In May, the Indian state of Goa began offering ivermectin to residents as a preventative measure, claiming it could protect the body from coronavirus infections, not just treat existing ones.

The debate over the use of ivermectin to treat coronavirus infections has been contentious for months. Researchers and institutions like the World Health Organization (W.H.O.) appear to agree that the drug may benefit patients in parts of the world where human parasitic worm infections are common for two reasons: ivermectin eliminates the worms, strengthening the immune system, and by doing so protects the human body from the potential of corticosteroids, a common coronavirus treatment, weakening the immune system and helping the worms reproduce.

In September – long before the discovery of the omicron variant – the Indian Council of Medical Research (ICMR) and the coronavirus National Task Force removed hydroxychloroquine and ivermectin from national clinical guidelines, justifying the move by arguing that the studies showing a positive effect in coronavirus patients were inconclusive and heavily biased.

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