(CNN)Less than a month ago, India’s future looked dire.

But so far, the world’s second-most populous country appears to have avoided the worst.
As of Tuesday, India had reported 31,360 coronavirus cases and 1,008 deaths, or about 0.76 deaths per million. Compare that to the United States, where the number of deaths per million is more than 175.
    Some experts say that India’s relatively positive numbers suggest the country’s nationwide lockdown to halt the spread of Covid-19 could be working — for now.
    “India didn’t wait for the problem to escalate,” India’s Prime Minister Narendra Modi said on April 14, as he extended the country’s 21-day nationwide lockdown until May 3. “Instead, as soon as the problem appeared, we tried to stop it by making swift decisions. I can’t imagine what the situation would have been had such quick decisions not been taken.”
    But the reality behind India’s numbers is more complicated — and experts caution that it is too early for India to congratulate itself.
    “At least in this round, it appears that the virus has not been able to damage as much as been feared,” Srinath Reddy, the president of the Public Health Foundation of India, a nonprofit that works on training, research and policy development. “I don’t think we can say that we have completely closed the book on this.”

    How swift were Modi’s decisions?

    On March 24, Modi announced that the country was going into a three-week lockdown.
    The scale of it was unprecedented. India has a population of 1.3 billion, and the only country with a bigger population — China — had imposed citywide lockdowns, but never a nationwide one.
    It was a high-stakes decision. Going into lockdown meant millions of daily-wage workers would be deprived of an income. But not imposing a lockdown risked overwhelming India’s health care system. One model estimated that without social distancing measures, about 150 million people in India would be infected by June. On Friday, India’s top pandemic official said that the country would have had more than 100,000 cases by now if it weren’t for the lockdown.
    India moved into lockdown relatively quickly — it was announced when the country had reported 519 coronavirus cases.
    By comparison, Italy waited until it had more than 9,200 coronavirus cases before it went into a nationwide lockdown, while the United Kingdom had about 6,700.

    Ramanan Laxminarayan, the director of the Center for Disease Dynamics, Economics & Policy, a non-profit research organization with offices in Washington, D.C., and New Delhi, said the decision to impose a lockdown promptly, even when case numbers was low, had likely reduced contact rates significantly.
    Following the lockdown, thousands of migrant workers attempted to leave India’s major cities after therestrictionsleft them without jobs. That prompted fears that the migrants could spread the virus, with some officials in the Indian state of Uttar Pradesh even spraying returning workers with disinfectant — an ineffective approach to controlling coronavirus.
    Around a week after the lockdown began, two people had died from coronavirus in Mumbai’s densely packed slums. Following the second death, several of the man’s family members had been tested and placed under home quarantine, and the block of 300 homes and 90 shops that make up his neighborhood have been sealed off.

    By the time the lockdown was imposed, India had already taken other measures.
    On March 11, India suspended all tourist visas, and announced that all travelers who had been in the most-affected areas of the world in the past few weeks would be quarantined for at least 14 days. From March 22, all international commercial flights were banned from landing in India and all passenger train services in the country were suspended.
    The United States, by comparison, has restricted foreigners traveling from China, Iran, and certain European countries, but there is no blanket ban on foreigners entering the country.

    What if the numbers aren’t right?

    As with every country, our understanding of the outbreak is only as good as the numbers we have available. And that depends on testing.
    According to India’s Health Ministry, the country has conducted more than 625,000 tests as of Sunday — more than South Korea, which has been praised for its approach to testing.
    When public health experts are assessing how aggressively a country is testing, they don’t look at the total numbers alone — instead, they often look at the country’s test positivity rate. If a large proportion of the tests are coming back positive, that suggests that only the most serious cases — such as those in hospital — are being tested.

    According to Mike Ryan, the executive director of the WHO’s Health Emergencies Programs, a good benchmark is to have at least 10 negative cases for every positive one.
    Around 4% of India’s tests are positive, according to data from India’s Health Ministry — well below that benchmark. It’s also a significantly lower rate than the US, where the rate is about 17%, according to data from Johns Hopkins University (JHU). It’s also lower than the UK, where the rate is around 21%, based on government data.
    Another useful measure is the proportion of cases that are fatal. In India, about 3% of cases have died, compared with more than 13% in Italy, the UK and France, according to JHU. That suggests that India is testing people besides those with the most serious symptoms.
    But India’s testing rate is extremely low per capita. Only about 48 out of every 100,000 people have been tested, compared with around 1,175 in South Korea and 1,740 in the US.
    Samir Saran, the president of the Observer Research Foundation, says India has ramped up its testing capabilities dramatically — but he’s still not happy with the numbers. While other experts say that widespread community testing would be impractical and a waste of resources, Saran says that’s something India needs to look at, given it has large swathes of the population who travel between regions for work.
    While India may not be testing enough, Reddy says, doctors are probably catching most of the moderate and serious cases. If there was a huge surge in Covid-19 cases that weren’t being caught by testing, then hospitals would be crowded with cases and there would be a spike in influenza-like symptoms in the community, he said.
    For now, there’s no indication of either. However, there is a growing body of evidence that Covid-10 causes symptoms far beyond influenza-like symptoms.

    Could more people be dying than we know?

    Even when India isn’t facing a pandemic, only about 22% of all registered deaths are medically certified. That means that, in the majority of deaths, the official cause of death has not been certified by a doctor.
    And there’s already evidence that some deaths may be flying under the radar. A resident doctor at one of the main government hospitals in Mumbai said last week that when dead bodies were brought into the hospital, they didn’t test them for coronavirus, even if they suspected that was how patients died.
    “If the personal history shows that the person came in contact with someone who tested positive for the virus, we dispose of the body in the same way that we would for Covid-positive patients,” said the doctor, who asked not to be named as they were not authorized to speak to media.
    But, experts say, at this stage, it doesn’t look like there is a huge flood of coronavirus deaths.
    “Even if we are not testing enough and are not discovering enough, there are not enough bodies being piled up in hospitals or in ICUs or in mortuaries … to suggest we are in the midst of something really dramatic at this stage,” said Saran.
    Even so, the true count of Covid-19 deaths will only come much later, when we are able to compare statistics from this year with past years, said CCDEP’s Laxminarayan.

    When did coronavirus take hold?

    India’s swift policy measures only tell part of the story. Even before India’s lockdown, coronavirus was present in the country, the country had reported some coronavirus cases, but not many.
    On January 30, India reported its first case — a student who had been studying at Wuhan University in China.
    It was around the same time that the UK, France, and Italy also reported their first cases, although their coronavirus outbreaks followed dramatically different trajectories. All three countries now have well over 100,000 coronavirus cases.
    Experts still aren’t sure why the virus would have shown a different pattern of spread in India.
    One possible reason, said Reddy, is that coronavirus may thrive in colder conditions, meaning that it might not spread so efficiently in India, where temperatures are often more than 30 degrees Celsius (96.8 degrees Farenheit).
    But scientific evidence so far contradicts this idea. The World Health Organization says the evidence so far shows the virus can be transmitted in all areas, including those with hot and humid weather. The US’s National Academy of Sciences committee said the data is mixed on whether coronavirus spreads as easily in warm weather as it does in cold weather.
    Another possibility, Reddy said, is that India’s population may be less susceptible due to the country’s policy of universal Bacillus Calmette-Guerin (BCG) vaccination. BCG — which was developed to fight tuberculosis — is being studied in clinical trials around the world as a possible way to fight the novel coronavirus.
    However, the WHO notes that there is no evidence that the BCG vaccine protects people against infection from coronavirus, and the WHO does not recommend the vaccine as a prevention against Covid-19.
    But for now, more evidence is needed. “We do not know what is the factor that has helped us,” Reddy said.

    Will a 40-day lockdown be enough?

    Even if India’s outbreak is comparatively small, it’s not yet time for celebration.
    There’s a huge diversity of opinion about what will happen when India lifts its lockdown on May 3 — whether cases will then skyrocket, or if the lockdown will have succeeded in restraining numbers.
    “A surge is going to happen … as soon as we go back from the nationwide lockdown. That is my hunch,” said Oommen Kurian, a senior fellow at theObserver Research Foundation. “India has successfully hit a pause button. But the problem now is we cannot be on pause forever.”
    The determining factor will likely be what restrictions are still in place when the lockdown lifts. As Reddy put it: “It’s not as though tomorrow we declare victory and then we get back to normal.”
    Experts say that social distancing will need to be maintained, although some states with fewer cases may be able to ease restrictions. Uttar Pradesh — India’s most populous state with 200 million residents — has extended a ban on public gatherings until the end of June.
    Laxminarayan warned that if social distancing and hygiene measures “are not taken seriously, we will have a serious issue that the health system is not equipped to handle.”
    One thing that won’t work in India is an age-specific lockdown, where elderly stay inside and the young are allowed to go back to work. Around the world, the elderly have been at a higher risk of dying from coronavirus — in the US, 80% of deaths have been those ages 65 or older.
    India has a relatively young population — 44% of the population are 24 or younger, compared with 23% in Italy and 29% in China, according to data from the CIA World Factbook. But many Indians live in a three-generation household, meaning that there is significant contact between younger and older generations, said University of Cambridge mathematician Ronojoy Adhikari, who modeled India’s outbreak.
    “This makes the elderly in India particularly vulnerable, as they are far more likely to catch the infection from the second and third generations, on whom the infection will, statistically speaking, only have mild effects,” he said.
      Even if India does manage to avoid the worst of the virus this time around, there’s plenty to be done. The government needs to be working to support the country’s informal workforce, who are “underwriting the cost of the lockdown,” as Saran puts it. The government needs to strengthen the public health system to prepare for a possible return and resurgence in the winter, said Reddy.
      “This is not a one month challenge, this is going to be a 12-month challenge,” said Saran. “I think this is a good 18-month examination of how we respond as people, communities, countries, states.”

      RELATED ARTICLESMORE FROM AUTHOR

      405 COMMENTS

      1. I do not even understand how I ended up here, but I believed this submit used to be good.
        I don’t know who you’re but certainly you are going to a famous
        blogger if you aren’t already. Cheers!

      4. Greetings from Colorado! I’m bored to tears at work so I decided to
        check out your website on my iphone during lunch break.

        I enjoy the info you present here and can’t wait to take
        a look when I get home. I’m surprised at how fast your
        blog loaded on my cell phone .. I’m not even using WIFI, just 3G ..
        Anyways, fantastic blog!

      5. Hi, I think your site may be having web browser compatibility problems.

        Whenever I take a look at your website in Safari, it looks fine but
        when opening in I.E., it’s got some overlapping issues.
        I merely wanted to give you a quick heads up! Other than that,
        great site!

      6. Hello would you mind stating which blog platform you’re using?

        I’m planning to start my own blog soon but I’m having a
        hard time making a decision between BlogEngine/Wordpress/B2evolution and Drupal.
        The reason I ask is because your layout seems different then most blogs and I’m looking for something unique.
        P.S Apologies for being off-topic but I had to ask!

      7. Excellent post. I was checking constantly this blog and I’m impressed!

        Extremely useful information specifically the final section 🙂 I
        take care of such information a lot. I was looking for this particular info for a very lengthy
        time. Thank you and best of luck.

      8. Howdy, i read your blog from time to time and i own a similar one and i was just curious
        if you get a lot of spam comments? If so how do you protect
        against it, any plugin or anything you can suggest?
        I get so much lately it’s driving me insane so any help is very much
        appreciated.

      59. My wife and i felt quite thrilled that Louis managed to finish up his inquiry while using the precious recommendations he received when using the weblog. It’s not at all simplistic to just find yourself giving away hints that many other people could have been trying to sell. We keep in mind we now have the blog owner to give thanks to for that. The specific illustrations you made, the simple blog menu, the friendships you can assist to engender – it is everything powerful, and it’s leading our son and our family do think that matter is enjoyable, which is unbelievably fundamental. Thanks for the whole lot!

      96. I’m impressed, I must say. Seldom do I encounter a blog that’s both equally educative and engaging, and let
        me tell you, you have hit the nail on the head. The issue is something not enough men and
        women are speaking intelligently about. Now i’m very happy that I
        found this in my hunt for something relating to this. asmr
        0mniartist

      98. My family all the time say that I am wasting my time here at web, however I
        know I am getting experience every day by reading such nice content.
        asmr 0mniartist

      105. I love your blog.. very nice colors & theme. Did you create this website yourself
        or did you hire someone to do it for you? Plz reply as I’m
        looking to construct my own blog and would like to find out where u got this
        from. many thanks 0mniartist asmr

      134. May I simply just say what a relief to uncover somebody who truly understands what they’re
        discussing over the internet. You certainly understand how to bring a problem to light and make it
        important. More and more people have to check this out and understand this
        side of your story. I can’t believe you’re not more popular because you
        surely have the gift.

      136. I loved as much as you’ll receive carried out right here.
        The sketch is tasteful, your authored material stylish.
        nonetheless, you command get got an nervousness over that you
        wish be delivering the following. unwell unquestionably come further formerly
        again since exactly the same nearly a lot often inside case you shield this increase.

      148. Hey! Someone in my Myspace group shared this website with us so I
        came to check it out. I’m definitely loving the information. I’m book-marking and will be tweeting this to my
        followers! Exceptional blog and superb design and style.

      154. This is very fascinating, You are a very skilled blogger.
        I’ve joined your feed and look ahead to seeking extra of your excellent post.

        Additionally, I have shared your web site in my social
        networks

      156. Good day! This is kind of off topic but I need
        some guidance from an established blog. Is it hard to set up your own blog?
        I’m not very techincal but I can figure things out pretty quick.
        I’m thinking about making my own but I’m not sure where to begin. Do
        you have any tips or suggestions? With thanks

      165. scoliosis
        Hello, i feel that i noticed you visited my site thus i came to go back the
        favor?.I am trying to find things to enhance
        my site!I suppose its adequate to use a few of your ideas!!
        scoliosis

      184. I love your blog.. very nice colors & theme. Did you create this website yourself or did you hire someone to do it for you?

        Plz reply as I’m looking to create my own blog and would like to find out where u got this from.

        thank you

      187. Great post. I was checking continuously this blog and I’m impressed! Extremely helpful information specially the last part 🙂 I care for such info much. I was seeking this certain info for a long time. Thank you and good luck.

      205. Normally I don’t learn post on blogs, but I would like to
        say that this write-up very compelled me to try and do so!
        Your writing style has been surprised me. Thank you, quite great article.

      212. Hmm is anyone else having problems with the images on this blog loading?
        I’m trying to determine if its a problem on my end or if it’s the blog.

        Any feed-back would be greatly appreciated.

      249. Hello there I am so glad I found your webpage, I really found
        you by accident, while I was browsing on Aol for something else, Anyhow I am here now and would just like to say
        many thanks for a remarkable post and a all round interesting blog (I also love the theme/design), I don’t have time to read it all at the
        minute but I have book-marked it and also included your RSS feeds, so
        when I have time I will be back to read a great deal more, Please do keep
        up the excellent job.

        Feel free to visit my website http://163.30.42.16/

      251. As I site possessor I believe the content matter here is rattling excellent , appreciate it for your hard work.

        You should keep it up forever! Best of luck.

        my blog post – Greg

      282. I blog frequently and I genuinely thank you for your
        content. This article has truly peaked my interest. I’m going to take a note of your blog and keep checking for
        new information about once a week. I subscribed to your Feed as well.

        Here is my blog … Max Extend Pills

      287. Does your blog have a contact page? I’m having a tough time locating it but, I’d
        like to send you an email. I’ve got some recommendations for your blog you might be interested in hearing.
        Either way, great blog and I look forward to seeing it grow over time.

        Review my webpage: Gentille Derma Cream

      289. Hello, Neat post. There’s a problem along with your website in internet
        explorer, could test this? IE nonetheless is the marketplace chief and a
        good element of other folks will pass over your wonderful writing because of
        this problem.

        my blog: Solvolt Reviews

      294. Hello! I know this is kinda off topic nevertheless I’d
        figured I’d ask. Would you be interested in exchanging
        links or maybe guest writing a blog post or vice-versa?
        My website discusses a lot of the same subjects as yours and I believe
        we could greatly benefit from each other. If you are interested
        feel free to send me an e-mail. I look forward to hearing from you!
        Fantastic blog by the way!

        my web page; http://deletedbyfacebook.com

      295. I’d have to examine with you here. Which is not one thing I usually do! I take pleasure in reading a post that may make folks think. Additionally, thanks for permitting me to comment!

      296. This is very interesting, You’re an excessively professional blogger.
        I have joined your rss feed and look ahead to searching for extra
        of your wonderful post. Also, I have shared your website in my
        social networks!

        Also visit my blog :: Xoth Keto BHB

      299. Oh my goodness! Amazing article dude! Thanks, However I
        am encountering problems with your RSS. I don?t understand the reason why I
        cannot subscribe to it. Is there anyone else having identical RSS problems?
        Anyone who knows the solution can you kindly
        respond? Thanx!!

        Feel free to visit my web blog; Pellamore Review

      301. Hello! I know this is kind of off-topic however I had to ask.

        Does building a well-established blog such as yours require a large amount of work?
        I’m brand new to operating a blog however I do write in my diary everyday.
        I’d like to start a blog so I will be able to share my own experience
        and feelings online. Please let me know if you have any kind of recommendations or tips for new aspiring bloggers.
        Appreciate it!

      305. Hello there, just became alert to your blog through
        Google, and found that it is truly informative. I am gonna watch
        out for brussels. I will appreciate if you continue this in future.
        Numerous people will be benefited from your writing.
        Cheers!

      307. I’d like to thank you for the efforts you’ve put in penning this blog.
        I am hoping to see the same high-grade blog posts from you in the future as well.

        In truth, your creative writing abilities has inspired me to get my own blog now 😉

      308. I’m still learning from you, as I’m trying to reach my goals.
        I absolutely love reading all that is written on your site.Keep
        the aarticles coming. I loved it!

        Feel free to surf to my web site: Deanna

      311. Wow! This blog looks exactly like my old one!

        It’s on a completely different topic but it has pretty much the same
        page layout and design. Wonderful choice of colors!

      314. Good day! I could have sworn I’ve been to this web site before but after looking at some of the articles I realized
        it’s new to me. Regardless, I’m certainly pleased
        I found it and I’ll be book-marking it and checking back frequently!

      315. Wonderful blog! I found it while searching on Yahoo News.
        Do you have any suggestions on how to get listed in Yahoo News?
        I’ve been trying for a while but I never seem to get there!

        Thank you

      317. Excellent blog right here! Additionally your website a lot up
        very fast! What host are you the usage of? Can I am getting your associate
        hyperlink on your host? I desire my site loaded up as quickly as yours lol

      322. With havin so much written content do you ever run into any
        issues of plagorism or copyright infringement? My site has a lot of exclusive
        content I’ve either authored myself or outsourced but it looks like a lot of it is popping it up all over
        the web without my agreement. Do you know any ways to help protect against content from being stolen? I’d really appreciate it.

      323. I’m really loving the theme/design of your blog.
        Do you ever run into any web browser compatibility issues?

        A number of my blog audience have complained about my blog
        not working correctly in Explorer but looks great in Chrome.
        Do you have any tips to help fix this problem?

        Also visit my page :: Pure Kana CBD Review

      340. Pretty nice post. I simply stumbled upon your blog and wanted to mention that I’ve truly
        enjoyed browsing your weblog posts. In any case I will be subscribing for your rss feed and I’m
        hoping you write once more very soon! scoliosis surgery https://0401mm.tumblr.com/ scoliosis surgery

      360. Somebody necessarily help to make significantly articles I’d state.
        That is the first time I frequented your web page and
        up to now? I surprised with the research you made to make
        this actual publish incredible. Magnificent activity!

        my page Reneaux Serum

      361. I was curious if you ever considered changing the structure of your
        website? Its very well written; I love what youve got
        to say. But maybe you could a little more
        in the way of content so people could connect with
        it better. Youve got an awful lot of text for only having one or two
        pictures. Maybe you could space it out better?

        Also visit my website: prettypeople.club

      364. Whoa! This blog looks just like my old one! It’s
        on a completely different subject but it has pretty much the same page layout and
        design. Outstanding choice of colors!

        Feel free to surf to my web blog – Lora

      376. Definitely believe that which you said. Your favorite justification seemed to be on the internet
        the simplest thing to be aware of. I say to you, I certainly
        get annoyed while people consider worries that they just don’t know about.
        You managed to hit the nail upon the top as well
        as defined out the whole thing without having side
        effect , people could take a signal. Will probably be back to get more.

        Thanks

        Also visit my website http://www.mhes.tyc.edu.tw

      380. Whats up this is kinda of off topic but I was wondering if blogs
        use WYSIWYG editors or if you have to manually code with
        HTML. I’m starting a blog soon but have no coding
        expertise so I wanted to get guidance from
        someone with experience. Any help would be greatly appreciated!

        Feel free to surf to my site: skin care experts

      382. Thank you a bunch for sharing this with all of us you really recognize what you’re talking approximately!
        Bookmarked. Please additionally consult with my site =).

        We will have a hyperlink trade agreement
        between us

        My web-site: yeast infection

      393. I would like to thank you for the efforts you have put in writing this blog.
        I’m hoping to see the same high-grade blog posts by you in the future as well.

        In fact, your creative writing abilities has inspired me to get my own blog now 😉

        Here is my homepage … fat loss diet

      397. Howdy great website! Does running a blog such as
        this take a large amount of work? I have virtually no
        understanding of computer programming however I had been hoping to start my
        own blog in the near future. Anyhow, if you have
        any suggestions or techniques for new blog owners please share.
        I understand this is off subject nevertheless I simply wanted to ask.
        Thanks a lot!

        My site :: treatments need

      402. Hey there! I know this is kinda off topic but I was
        wondering which blog platform are you using for this site?
        I’m getting tired of WordPress because I’ve had problems with hackers and I’m looking at options for another platform.
        I would be great if you could point me in the
        direction of a good platform.

        Have a look at my web-site http://www.fles.hlc.edu.tw/

      LEAVE A REPLY

      Please enter your comment!
      Please enter your name here