The second wave of the coronavirus disease in Europe, and the third in the US, comes as the number of cases nears 40 million (it was 39.1 million on October 17, according to the World Health Organization) around the world. Around 9 million (23%) of these are active currently, with a third of these in the US alone. India has just under 9% of active cases around the world. France has 8.1%, an indication of just how badly that country has been hit by the second wave.
It isn’t just France; Europe, according to WHO, accounted for almost 40% of daily cases on Saturday. Russia, the Ukraine, the UK, Spain, Italy, even Poland are all seeing a sharp surge in cases.
The Americas (powered by the US, but also by Brazil and Argentina), accounted for around 35% of cases. That number is likely to increase in coming days as the third wave in the US gathers momentum. Already, the country is seeing daily case numbers back at levels last seen in July. The second wave in the country was worse than the first. Some experts believe that coming as it does, at the onset of winter, the third wave could be still worse. Or maybe it won’t.
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India accounted for 16% of daily cases on October 17, almost a third off peaks seen in early September.
At 392,471 (according to WHO), the daily global case number was at a record high on Saturday, and nearing the 400,000 mark. With 4,630 cases on Saturday — this translates into a mere 1.18% of the total — Africa is a clear outlier, and in a good way. This, despite the recent surge in cases in the region from late September. There’s been some research on Africa’s relative immunity — 1.3-1.6 million cases and 28,000 to 40,000 deaths, according to various agencies — and while all of them have focused on the relative youth of the continent’s population, climatic conditions, and previous exposure to other viruses (including coronaviruses), none of the findings are conclusive. Interestingly, there are two schools of thought on the future course of the pandemic on the continent: one, that the coronavirus disease should have peaked by now, and the fact that it hasn’t means that Africa is unlikely to see a surge in the future; two, that it is only a matter of time before Africa sees a surge because, barring a few exceptions, the pandemic has shown similar trajectories across geographies.
The onset of a fresh wave in Europe and the Americas roughly coincides with the end of WHO’s solidarity trials last week on four drugs or drug combinations that showed promise, at various times over the past seven months, as a possible therapeutic (or prophylactic) for Covid-19. Of the four, HCQ, hydroxychloroquine, a widely used anti-malarial drug and the combination of retrovirals lopinavir and ritonavir, used to treat HIV, had already been shown to be ineffective by credible research. The results of the solidarity trials released last week by WHO also proved that antiviral Remdesivir did not reduce mortality or benefit those with severe conditions; nor did interferon-beta, widely used to treat autoimmune disorders. It’s still not clear whether Remdesivir or interferon-beta could help those with mild infections if given early. A paper published in the New England Journal of Medicine (but whose results were previously known) showed that in a study of over 1,000 patients, Remdesivir shortened the recovery time, although it did not reduce mortality. But as the authors of the solidarity trial, which covered around 11,000 people in 400-plus hospitals around the world (including in India) put it after comparing their own findings with previous studies on Remdesivir (including the one referred to above), the findings rule out the chance that the drug “can prevent a substantial fraction of all deaths.”
The Solidarity trials — they measure the effect of treatments on three parameters, “mortality, need for assisted ventilation and duration of hospital stay”, according to WHO — will continue, though, and will likely study the effectiveness of other treatments such as monoclonal antibodies. The trials are yet to study corticosteroids which other studies have shown, and WHO accepted, as effective in the treatment of severe cases of Covid-19.