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Even though there has been a decline in fresh covid-19 cases in last week, differential peak in disease curve across states cannot be ruled out, epidemiologists and mathematical modellers have cautioned.

A mathematical model developed by a team of scientists from Indian Institute of Technology (IIT) that earlier in April rightly predicted the cases to cross 3.5 lakhs by May, has now said that India is hovering around the peak.

However, the peak case load of about 4 lacs is limited by the daily testing capacity. Due to very high test positivity rate (TPR) of approximately 22%, it is expected that India will see a near plateau for around a week instead of a sharp peak. The model also has suggested that Karnataka and Andhra Pradesh are expected to peak soon, while Tamil Nadu may peak in the third week of May. ttarakhand, Punjab, West Bengal, Odisha, Puducherry, Chandigarh, Goa, J&K are still in the growth phase and may take a couple of more weeks to peak.

“We believe that strong measures are needed in these states to suppress explosive growth. Virus spread is now moving from North India to Eastern and Northeast states. West Bengal, Assam, Mizoram, Meghalaya, Manipur and Sikkim are behind other states in terms of overall spread and saturation. Therefore, it is possible to curb the growth now through strong intervention before situation becomes worse," said Mahendra K. Verma, professor, department of physics, IIT Kanpur.

The model indicated that Goa has highest TPR of about 50% suggesting very high spread of virus. Uttarakhand, Karnataka, West Bengal, Kerala and Haryana too have very high TPR of approximately 30%. Testing capacity needs to be ramped in these states while continuing interventions to effectively contain the spread of the epidemic, the IIT model suggested.

Among most impacted states, Kerala has the lowest CFR of just about 0.14% suggesting quality health infrastructure. Jharkhand (2.2%), Punjab (2%) and Delhi (1.7%) have very high CFR, which is a cause of concern, the model suggested.

The scientists used Susceptible-Infected-Recovered (SIR) model along with a data-driven decay rate to predict the future course of the pandemic. The model suggested that because of over-stretched healthcare systems, the case fatality rate (CFR) has also increased from about 0.7% in February to about 1%.

At least 3,62,727 new covid-19 cases were registered in the last 24 hours. Ten States reported 72.42% of the new cases in last 24 hours. Maharashtra has reported the highest daily new cases at 46,781. Itis followed by Kerala with 43,529while Karnataka reported 39,998new cases.

“Mathematical models have indicated that the new cases in the second wave are likely to peak by mid-May and deaths by end of May. We are almost in the mid May and there do not appear any sign of plateauing of cases," said Lalit Kant, former head of epidemiology and communicable diseases at the Indian Council of Medical Research (ICMR).

“The movement of the virus in the rural areas and more than 500 districts 10% positivity or more, peak seems to be still further away for the country as a whole. However, if we look at data from some states like Maharashtra and Delhi, cases and deaths have been decreasing during the week indicating that they may have passed the peak," he said.

According to the mathematical model, Maharashtra, Uttar Pradesh, Madhya Pradesh, Gujarat, Delhi and Chattishgarh are exhibiting clear signs of decline indicating that lockdown has an impact in arresting the spread. “Model suggests that in recent times, daily cases have reached their peaks in Kerala, Haryana, Rajasthan, Telangana, Bihar and Jharkhand, but there are strong fluctuations in the data. However, considering the high infectiousness of the virus, strict vigilance is a must even in regions exhibiting decline," said Verma.

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