Abstract
India experienced a second wave of COVID-19 infection with an unprecedented upsurge in the number of cases. We have analyzed the effect of different restrictive measures implemented in six Indian states. Further, based on available national and international data on disease transmission and clinical presentation, we have proposed a decision-making matrix for planning adequate resources to combat the future waves of COVID-19. We conclude that pragmatic and well calibrated localized restrictions, tailored as per specific needs may achieve a decline in disease transmission comparable to drastic steps like national lockdowns. Additionally, we have underscored the critical need for countries to generate local epidemiological, clinical and laboratory data alongwith community perception and uptake of various non-pharmaceutical interventions, for effective planning and policy making.
Highlights
India experienced a second wave of COVID-19 infection which peaked in April-May 2021
Rise in cases across the country was associated with emergence and spread of the delta variant of SARS-CoV-2, which is known to be highly transmissible with possibly enhanced disease severity [1–3]
Non-pharmaceutical interventions (NPIs) including masking, social distancing, largescale lockdowns, resource allocation, risk communication and travel restriction have played an important role in reducing transmission of SARS-CoV-2 worldwide [4]
Summary
India experienced a second wave of COVID-19 infection which peaked in April-May 2021. TPR based restriction or relaxation strategy alongwith enforcement of other NPIs, was implemented in several parts of India from the second week of April 2021 when the disease transmission was high and national average TPR was around 10%. We have estimated the total number of hospital beds that were required at the peak of the second wave in India for improved access and availability, using the assumptions of CIR of 27; asymptomatic infection in 25% of those infected; 80% of the symptomatic individuals presenting with mild illness and not requiring hospitalization; median duration of hospitalization of 7 days; 50% of the infected patients requiring hospitalization and 20% requiring mechanical/non-mechanical ventilation. We could not calculate the proportionate shortfall in oxygen and ICU beds, using the above assumptions, due to absence of reliable information in public domain on availability of such beds in various states of India
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