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After Dropping Dramatically, COVID-19 Cases Surge In India, Pakistan

NOEL KING, HOST:

Coronavirus infections in India and Pakistan are surging. But until just last month, there had been a dramatic drop in cases in those two countries. This sudden change has confounded public health officials who are now investigating two mysteries. Why did cases in India and Pakistan drop, and why are they surging now?

NPR India correspondent Lauren Frayer is on the line from Mumbai. Hi, Lauren.

LAUREN FRAYER, BYLINE: Hi there.

KING: What is the situation in Mumbai now?

FRAYER: So Mumbai is seeing its highest caseload since the start of the pandemic, worse than last spring when there was a total lockdown. Now, we're not under lockdown here yet, partly because of how damaging it was the last time around. India's economy shrank 24% last spring and summer. We're under an 8 p.m. curfew here. There's a ban on gatherings. The Indian festival of Holi, this big colorful festival, was basically canceled last weekend. And this has all come as kind of a shock to a lot of Indians because, until recently, as you mentioned, cases had dropped here to a tenth of what they once were.

KING: And that hasn't happened in lots of places that have done lockdowns, like the ones you describe. So what are scientists telling you about why there was such a dramatic drop in cases?

FRAYER: So random tests last summer and fall showed about half of people in India's biggest cities had antibodies. And so what we thought is those people had already been infected, many of them asymptomatically, and they had some protection.

KING: And - OK. That would make sense. But then why would cases suddenly be surging now?

FRAYER: Yeah, that's the real big question. And I called up a virologist, Dr. Gagandeep Kang, and she says it looks like this wave is straining private hospitals more than public ones, so this latest round of infections could be affluent Indians who stayed home during the first wave and now are going out and maybe let their guard down.

GAGANDEEP KANG: People who were previously able to isolate themselves and stay away from getting infected are now out and about and more likely to be infected.

FRAYER: But on the other hand, Dr. Kang says, this could be people who are getting reinfected.

KANG: Now we've reached a stage where previously infected people cannot ward off infection anymore.

FRAYER: I mean, essentially, she says, too much time may have passed for those folks who were infected last year to still have protection from the virus. And she says there could be another explanation - new variants. Last week, India said its detected one they're calling a double mutant, which has two mutations, the mutation that first emerged in the U.K. and then another mutation that was first discovered in South Africa. But it's too soon to tell whether that's really to blame for this latest spike.

KING: And so what is India doing about all of this?

FRAYER: Trying to vaccinate people as quickly as possible. Starting tomorrow, India is opening up vaccinations to anyone over the age of 45. I mean, India is in a good position in that it's the world's biggest vaccine producer, so supply isn't an issue here. I visited an Indian factory a couple weeks ago that's churning out 100 million doses a month. But India's really big. It's got nearly 1.4 billion people, and so it takes a lot of time to get shots in all those arms. Other countries in the region may have smaller populations, but they don't have the supply. Neighboring Pakistan is importing doses from China, and they're seeing a huge surge. Even the prime minister has it there.

KING: NPR's Lauren Frayer in Mumbai. Thank you, Lauren.

FRAYER: You're welcome. Thanks for having me.

(SOUNDBITE OF EDAMAME'S "THOUSAND-HAND") Transcript provided by NPR, Copyright NPR.