Could half of India contract COVID-19?

Half of India, or 670 million people in India could contract COVID-19. 

This alarming claim comes from Dr Jayaprakash Muliyil, former principal of the Christian Medical College in Vellore and chairman of the Scientific Advisory Committee of the National Institute of Epidemiology. In a 37-minute interview with Karan Thapar for The Wire, Dr Muliyil said he “accepted and agreed with Harvard professor Ashish Jha’s forecast, that India could see a total of 200,000 cases a day by August.” Dr Muliyil was a guest on the ninth episode of PandemiCast, a video podcast concerning the pandemic which is co-hosted and co-produced by Health Issues India.

Muliyil went on to state that a forecast made by Ramanan Laxminarayan, the director of the Washington-based Center for Disease Dynamics, that India could have 200 million cases by September is likely to be accurate. While such overwhelming figures seem worrying, Dr Muliyil claimed that this was expected, and that there is no need to worry.

Dr Muliyil takes a stance throughout the interview that often comes across as deterministic. He refers to the dreams of controlling the disease in India as being “shattered”. In many regards, this is simply a realistic view taken by an expert that is partial to the whole picture. Rural spread of the disease is now confirmed and any hopes of containing COVID-19 to a limited number of areas are indeed shattered. This is underlined by the daily case count now numbering in excess of 15,000 a day.

The discussion now, according to Dr Muliyil, is how fast herd immunity can be achieved. Health Issues India has previously reported on the debates of herd immunity versus quarantine measures, with many experts previously claiming that pursuing herd immunity would potentially put millions of lives on the line. Quarantine measures have now failed to control the virus, and so Dr Muliyil argues that herd immunity is simply the best situation we can hope for.

Some, including Dr Muliyil, have argued that due to India’s comparatively young population the overall mortality of COVID-19 is likely to be lower in India. The theory is that through rapid development of herd immunity among the young, the older population is less likely to come into contact with individuals who carry the disease.

The Wire posits the fact that in India it is quite common for individuals from different generations to share the same household. Dr Muliyil acknowledges that not all elderly people will be able to be protected in this manner.

This comes as grim news, with the acknowledgement that those from impoverished backgrounds — some having members of the family from older generations living in houses as small as a single room together — are far more at risk. It is therefore the case that wealthier elderly individuals may be protected by herd immunity, as they can afford to isolate themselves to their own houses, or in other areas of larger houses. The poor, however, remain at risk.

Expert opinion on the prospects and outcomes of COVID-19 seem increasingly dire. While some smaller countries have managed to run effective lockdown programmes, many nations struggle with high caseloads even despite quarantine measures being in place. India, with its high population and densely-packed cities coupled with an ever increasing daily case count, could soon become overwhelmed.