IHME | New COVID-19 Projections (April 23, 2021)

In this week’s IHME analysis of the pandemic, the main focus is on the extraordinary surge in India and other parts of South Asia. The exponential rise in cases and deaths continues in India, and our analysis of seroprevalence surveys, is telling us what the infection detection rate is below 5% – maybe even around 3-4%. This means that the number of cases that are being detected needs to be multiplied by 20 or more to get the number of infections that are occurring in India. The number of infections right now is extraordinarily large. There’s more infections happening in India than what occurred globally two weeks ago.

Our latest projections show that the number of infections driven by the surge in India, perhaps also in Bangladesh and Pakistan, will be reaching 15 million a day globally. The huge epidemic is likely to continue at least into the second week of May, but given the extraordinary volume of infections in India, COVID-19 may run out of people to infect pretty soon. Our models are suggesting that transmission may start to decline in India as we get into the latter half of May. Meanwhile, the surge in India is now spreading to Nepal.
Cases elsewhere in South Asia have peaked and started to come down – particularly in Bangladesh – but we think that might be a reporting artifact from the Ramadan period, where fewer people may be seeking to be tested, and/or there may be lags in the data. So we’ll watch very closely the trends in Bangladesh and Pakistan.

Elsewhere in the world, where the epidemic is really fundamentally driven by P1, we’re seeing rising cases and deaths but nowhere near explosively as the South Asian epidemic. It’s important to consider what the variant is in the South Asian epidemic. We think it’s mostly related to B.1.617, although sequencing data in the public domain is quite sparse for India and there is certainly plenty of B.1.351 and also B.1.17 sequenced in India. But given the explosive increase in South Asia compared to Latin America, given the high prevalence of previous infection in some states like Deli which was already 75% infected before this started to happen, it’s clearly an escape variant, and that makes it most likely that it’s B.1.617.

In Europe, aggregate cases and deaths seem to have come down slightly in the past week, but there are certainly a number of countries like Spain and the Netherlands and a few others, where cases are going up but deaths are either constant or even declining slightly. So we’re perhaps seeing continued transmission related to behavioral relaxation but effective vaccination is enough to keep the death rate constant or declining.

Those are the main areas of development in this week’s assessment. But just to reiterate, what’s happening in South Asia is overwhelmingly driving our assessment of the global pandemic.

The Institute for Health Metrics & Evaluation is an independent population health research center at UW Medicine, part of the University of Washington, that provides rigorous and comparable measurement of the world's most important health problems and evaluates the strategies used to address them. IHME makes this information freely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to best improve population health.