Second wave of COVID-19 pandemic in India: Barriers to effective governmental response

Kar, Sujita Kumar; Ransing, Ramdas; Arafat, S. M. Yasir; Menon, Vikas

doi:10.1016/j.eclinm.2021.100915

Cited by 110 publications

(72 citation statements)

References 2 publications

(2 reference statements)

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“…At the onset of the COVID-19 pandemic, India imposed world’s strictest nationwide lockdown beginning from March 25, 2020 [ 39 ], But, as of April 10, 2021, India was the third leading country after USA and Brazil’s identified cases [ 40 ]. Like several other parts of the world, India has been experiencing a massive surge of COVID-19 cases and deaths [ 41 – 43 ]. The second wave has started in the middle of March, 2021 and recorded highest number of cases (144,829) on April 09, 2021 [ 42 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…Like several other parts of the world, India has been experiencing a massive surge of COVID-19 cases and deaths [ 41 – 43 ]. The second wave has started in the middle of March, 2021 and recorded highest number of cases (144,829) on April 09, 2021 [ 42 , 43 ]. The major affected states were Maharashtra, Kerala, Karnataka, Andhra Pradesh, Tamil Nadu, Andhra Pradesh, Delhi, Uttar Pradesh and West Bengal [ 39 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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District level correlates of COVID-19 pandemic in India during March-October 2020

et al. 2021

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Background COVID-19 is affecting the entire population of India. Understanding district level correlates of the COVID-19’s infection ratio (IR) is essential for formulating policies and interventions. Objective The present study aims to investigate the district level variation in COVID-19 during March-October 2020. The present study also examines the association between India’s socioeconomic and demographic characteristics and the COVID-19 infection ratio at the district level. Data and methods We used publicly available crowdsourced district-level data on COVID-19 from March 14, 2020, to October 31, 2020. We identified hotspot and cold spot districts for COVID-19 cases and infection ratio. We have also carried out two sets of regression analysis to highlight the district level demographic, socioeconomic, household infrastructure facilities, and health-related correlates of the COVID-19 infection ratio. Results The results showed on October 31, 2020, the IR in India was 42.85 per hundred thousand population, with the highest in Kerala (259.63) and the lowest in Bihar (6.58). About 80 percent infected cases and 61 percent deaths were observed in nine states (Delhi, Gujarat, West Bengal, Uttar Pradesh, Andhra Pradesh, Maharashtra, Karnataka, Tamil Nadu, and Telangana). Moran’s- I showed a positive yet poor spatial clustering in the COVID-19 IR over neighboring districts. Our regression analysis demonstrated that percent of 15–59 aged population, district population density, percent of the urban population, district-level testing ratio, and percent of stunted children were significantly and positively associated with the COVID-19 infection ratio. We also found that, with an increasing percentage of literacy, there is a lower infection ratio in Indian districts. Conclusion The COVID-19 infection ratio was found to be more rampant in districts with a higher working-age population, higher population density, a higher urban population, a higher testing ratio, and a higher level of stunted children. The study findings provide crucial information for policy discourse, emphasizing the vulnerability of the highly urbanized and densely populated areas.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

District level correlates of COVID-19 pandemic in India during March-October 2020

et al. 2021

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“…The recent variants of SARS-CoV-2 are cause of the second wave of the COVID-19 around the world and setback to healthcare infrastructure specially in India [28,34]. The transmission of the three variant of concerns (VOC), namely, Alpha, Beta and Delta identified in UK, South Africa and India, respectively were drivers of subsequent infection waves in these nations (https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/) (accessed on 6 June 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Earlier this year, in March 2021, the B.1.617 lineage found in India transmitted rapidly and is being investigated for its role in severity and mortality [34]. Recently, sub lineages of the B.1.617 -Kappa, Delta and B.1.617.3 were reported and characterized.…”

Section: Discussionmentioning

confidence: 99%

Possible Link between Higher Transmissibility of Alpha, Kappa and Delta Variants of SARS-CoV-2 and Increased Structural Stability of Its Spike Protein and hACE2 Affinity

Kumar

Singh

Hasnain

et al. 2021

IJMS

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The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak in December 2019 has caused a global pandemic. The rapid mutation rate in the virus has created alarming situations worldwide and is being attributed to the false negativity in RT-PCR tests. It has also increased the chances of reinfection and immune escape. Recently various lineages namely, B.1.1.7 (Alpha), B.1.617.1 (Kappa), B.1.617.2 (Delta) and B.1.617.3 have caused rapid infection around the globe. To understand the biophysical perspective, we have performed molecular dynamic simulations of four different spikes (receptor binding domain)-hACE2 complexes, namely wildtype (WT), Alpha variant (N501Y spike mutant), Kappa (L452R, E484Q) and Delta (L452R, T478K), and compared their dynamics, binding energy and molecular interactions. Our results show that mutation has caused significant increase in the binding energy between the spike and hACE2 in Alpha and Kappa variants. In the case of Kappa and Delta variants, the mutations at L452R, T478K and E484Q increased the stability and intra-chain interactions in the spike protein, which may change the interaction ability of neutralizing antibodies to these spike variants. Further, we found that the Alpha variant had increased hydrogen interaction with Lys353 of hACE2 and more binding affinity in comparison to WT. The current study provides the biophysical basis for understanding the molecular mechanism and rationale behind the increase in the transmissivity and infectivity of the mutants compared to wild-type SARS-CoV-2.

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“…The SARS-CoV-2 delta variant (lineage B.1.617.2), which was first detected in India in October 2020 and named as the Delta variant on 31 May 2021 by the WHO, was identified as the primary cause of the 2 nd wave (beginning from mid-March 2021 and ongoing). 6 As genome sequences of our patients were not done to determine the causative variant, we retrospectively infer that most of our recipients could have been infected with the alpha variant, which was responsible for the 1 st wave.…”

Section: Discussionmentioning

confidence: 99%

Impact of Living Donor Liver Transplantation on COVID-19 Clinical Outcomes from a Quaternary Care Centre in Delhi

Jamir¹,

Kumar²,

Sood³

et al. 2021

J Clin Transl Hepatol

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Background and Aims:The anticipated fear of serious outcomes in coronavirus infected liver transplant recipients led to disruption of transplant services globally. The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early (<1 year) vs. late (>1 year) post-transplant period. Methods: 41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021. Results: The median age was 49.00 years with a male preponderance (80.49%). Fifteen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant. The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days. Fever and malaise were the common presenting symptoms. The most common associated comorbidities were diabetes mellitus (65.85%) and hypertension (46.34%). The severity of illness was mild in 28 (68.29%), moderate in 4 (9.76%), severe in 6 (14.63%) and critical in 3 (7.32%). To identify associated risk factors, we divided our patients into less severe and more severe groups. Except for lymphopenia, there was no worsening of total bilirubin, transaminases, alkaline phosphatase, and gamma-glutamyl transferase in the more severe group. Eight (19.51%) patients required intensive care unit admission and three (7.32%) died, while none suffered graft rejection. In recipients with early vs. late posttransplant COVID-19 infection, there were similar outcomes in terms of severity of COVID-19 illness, intensive care unit care need, requirement of respiratory support, and death. Conclusion: Living donor liver transplantation can be performed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.

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Second wave of COVID-19 pandemic in India: Barriers to effective governmental response

Cited by 110 publications

References 2 publications

District level correlates of COVID-19 pandemic in India during March-October 2020

District level correlates of COVID-19 pandemic in India during March-October 2020

Possible Link between Higher Transmissibility of Alpha, Kappa and Delta Variants of SARS-CoV-2 and Increased Structural Stability of Its Spike Protein and hACE2 Affinity

Impact of Living Donor Liver Transplantation on COVID-19 Clinical Outcomes from a Quaternary Care Centre in Delhi

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