Covid-19 surge in Northeast explained in 8 charts

The second wave of Covid-19 unleashed unprecedented devastation in almost every region of India. Nearly 1.6 crore people were infected and over 1.68 lakh lost their lives in April and May 2021.The northeast region — which comprises Assam, Arunachal, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura — accounted for over 2.8 lakh infections during this period, which is 1.78% of the total cases in India.However, the trajectory of the second wave was such that Covid struck the northeastern part of India towards the very end when nearly every state had already hit its peak.Even in early April, when the rest of India was witnessing a gradual rise in cases, the then Assam health minister Himanta Biswa Sarma played down the situation in the state. Sarma, who is now the chief minister, said masks were not needed since there was no coronavirus in Assam.However, just days after his comment, Assam started witnessing a sharp rise in cases. Eventually, Covid engulfed most of the northeastern region.Here's a state-wise analysis of the Covid surge in the northeast during the second wave in April and May, which is when cases were at their peak:Assam medium nocaption83403689Assam comprises nearly 68% of the total population of the northeast region. Hence, it is hardly surprising that it accounted for the bulk of the infections during the second wave.In April and May, Assam recorded nearly 1.89 lakh Covid cases and 2,196 fatalities.Cases during the second wave peaked on May 21, when the state recorded its highest single-day rise of 6,573 infections. The peak came nearly two weeks after the national peak, suggesting that the virus reached Assam after it had already affected most other regions of India."Election rallies were happening in Assam in the first half of April and then there was the Bihu festival (April 14-16). There were massive gatherings during this time and no one was maintaining Covid protocols. Since the incubation period of Covid is up to 14 days, the surge eventually happened in May," Dr Benudhar Nath, assistant professor (department of community medicine) and nodal officer of Covid-19 at Tezpur Medical College, said.Dr Nath pointed out that since Assam is the gateway to the northeast, the virus then eventually impacted the neighbouring states as well.He also did not rule out the possibility of Delta variant — a more transmissible strain of the virus first found in India — triggering the second wave in the northeast. However, he added there is no concrete study yet to indicate the impact of the new variant on the region.Dr Lakshmanan S, mission director at National Health Mission (NHM), said that since the diaspora of Assam is well-distributed across India, the influx of people from different parts of the country before restrictions came into force may have also contributed to the surge.Meghalaya medium nocaption83403698Meghalaya was the second worst-hit northeastern state during the second wave of the pandemic. It recorded over 21,000 cases and 414 deaths during April and May.The cases touched the 1,000-mark twice during May with the state registering an all-time high of 1,183 infections on May 21.Dr Aman Warr, director of Health Services, Meghalaya, said that the virus during the second wave was more virulent with very high transmissibility, which contributed to the surge of cases in the state.He also cited other reasons like complacency among the people, who had lowered their guard after a muted first wave of the virus. "The second wave hit the elderly very hard in Meghalaya," Dr Warr added.Chief minister Conrad Sangma had suggested in April that the surge was primarily triggered by a large number of individuals returning to the state.“We are seeing that more and more returnees are testing positive. We are seeing close to 65% of returnees testing positive, which is a very large and alarming number,” the CM had said in a statement on April 27. Manipur medium nocaption83403709The cases had started rising in Manipur towards mid-April but the steep surge came in May. The state recorded 20,489 cases during the two months and logged 419 deaths.However, the second wave peak came only at the end of May. The infections hit an all-time high of 1,032 on May 31. Since then, there has been a gradual decline in cases.Besides Arunachal Pradesh, Manipur is the only other state where the contact rate during the second wave was significantly higher at 0.6. Contact rate is the rate at which an individual spreads the infection to others in a single day.Tripura medium nocaption83403716The second most populous state in the region after Assam, Tripura's Covid situation remained mostly in control compared to the neighbouring state if we consider factors like population density.The state was the fourth-worst hit during April and May, recording 17,630 cases and 121 deaths. The cases peaked at 879 on May 19 but remained close to the peak figure till June 1.The surge trajectory, which more or less mirrors that of Assam, indicates that Tripura may have faced the ripple effect of the virus which first began surging in neighbouring Assam.Arunachal Pradesh medium nocaption83403724The state has the lowest population density in the entire northeast region. However, the impact of the second wave was worse than what it was in Mizoram and Sikkim, where population density is higher.Arunachal recorded over 10,100 cases and 59 deaths in April and May and was the fifth worst-hit northeastern state. The cases peaked at the very end of May when the state saw a record single-day rise of 497 cases on May 29.IIT Kanpur Professor Manindra Agrawal, who works on a mathematical model to predict the spread of Covid, said that the contact rate in Arunachal increased significantly during the second wave.The contact rate in Arunachal during the peak was 0.6, which means that a Covid positive individual infected 0.6 people in a single day during the period.Agrawal said the despite low population density, a contact rate of 0.6 is fairly high for a state like Arunachal.Nagaland medium nocaption83403733The cases started surging in Nagaland in early May with the state registering its peak of 366 cases on May 14.Overall, the state recorded 9,330 cases and 271 deaths during April and May.The spread of infections was higher in places like Dimapur than in capital Kohima, which is in the upper reaches.Sikkim medium nocaption83403750Sikkim, which has the lowest population in the entire northeast region, was the seventh worst-hit state in the region. It recorded 8,939 cases and 115 deaths in April and May.Like Arunachal, Sikkim also saw its peak on May 29 when it recorded the highest single-day rise of 420 cases.Dr Yogesh Verma, medical superintendent at Manipal's Central Referral Hospital, Gangtok feels that surge could have been fuelled in part due to the high volume of tourist traffic in the state between December and March.Other factors like the movement of people and general complacency may have further exacerbated the situation, he said.Mizoram medium nocaption83403867Mizoram was the least affected state in the northeastern region during the second wave of the pandemic. The state, which has the second-lowest population, recorded 8,161 cases and 27 deaths during April and May.However, the cases continue to remain on an upward trajectory. The state recorded its all-time high of 338 cases on June 10. Thus, Mizoram is the only northeastern state which is yet to reach its second wave peak.Moreover, despite an overall low case count, the spread of Covid in Mizoram came at a rapid pace in early May. Between May 4 and 11, the number of new cases in the state grew by an average of 2.5% every day, which was the highest for any northeastern state.Second wave wanesLike the rest of India, Covid cases are on a decline in all the northeastern states, barring one – Mizoram. But talk of a possible third wave has kept northeastern states on the edge. According to Dr Lakshmanan, the nature of the virus is such that when cases start surging in places with high population density, the ripples are eventually felt in other states as well."When Assam witnesses a surge in cases, the ripples are bound to be felt in neighbouring states. For instance, when Assam crosses 100, then only Meghalaya starts to cross 10. Similarly, when India had such a high caseload [during the second wave], the ripples were felt in the northeast," he said.Thus, some states are already preparing for a possible third wave and have started ramping up healthcare infrastructure in advance.