India unlikely to witness a fourth wave, however, proper COVID behaviour should be followed, say doctors and experts

• One in three Indians believes that the fourth wave of COVID-19 has already arrived in the country.
• Business Insider spoke to a few doctors and experts to gain some perspective on the reason behind rising COVID cases and possibility of fourth wave in India.
• Indians should be more ‘vigilant’ and should not worry about the new wave, said Dr. Anita Mathew.

India is facing an uptick in COVID-19 cases for a couple of weeks now and it has again raised concerns over the probability of a fourth wave in the country.

Today, April 29, over 3,300 new cases were reported with 60 new fatalities, while the total number of active cases crossed 17,000.

States like Delhi, Maharashtra, Kerala are witnessing the maximum surge in daily COVID-19 cases. Prime Minister Modi in a meeting, on Wednesday, April 27, with state chief ministers asked to take appropriate actions to control the spread of the virus in their respective states.

The national capital recorded over 1,500 cases on Thursday, April 28, and two deaths. “There are over 5,000 active cases in New Delhi but hospital admissions are quite low,” said Delhi Health Minister Satyendra Jain in a statement on Thursday.

Very few recombinant variants of the coronavirus have been found in India and none of those have shown increased transmission, nor were they associated with severe disease or hospitalisation, according to a report of the Indian SARS-COV-2 Genomics Consortium (INSACOG).

The INSACOG report further suggested that some labs in New Delhi have detected a new variant of Omicron i.e. BA.2.12.1 and it could be linked to rise in cases in the national capital.

Fourth wave of COVID-19 to hit India?

According to a survey conducted by LocalCircles, which is a community social media platform, one in three Indians believe that the fourth wave of COVID-19 has already started. The survey received responses from 11,563 people in India.

However, a few doctors and experts have a different opinion on this. Business Insider spoke to a few doctors and experts to gain some perspective on the reason behind rising COVID cases and possibility of fourth wave in India.

“The probability of a fourth Covid-19 wave in India is low. Although, there is [an] ongoing increase in cases in some northern states of India, there is no scientific, epidemiological, virological reason to predict a fourth COVID wave in India”, said Dr. Subhash Thuluva, senior vice president and head of clinical development at Biological E.

Another eminent virologist Dr. T Jacob John also believes that the likelihood of a fourth wave of COVID-19 in the country is ‘extremely low’. “If a fourth wave comes it will be a total surprise to me. Therefore, I cannot guess anything about it. The probability of a fourth wave is extremely low. Our best defence against the ill-effects of a wave is very high coverage of vaccination,” John said.

India has already vaccinated around 1.8 billion people so far. According to news agency ANI, 75% of the adult population has been vaccinated with the first dose, while 65% have received their second dose as well.

Doctors say no need to worry or panic

“The present cases reported are mild in nature with very few hospitalisations. Breakthrough infections in people who are vaccinated can be expected, but studies have shown that in fully vaccinated individuals, vaccines are effective at preventing severe illness, hospitalizations, and death and symptoms are more likely to be mild,” Thuluva added.

According to Dr. Anita Mathew, who is an infectious disease specialist at Fortis Hospital in Mulund, Indians should be more ‘vigilant’ and should not worry about the new wave. She urged people to follow the COVID appropriate behaviour as it is the only way to reduce the transmission.

The third wave of COVID, which was largely due to the Omicron variant was said to be less severe as compared to the second wave that happened exactly one year ago.

“With a significant adult population vaccinated, or having already contracted COVID-19, we are hopeful that it will be less severe if we have the fourth wave unless there is a new more virulent, and transmissible variant that will elude previous vaccine immunity,” Mathew told Business Insider.

Protection level may increase more significantly with a third precautionary or booster dose of vaccination. So, the new wave, if it occurs, may not be as severe as the second wave.

New symptoms are emerging

Dr. Pruthu Narendra Dhekane, consultant and infectious disease specialist at Fortis Hospital at Bannerghatta Road, Bengaluru said that symptoms are slightly seen to be different in presentation.

He said, “In [the] first, second and third waves — mostly symptoms for COVID have largely been [the] same, however, the symptoms have slightly been different in presentation as there has been a mix up in the immunological with natural infection and vaccine mediated immunity and new variants. So, people are not experiencing the standard symptoms, but slight differences are there.”

Other than fever, cough and cold, sore throat – stomach problems, diarrhea are also now counted as early COVID signs.

“In recent COVID-19 cases, early symptoms like fever, sore throat, cough, mucus and cold, and stomach problems like vomiting or diarrhoea were seen. All the symptoms were of lesser duration when compared to those of previous waves. Most of the affected individuals show minimal or no symptoms (asymptomatic). Symptoms of newer COVID-19 cases are typical COVID symptoms except that the involvement of [the] respiratory tract is less than that of the COVID-19 cases from first and second waves,” Thuluva told Business Insider.

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