Also Read | India has administered at least 490 million Covid vaccine doses till now

This reversal in case trend, pushed largely by the high volume of daily cases in states such as Kerala, had been seen after nearly three months of steady decline. But Kerala is no longer the only state which is seeing numbers rise. At least two more major states, Himachal Pradesh and Madhya Pradesh, have seen their seven-day average of daily infections rise by over 105% and 66% respectively from the lows seen after the end of the second wave.

Meanwhile, the national average positivity rate — a crucial metric that shows the spread of infection within the community — has also started slowly inching upwards, and has risen from a low of 2% to 2.4% in the past 20 days.

The threat of a probable third wave hitting India appears to be drawing closer. There is a pressing need to control infections before things get out of control. However, such an outcome would be contingent primarily on how effectively we act on two issues – vaccination and containment.

The incomplete vaccine story

The biggest weapon against the disease that is available in the hands of the government and people alike against a probable future third wave is vaccination. This was an option that was nowhere close to being on the table during India’s first wave (which peaked in September 2020), while the second wave ravaged the country through April and May this year before vaccination numbers could make any dent against the rapid spread of the disease.

According to data from the Co-WIN dashboard, around 41% of the country’s adult population – 382 million out of India’s estimated adult population of 940 million – has received at least one dose of the vaccine as on August 5. The share of population that has been fully vaccinated (been administered both doses), however, is much lower at 12%.

This proportion, however, is too small to prevent a third wave by itself.

Even in countries such as the United States and the United Kingdom, both of which have fully vaccinated more than half their population (which means they have covered their population five times better than India), cases have started rising at a rapid pace in both countries, largely due to the Delta variant Sars-CoV-2. But while the Delta variant has pushed up cases in these nations, they have managed to keep deaths down. This is clear from a comparison of deaths in the adequately vaccinated West and poorly vaccinated Asian and African nations by HT earlier this week.

One of the biggest constraints in the vaccination programme, according to several states, has been the patchy supply of vaccines being delivered to them. For instance, according to the Union health ministry’s data as on Friday (August 6) morning, states and UTs across India have currently, lying with them, 23 million doses of unused vaccines, while another 2 million is in the pipeline. This is enough for five days’ worth of supply given that 5 million doses a day are administered daily (the country needs to go several times above that to cover its adult population by the end of this year).

The limitations on supply exist partly because even after nearly eight months of the rollout of the vaccination programme, only two major vaccines – Serum Institute of India’s Covishield and Bharat Biotech’s Covaxin – are responsible for nearly all doses administered (a third Sputnik, though approved and being administered, is too insignificant in numbers to be considered here).

If India wants to achieve major coverage of its population, then this needs to change. Approval of more vaccines is critical in this aspect because of how it would ease the manufacturing pressure on just two vaccines.

Containment as weapon

The second key weapon against the disease is our understanding of the virus. Having run through the country twice now, the outbreak has left a trail of evidence on how it behaves. This pertains to how we know the virus spreads, why (double) mask hygiene is so crucial along with proper indoor ventilation, and educating people as clearly on mask usage and importance of having windows open in enclosed places.

It is also crucial to know how the virus spreads through regions. It’s become clear from the first two waves that the disease first creates one or two hot spots in its initial stages and later captures a wider geographical spread. When these hot spots emerge, the government should not treat them as isolated islands of infection as it clear by now that an outbreak in one state will easily spread to another, then several more – a pattern visible in all waves not just in India, but also globally. This makes the process of forming microcontainment zones to terminate the spread important.

India is getting to a fragile spot once again. Aggressive containment and expedited vaccination are the only solutions available to prevent a third wave, or at least, minimise its lethality.