Country update: India

Data and Metrics Infection and Spread

India has been in the headlines over the past weeks for soaring case numbers, rising deaths, and a severely strained health system.

What is happening, and how can other countries help?

Let’s start with the numbers:

For the past 4 days, India has recorded over 300,000 new cases *per day*, by far the highest number in the world. The 7-day average is 310,309 new cases per day, more than double the 7-day average just 2 weeks ago. The country is recording over 2,000 deaths per day, a number many experts in the country fear is vastly undercounted. (For comparison, the US is seeing about 60,000 cases and 700 deaths per day recently.)

Also worth noting: With a population of 1.38 billion, India’s rate of new COVID cases per million population per day is *not* the highest in the world — far from it. At 224 new cases per million per day, India is lower on that metric than 53 other countries, including Cyprus (1006), Uruguay (819), and Sweden (540).

But the sheer number of cases is putting a strain on India’s health system, with hospitals full to overflowing and oxygen supplies running short in many areas. A vivid image that pointed to the high death toll: Metal parts of crematorium facilities were melting from running non-stop (link below).

Two crucial questions we need to ask:

1. Why this outbreak, now? India had a large surge in August-September but managed to get case numbers down. Seroprevalence studies indicated that perhaps up to half of India’s urban and rural population had been exposed to COVID, boosting hopes that herd immunity was in reach as vaccination efforts started. What seems to be driving this “wall” of cases (“surge” doesn’t begin to describe the rapid increase in cases) is a new variant, B.1.617.

One thing that distinguishes B.1.167 is the presence of two common mutations that haven’t been seen in the same variant before, earning it the nickname “double mutant” (but see linked story below on why that’s maybe not the best name — variants frequently have multiple mutations). Additional potential mutant strains are also under investigation. With limited resources for genomic sequencing, however, it’s hard to know yet what role these variants are playing in both spread (increased transmissibility) and severity (increased virulence) of COVID-19.

2. What can other countries do to help? Dr. Ashish Jha, Dean of the Brown University School of Public Health wrote in a Washington Post Op-Ed yesterday that India urgently needs assistance in three areas:

1️⃣ Testing to support screening, diagnosis, and sequencing
2️⃣ Medical supplies, PPE and treatments (most critically, oxygen)
3️⃣ Vaccines

The US has pledged $1.4 billion in aid, with more to come. Dr. Jha specifically urged sharing US supplies of the Astra-Zeneca vaccine (not yet authorized for emergency use in the US), and reversing export embargos on vaccine raw materials.

We will continue to monitor India’s outbreak and response, and keep you updated on other country hotspots around the globe.

As always, if you feel strongly about how your government is responding to the crisis and what actions should be taken, we encourage you to be in touch with your elected officials to make your voice heard.


Coverage of India’s recent surge: The Atlantic (photo essay)

Reuters on crematoria

NPR on B.1.617

Ashish Jha’s Washington Post Op-Ed

For US residents: Contacting your Congressional representatives:



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