Covid-19 lockdown isn’t flattening India curve as in Italy or Spain

More than a month into the world’s largest lockdown, India is failing to see an easing of new cases similar to what hot spots such as Spain and Italy have experienced.

India’s fresh coronavirus cases are still rising with little sign of slowing momentum. India reported 1,909 new coronavirus cases on Tuesday — the country’s 35th day in lockdown — which was the second-highest jump since it began reporting infections at the end of January. For Thursday, the country saw an additional 1,823 cases.

Italy and Spain, which implemented their lockdowns a few weeks before India puts its 1.3 billion people into quarantine, saw an impact much faster. Those countries saw the daily count of new cases peak around the 13th day of their lockdowns, and started trending downward from there, according to data compiled by Bloomberg.

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The lack of progress could be a cause for concern as India moves toward easing its lockdown. New guidelines will come into effect next week, giving considerable relaxations to many districts, a spokesperson for the Ministry of Home Affairs said in a Twitter post.

India began its containment measures on March 25, when its outbreak showed only about 600 cases. Italy and Spain, which have far smaller populations, implemented their own restrictions as infections were already exploding above 7,000.

It’s widely accepted that the country’s moves slowed the spread: with 33,610 confirmed cases, India still has far fewer than both those European countries, and the number of new cases its finding each day is still lower than the daily growth rates in these nations, at least for now.

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But India’s daily case numbers are still trending in the wrong direction, and why its lockdown doesn’t seem to have had the effect that similar policies had in other countries is a matter of some debate.

One difference between India and other places is that it’s testing a much smaller portion of its population. Though India is now conducting about 50,000 coronavirus tests a day, not far behind Italy’s daily number, those efforts only amount to about 0.5 tests for every thousand people in its massive population, according to data compiled by Our World in Data. Italy, by comparison, has conducted about 30 tests for every thousand people.

The reason India’s new daily case count isn’t declining may be because the scarcity of test kits means a lot of suspected cases identified and put in isolation by health authorities just haven’t been confirmed, according to Vivekanand Jha, executive director of the George Institute of Global Health, India. Or worse, the virus could be spreading untracked in the community and the real number of cases is actually growing much faster than the official numbers show, he said.

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The government has denied there is community spread of the virus in India. India’s daily case trend could also just be revealing the limits of a lockdown in such a densely populated country. Multigenerational families often share apartments and large sections of the populace live in slums like Mumbai’s Dharavi — often considered the most densely populated place on Earth — where entire families pack into 100 square foot rooms, and whole neighborhoods share a toilet.

Maintaining social distance can be difficult under these conditions, and that could be making the lockdown less effective in India than in other countries where maintaining distance is easier for more people, said Ramanan Laxminarayan, director of the New Delhi and Washington-based Center for Disease Dynamics, Economics and Policy.

If these factors are keeping the rate of new cases from slowing during the lockdown, it doesn’t provide much hope they’ll start trending down when the lockdown restrictions start to ease.