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Health experts are alarmed by the surge in daily covid-19 cases, expecting India to top the list of countries with the maximum number of infections.

“India is the third most affected from covid-19 now, but with increased testing, it could emerge as the top country affected by the pandemic. While testing rates have increased by 240% since the beginning of July, covid positive cases have increased by almost 325%," said Himanshu Sikka, lead-health, IPE global, an international healthcare development consultancy.

While 80% cases are from Andhra Pradesh, Karnataka, Tamil Nadu, Telangana, West Bengal, Bihar, Uttar Pradesh, Delhi and Maharashtra, the burden has shifted from the earlier covid hotspots of Delhi and Mumbai.

Average daily cases have increased to 65,000 from 55,000-60,000 till last week, with the total count on Tuesday reaching 2,235,677, including more than 44,700 deaths.

“This is an alarming trend and strengthens the findings of the numerous studies suggesting that with increased testing, India could very well emerge as the top country affected by the pandemic," Sikka added.

While Andhra Pradesh has been recording more than 10,000 cases every day for the past five days, Chandigarh’s average growth rate for covid-19 stands at 4.6%, surpassing Delhi’s (0.8%) and Maharashtra’s (2.4 %) growth. The national average of daily growth for covid-19 cases is around 3.25%.

“There is a shift in the epicentres of covid cases in the past one month with Andhra Pradesh and Karnataka having maximum growth rate, while Delhi is faring much better," said Dr Suneela Garg, director professor, department of community medicine, Maulana Azad Medical College.

In fact, the pandemic continues to spread and infect all sections of society, from politicians to the entertainment world. On Tuesday, former President Pranab Mukherjee, 84, said on Twitter that he tested positive for covid-19 while on a hospital visit. “On a visit to the hospital for a separate procedure, I have tested positive for covid-19 today. I request the people who came in contact with me in the last week, to please self isolate and get tested for covid-19. #CitizenMukherjee," he tweeted.

However, despite all the gloom around the pandemic, the silver lining remains the recovery rate. India on Tuesday recorded 1,552,545 covid-19 recoveries, witnessing the highest single-day count of 54,859, with a recovery rate of nearly 70% and a case fatality rate of 2%.

“India has so far been successful in keeping the fatality rates low and the recovery rates high. However, with the opening up of the economy, the pandemic is penetrating deeper in the country, and the situation could soon deteriorate further," said Sikka.

So far, the covid-19 hotspots were concentrated in bigger cities, such as Mumbai, Ahmadabad and Delhi, which could control and handle the situation due to better health infrastructure.

“But as the economy opens up, and the pandemic penetrates tier 2 and 3 cities and rural hinterlands, the situation could soon deteriorate with weak health systems not being able to cater to the pressures posed by the pandemic, especially in states like Bihar and Uttar Pradesh," said Sikka.

India has accelerated its testing and tracing infrastructure, but much more was required. Innovations for mass testing and screening protocols need quick adoption and scale-up, he said.

While India continues to deny the onset of community transmission, community medicine experts said prevention measures must be practised to limit the spread of the virus.

“If community transmission begins to occur, isolation and quarantine will have limited or no role to play," said Garg, adding that community-driven social changes will then play an important role in containing the spread of covid-19, such as wearing masks, washing hands regularly and maintaining social distancing. Lockdowns in specific clusters will be required.

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