The vanishing pandemic of India – What really is going on?

When the coronavirus cases started rallying around the world, the developing world was considered to be a ticking time bomb of cases and deaths. India, with the second-largest population in the world, with its high population density, poor level of hygiene, and high illiteracy, was set to be a world leader in cases and deaths. Almost no-one doubted this, including me and my doctor colleagues. We were just waiting for our turns to work in the COVID ICUS’s.

A lot of it did come true. There was a steep rise, followed by a second wave, followed by few spurts of cases here and there. India soon reached the top of all charts, just second to mighty America. The number of cases per day, the total number of cases, deaths, and every other parameter were increasing alongside an acute shortage of hospital beds and ventilators.

Things have changed over the past few months though. To everyone’s utter disbelief, cases per day in India have reached less than 300. On a few days, there were rather less than 200 cases. There are days when there are less than 10 reported deaths. These numbers seem very small compared to the daily 50,000 figures. Personally, in my hospital, wards are empty. Doctors are sitting, waiting for cases to come. Hospitals are busy preparing for another wave. But the charts aren’t moving over the past 2 months.

How is this possible?

With the USA still reporting 10-100 times more cases, India is well on its road to normalcy. It is surprising how even after having the right recipe for disaster, India is doing so well.

Anyone and everyone I meet these days has the same question – What do you feel about it? Why is it happening? Did you get vaccinated? Are there any side effects? Can we finally travel?

So I dug up some legitimate scientific literature to understand what is happening in India and why is the pandemic is vanishing from our country-

1. India is still a Young country!

A major chunk of the Indian population at present is young. More than half of our population is below 25 years. Only 4.8% is above 65 years. Coronavirus is equally dependent on the host as much as it is on the virus spread. Young hosts are more resilient to getting infected. They might become spreaders, but they never have anything except mild cold themselves.

2. Climate too!

India’s warm and humid climate is considered another proponent for the bumpy spread of the virus. Although there are studies that negate this point too, and I personally don’t believe strongly about it, but there are a few studies that actually consider that climate has a role to play in the spread of the virus.

3. Endemics protected us from the pandemic

India is a country with multiple endemic diseases. These are diseases that have been eradicated from the world. Especially from the USA and Europe. I am talking about diseases like Dengue, Japanese encephalitis, chikungunya, and so on. These diseases have one thing in common with the coronavirus – All of them are RNA viruses.

This has lead to the theory that constant exposure to these viruses might have conferred some form of protection from the novel coronavirus to the Indian population.

4. Tuberculosis pitched its part in!

Tuberculosis is one of the leading cause of death in most of the developing world including our country. Most of such countries have mandatory vaccination, called BCG (check your left shoulder for the circular mark if you’re from a developing country). BCG has been shown to confer immunity to some respiratory diseases. Some studies believe that BCG could also be another reason why the coronavirus was not so novel for the already trained immunity of Indians.

5.Was India ever in Community Transmission?

The government of India was hell-bent on the fact that India was never in the community transmission stage of the pandemic. Can it be true? Some studies believe, that the virus was definitely spreading in the community, given the huge population, poverty, and poor hygiene of the Indian population. But the virus encountered individuals, where it could not replicate at a high rate, due to better immunity of these individuals and hence the cycle of transmission was broken. This happened multiple times, eventually preventing the virus from having a free community transmission. Another reason why Indians got exposed to the virus slowly, the ideal way of getting herd immunity.

6. Hygiene theory

Old is gold. Hygiene theory was given in 1958 by Staranch. He correlated the high rates of allergic and noninfective diseases (asthma, arthritis, dermatitis, etc) in the developed world, to the low exposure to infections at young ages. The basic idea was that exposure to mild respiratory and stomach infections to young kids, till their school-going age provides them immunity against a lot of diseases later in life. Lack of this exposure due to better hygiene leads to poor immune response. Another reason why the disease hit the developed and the rich more as compared to the migrant workers.

All in all multiple reasons have played some part of their own. No-one knows the real reason. It will take a to of coming years and a lot of research to finally understand what exactly happened in India! Reading all the theories around, only a few made sense to me, which I have reiterated here. Tell me what you think is the real reason behind the low number of cases in India is?