A robot dispenses sanitizer at a polling station during state elections in Kochi. Photo: AFP

India, with the world’s second-highest number of Covid cases, is edging closer to overcoming the pandemic with a sharp decline in active cases and fatalities.

Such a fall will make it easier to dispense vaccines to India’s 1.38 billion people.

The country is now close to its July level of active cases after crossing a million mark in mid-September, government data shows. Daily increases in cases have dropped below 30,000 for the first time since mid-July, almost hitting 100,000 mid-way.

Almost 80% of recoveries were in 10 states, showing restricted spread of the virus. Kerala, Maharashtra and West Bengal lead in new infections. Maharashtra, Delhi and West Bengal have most daily fatalities. Karnataka, Maharashtra, Kerala and Delhi lead in recoveries.

Likewise in fatalities, India has reported a smaller number compared with most worst-affected countries. India has 103 deaths per million, which is about half the global average, and stands at 98th position out of 220, according to Worldometer.

Experts have different views on the likely causes of India’s high recovery and lower mortality rates. Sustained strict restrictions by housing complex, faster herd immunity among those living in clusters such as the slums, as shown by serological surveys, surely helped.

A key positive that is widely believed to have stood India in good stead is childhood vaccination against diphtheria, whooping cough and polio among others. The propensity of having to work in direct sun helped boost vitamin D and thereby immunity, medical experts say.

A man walks past a mural depicting Covid-19 frontline workers in New Delhi. Photo: Sajjad Hussain/AFP

About a fourth of Indians may have simply acquired herd immunity with the infection in crowded areas, Dr Jayaprakash Mulyil, chairman of the Scientific Advisory Committee of the National Institute of Epidemiology said last month.

With 9.8 million cases, India is second behind the United States which has 16 million cases. Unlike the US which has 6.4 million active cases, India has fewer than 364,000, less than 3.7% of the total. So almost 94.85% of those who contracted the virus are now cured. Active cases mean a person is still at some stage of treatment for the virus.

Others with a high proportion of active cases include France, Italy, Brazil, Turkey, Belgium Russia and Ukraine. India ranks ninth behind these countries, most of them with advanced medical facilities and systems.

Surprisingly, France has 2.1 million of its 2.34 million total cases classified as active.

The second wave of the Covid virus across Europe from the beginning of November is the likely cause of resurgence in these countries, say experts.

Italy has more than 696,000 active cases out of its 1.78 million cases. Belgium’s 542,000 active cases come out of the 600,400 total cases. Likewise, Ukraine has 379,223 active cases out of 858,700 total cases.

Companies likely to provide India with the vaccine include Pfizer, Pune-based Serum Institute in collaboration with Oxford-AstraZeneca, and Hyderabad-based Bharat Biotech. Others may also join the race to offer the vaccine. India has not confirmed a date except to say it will be early next year, and is building storage, identifying initial candidates and working out the mechanism for inoculation.

Ramping up of testing, especially in hotspots, and keeping pace with the spread of the infection also played a role in India keeping up with the number of recoveries.

A health worker checks the body temperature of passengers at a railway terminus in Mumbai. Photo by Indrandil Mukherjee/AFP

India has conducted more than 150 million tests across the country, the last 10 million coming this month. China has conducted 160 million tests, with the United States leading with 225 million.

Several states in India ordered hospitals and pathology laboratories to slash the cost of tests to less than a third of what they had been charging a few months earlier. A test in most states costs around 800 rupees ($11) with Delhi making it free for many.

Most states have retained some lockdown restriction so they still have the ability to pull the reins when required, even though many people are beginning to move about, mainly on personal transport.

Suburban trains still remain closed as a precaution against a sudden spurt in the infection. Mumbai on Thursday warned restaurants and bars they could face early closure and penalties if they flouted Covid discipline.