According to the report, based on an estimate by the IHME, there were 417 million infections and 16 million deaths in the country associated with the Delta wave between April 1 and July 1, 2021, compared with 18 million infections and 25,2997 deaths reported by the government

India undercounted COVID-19 deaths but the strict lockdown imposed by the government saved many lives, the recent Lancet COVID-19 Commission’s report said.

The Commission also called the launch of the country’s COVAX vaccine “a timely and meritorious achievement”.

“It is well established that deaths from COVID-19 in India were vastly undercounted during the Delta (B.1.617.2) wave of April–June, 2021,” the Commission highlighted.

It pointed out that the Delta wave caused a spike in cases in most countries in the region, with much higher mortality, although actual deaths have been substantially under-reported in several countries.

“This under-reporting was perhaps most notable in India during the Delta wave from March to July, 2021,” the Commission added.

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Timely restrictions

At the same time, the Commission praised India’s timely Covid-19 restrictions.

“India was among the first countries to impose travel restrictions, suspend international flights, and impose a strict lockdown early in the pandemic,” the report stressed.

“In March, 2020, India had 654 cumulative confirmed cases of COVID-19, and adopting restrictions aimed to prevent community transmission, gave the health system time to ramp up,” the report added.

Delta variant and spike in cases

But after the lockdown was relaxed at the end of May, 2020, India saw a surge in cases during June and July. The case counts decreased by the end of the year, persuading the Indian government to relax most controls early in 2021.

“In March, 2021, two factors combined to markedly increase the number of infections. First, the highly infectious Delta variant emerged, and other variants of concern arrived from other countries,” the Commission said, adding, “several events in the country—such as elections, public protests, and religious festivals—brought large aggregations of people together, and most participants in these events did not wear face masks.”

Devastating impact

The combination of new variants and crowds proved devastating in India, the Commission said. “All levels of government—central, state, and local—were unprepared for the speed and the scale of the delta surge as it gathered momentum in March, 2021,” the Commission explained.

“Hospitals were overwhelmed within weeks, and breakdowns in the medical supply chain contributed to a severe shortage of oxygen, hospital beds, and pharmaceuticals. In smaller towns and rural areas, large numbers of patients went untreated,” the report added.

The actual numbers

India, according to the Commission, reported roughly 20 million COVID-19 infections and 250,000 deaths attributed to the disease between Jan 1 and June 30, 2021.

“But the actual numbers are estimated to be vastly higher,” the Commission said.

“Seroprevalence of COVID-19 IgG antibodies in non-vaccinated individuals older than 6 years increased from 24% in December, 2020 and January, 2021, to 62% in June and July, 2021, confirming that hundreds of millions of people were infected during the delta wave,” the report revealed.

According to the report, based on an estimate by the Institute for Health Metrics and Evaluation (IHME), there were 417 million infections and 16 million deaths associated with the Delta wave between April 1 and July 1, 2021, compared with 18 million infections and 25,2997 deaths reported by the Indian government.