A medical staff wearing Personal Protective Equipment takes a nasal swab sample from a resident for a Covid-19 test in a residential area in Mumbai on September 14, 2020. Photo: AFP/Punit Paranjpe

India could have the highest number of Covid-19 cases in the world if it is unable to control the rapid spread of the virus, say observers.

The challenge of containment may get stiffer as the predominantly Hindu country heads into its month-long festival season, which usually means people mingling in large groups, and then four months of winter, a season that is conducive to the spread of viruses.

India has a total of 6.3 million cases after recording 85,000-95,000 new cases each day for several weeks. The United States, the world’s worst-affected country, has recorded a total of 7.45 million cases but is recording only half India’s daily number of cases.

BITS Pilani last month predicted that India would surpass the United States in October. Its prediction was based on advanced statistical techniques, which accurately predicted that India would race past Brazil, now the third worst-affected country. BITS’s lead researcher was not immediately available for comment.

Adding to India’s challenge are the steady lifting of lockdowns and people not wearing proper masks, physically distancing, or washing their hands. Mumbai municipality fined just 14,200 violators of Covid-19 rules between April and September out of a population of 18 million people, despite being the worst-affected locality.

The central government has permitted cinemas, theaters and multiplexes to open from October 15 with up to 50% of their seating capacity for regular use, as well as entertainment parks, and business-to-business exhibition centers. It is also allowing up to 100 people to congregate for political, religious, academic, cultural, social and sports events from October 15.

People can be seen loitering on streets in groups without masks, many of them spitting on the pavement. Lockdowns are now restricted only to virus containment zones.

Maharashtra state, which accounts for 28% of active cases in the country, plans to open hotels, food courts, bars and restaurants for up to 50% seating capacity from October 5. It has opened all industrial and manufacturing units to boost economic activity and employment in the nation’s most industrialized state, which contributes significantly to the national exchequer.

It is restarting trains within state limits, and increasing the frequency of suburban trains in Mumbai and later in Pune, and allowing more passengers to board them. Peak-time metro trains, the city’s transport backbone, normally carry three times the number of passengers they were designed for, moving up to six million commuters daily.

Observers say that while this may help to revive economic activity, it could also lead to more infections. The number of cases and fatalities continue to surge. India has recorded around 90,000 cases daily for weeks, double that of the United States and three times that of Brazil.

The Indian Council of Medical Research (ICMR), India’s top medical research body, said on September 29 that the infection rate rose to 7.1% of the population from 0.73% two months earlier.

The ICMR’s second serological survey, which involved testing blood samples from 29,000 people for Covid-19 infection between August 17 and September 22, showed that urban slums have twice the infection rate of non-slums and four times that of rural areas.

It has cautioned that a large proportion of the population is still susceptible and recommended adhering to the 5T strategy (Test, Track, Trace, Test, Treat and Technology).

Still, experts point to signs of hope.

India has the highest recovery rate – 83.5% – in the world, the Ministry of Health and Family Welfare announced on Thursday.

Out of the 6.3 million cases in India, more than 5.27 million people have recovered. The number of active cases on Thursday was 940,000, the same as on September 11. There were 98,708 fatalities, compared with 211,740 in the US and 144,000 in Brazil.

It was feared that the pandemic would ravage all of India’s 28 states and eight union territories, but 10 industrialized and heavily populated states have accounted for 76% of all cases and 77% of recoveries: Maharashtra, Karnataka, Andhra Pradesh, Uttar Pradesh, Tamil Nadu, Delhi, Kerala, Odisha, West Bengal and Punjab.