India could face 1.3 million confirmed coronavirus cases by May says US based study of health systems

India could face between around 100,000 and 1.3 million confirmed cases of the disease caused by the new coronavirus by mid-May if it continues to spread at its current pace, according to a team of scientists based mainly in the United States. The estimates reinforce concerns among some medical officials and experts in India that the country of 1.4 billion people could see coronavirus cases jump sharply in the coming weeks and put its health system under severe strain. [caption id=“attachment_8152061” align=“alignnone” width=“1280”] Health officials disinfect a street in Jammu as part of measure to contain coronavirus pandemic. Image credit: PTI[/caption] The scientists said projections could change as the country conducts more testing, while also putting in place stricter restrictions and measures to stem the spread of the virus. “Even with the best-case scenarios, probably, you are in a very painful crisis,” said Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan who was involved in the study. The study was carried out by the COV-IND-19 Study Group of scholars and scientists looking into the threat posed by the coronavirus, and COVID-19, the disease it causes, in India. The analysis first appeared on Medium, a U.S. publishing platform, on Saturday. India probably has only around 100,000 intensive care unit (ICU) beds and 40,000 ventilators, said Dhruva Chaudhry, president of the Indian Society of Critical Care Medicine, based on industry estimates and other data. “We can handle it if an even number (of cases) come over a period of time,” Chaudhry said. But he warned that there was not sufficient infrastructure or staff to handle a sharp spike in critical patients. India’s federal health ministry and the Indian Council of Medical Research did not respond to questions about the forecasts.

Partial Lockdown

So far, India has reported 471 cases of the coronavirus and 9 deaths, numbers dwarfed by countries like China, Italy and Spain, but which are nonetheless beginning to accelerate. Authorities have imposed a lockdown across large parts of the country, including in the capital city New Delhi and the financial hub of Mumbai. The original study was based on data up to March 16, but following a request from Reuters, the team updated their model using cases from Indian health authorities up to March 21. The model was based on one used by colleagues to analyse the coronavirus outbreak in Hubei, China, and employed a set of equations taking into account the number of susceptible people, those infected and those who recovered. [caption id=“attachment_8152041” align=“alignnone” width=“1280”] Theatres were closed in Bengaluru in the wake of coronavirus pandemic. PTI[/caption] That created a predictive model for case counts in India and provided projections under hypothetical public health interventions of varying intensities. According to the estimates, the number of confirmed cases could rise to more than 4,000 by the end of March and to between 30,000 and 230,000 by end-April. Although the researchers have not projected the number of fatalities, Mukherjee said India could be hard hit because of large numbers of people with existing conditions who were potentially more vulnerable to the virus.

Early Containment

India has tested around 20,000 individuals, and health authorities have said the virus has remained largely restricted to those who travelled to affected areas and others who came into direct contact with them. India has shut down its massive railways network, banned all incoming international flights and has ordered commercial airlines to stop domestic operations from midnight on Tuesday. But some health officials are concerned that individuals from high-risk areas may not have been caught by multiple safety nets, allowing the virus to spread. Over the weekend, a group of federal lawmakers and bureaucrats in New Delhi were forced to self-quarantine after a Bollywood singer who travelled from London tested positive for the virus in a neighbouring northern state. The singer had earlier been at an event attended by a member of parliament, who subsequently went to several meetings in New Delhi. Mukherjee said India needed quickly to undertake large-scale testing and contact tracing for exposed individuals. “But if there is expanded community transmission, central lockdown may be the only way,” she said.