There has been a huge change between my last presentation on 14.02.21 and now. The second wave has India (and especially Maharashtra) suddenly and hard. What are the contours of the second wave? How bad will it be and when will it start abating? This presentation seeks to explore the above areas.

1. Covid 19 Stats in India –
Update 18
Review of key data and presentation of a projection model
Data updated till 5.04.21
Data Sources: https://www.covid19india.org/; https://www.worldometers.info/;
https://censusindia.gov.in/2011-prov-results/paper2/data_files/india/paper2_1.pdf
https://ig.ft.com/coronavirus-
chart/?areas=eur&areas=usa&areas=bra&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&area
sRegional=ustx&byDate=0&cumulative=0&logScale=1&perMillion=0&values=deaths
https://ourworldindata.org/covid-vaccinations
https://www.mygov.in/aarogya-Setu-app/

2. I got it wrong
Prediction on 14.02.21 that a second wave is unlikely but possible has been proved
wrong. We are in the midst of the second wave

3. Agenda
• Presentation of key data for All India
• India – 2nd wave Analysis
• International comparisons
• Discussion

4. All India Data

5. • Testing has not been able
to keep pace with the
pandemic after the second
wave has started
• Positivity rates have
crossed 10% (similar to
what they were in
September)
• Ramp up of testing is very
slow. It is likely that the
shift in focus to vaccination
has tied up medical
resources
• Urgent need to ramp up
testing and isolate people
with mild symptoms who
may be carriers
• Covid fatigue has set in

6. • Cumulative CFR has declined to 1.3%
• On a 7DMA basis the CFR is around 0.5% indicating
that the current cases are less fatal than the earlier
ones

7. • New infections reached their lowest
point on 11.02.21 at 10983 7DMA
• Cases have galloped after that and the
previous peak was surpassed on 4.04.21.
The rate of growth has been steeper
than for the first peak. Doubling rate is
currently 13 days
• Maharashtra continues to account for
over 50% of the cases load

8. • Deaths per day have been growing with a
doubling rate of 10 days

9. 2nd Wave Analysis

10. • India’s curve of cases and deaths is an aggregate of villages,
towns, districts and states
• Many parts of the country have been thru second and even
third waves earlier. However, growth in some places was
compensated by a decline in others
• For the first time, from 11th Feb 2021, national cases have
started rising again. Deaths are not far behind
• However, CFR has been low as we have seen earlier

11. • Maharashtra accounts for close to 50% of All India
cases and deaths
• Cases have been rising steeply and there is evidence
of several mutations including the well known ‘double
mutation’ that was first detected in Amravati
• CFR has so far been low. However, cases have risen so
steeply that there may be deaths from this group that
come in later

12. • Overall, the pattern is similar
with CFR being lower than in the
first peak
• There are some signs of cases
peaking out in the Vidarbha
region

13. • Lower CFR is observed here also
• Some early signs of peaking out in Punjab

14. 0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
Karnataka CFR Cum and 7DMA
• Tamil Nadu and Karnataka are mirroring the national trend. CFR is lower in this wave
• Kerala has been historically different. They had a prolonged first wave after which a decline and now followed by an
uptick

15. Cases/Day 7DMA Deaths/Day 7DMA CFR 7DMA Day Cases/Day 7DMA Deaths/Day 7DMA CFR 7DMA
USA 32928 2246 6.8% 62 70784 1185 1.7%
UK 4884 944 19.3% 123 25280 461 1.8%
Turkey 12400 122 1.0% 128 32096 256 0.8%
Iraq 4483 106 2.4%
India 93280 1166 1.3%
1st Peak 2nd Peak
Pop Cases 7DMA Deaths 7DMA CFR Cases/Mn Deaths/Mn Day
USA 332 32928 2246 6.8% 99.0 6.8 31
UK 68 4884 944 19.3% 71.7 13.9 30
Turkey 85 12400 122 1.0% 145.9 1.4 30
Iraq 40 4483 106 2.4% 112.1 2.7 134
India 1,390 93280 1166 1.3% 67.1 0.8 172
1st Peak
• A few representative countries are shown here. Several countries have been analysed as explained in the previous
presentations
• The salient features are:
• In the first peak, the cases per Mn for India are comparable to UK and USA though India has the lowest reported
case load. This may be due to lower testing
• In deaths per Mn, Asia has been much lower than Europe and USA. This has been discussed in the past
• Usually, the second peak has more cases and less deaths

16. Cases Deaths CFR
USA 2.15 0.53 24.5%
UK 5.18 0.49 9.4%
Turkey 2.59 2.10 81.1%
Iraq
India 2 0.6
Ratios 1st Peak to Second Peak
7DMA as of 5.04.21 Decline Forecast Date of Decline
Cases Deaths Cases Deaths Cases Deaths Cases Deaths
USA
UK
Turkey
Iraq
India 13 10 84160 445 186560 700 21.04.21 15.04.21
Doubling Rate
• The ratios of the second peak to the first one are
shown this table
• Cases are around 2 – 5 times. Deaths around 0.5
though Turkey was much harder hit
• CFR declines in the second wave by as much as
80%
• As a working assumption, we have taken India to
have a case load at the second peak that is double
of the first one with deaths being at 60%
• The above analysis suggests that the second wave in India will start abating when cases (7DMA) hit 186,560 and deaths touch
700
• The current doubling rate for cases is 13 days and for deaths it is 10 days
• Based on the above, cases and deaths should start declining in the 3rd week of April 2021. However, experience suggests that
as cases and deaths start slowing down the doubling rate increases. Therefore the date of decline may be somewhat later.

17. Additional Points and Caveats
• The second wave for other countries happened before vaccination started, so the decline cannot
be attributed to vaccination
• This is also applicable for India as the number of doses administered up to now is 8,31,10,926
(5.9% of the population) while 1,08,33,617 have received 2 doses. This is a relatively small
number and will not serve to bend the curve in the second wave
• International comparisons are fraught with risk. The number of variables after the first peak have
multiplied and West Asian countries which were the role models in predicting the first wave have
been behaving divergently
• The proliferation of variants is an imponderable. 80% of cases in Punjab for instance are of the UK
variant. Variant wise case and deaths estimates are not available in India. Higher infectivity is well
known. Immune escape may be a serious issue
• The second wave has come on very suddenly. There has not been enough time for deaths to catch
up. The prediction may be being made too early in the second wave life cycle

18. Vaccination
• Anecdotally, the second wave has hit the middle class and the upper
class worst. This segment is very easy to access by private healthcare
• The govt needs to take the following steps:
• Open up vaccination to 18+ starting with the key states or even the key
districts
• Vaccine distribution and pricing for the private sector should be decontrolled
and all clinics, doctors, nurses and even pharmacists should be allowed to
vaccinate and upload the data on the Cowin app
• Other vaccines should be given clearance. It is very surprising that Pfizer has
not been allowed yet. If it is due to pricing this should be addressed as above.
Other candidates like Sputnik and J&J should be made available

19. Discussion

20. Thank You!
Please mail me at debubhatnagar@gmail.com
with any comments.
Disclaimer: These projections and analysis are not official and are the work of an
amateur. They should not be the basis of any decision making.