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India's worrying COVID surge could be 20 times worse than feared

People wearing face masks as a precaution against the coronavirus line up without any physical distancing to get tested for COVID-19 at a government hospital in Jammu, India, Monday, April 19, 2021. India now has reported more than 15 million coronavirus infections, a total second only to the United States. (AP Photo/Channi Anand)
People wearing face masks line up to get tested for COVID-19 at a government hospital in Jammu, India, on Monday. (AP)

India is reporting more daily cases of coronavirus than the whole of Europe combined as it struggles with a new wave of infection.

Figures from Our World In Data, based at the University of Oxford, show there were nearly 225,000 confirmed new cases in India on Sunday, compared with around 170,000 across Europe.

More worrying is that the country’s "positivity rate" – which means the percentage of tests coming back positive – has sparked fears that the actual number of cases is far higher than those recorded.

On Monday, Boris Johnson's government added India to its travel 'red list' - which means most travel to the UK is banned - amid concerns over a new COVID variant that has been detected there. Boris Johnson has also cancelled a planned trip to the country that was due next week.

Watch: Boris Johnson says it is 'sensible' to cancel India trip

The capital New Delhi entered a new week-long lockdown on Monday, as the number of cases in India passed the 15 million mark, according to Johns Hopkins University, making it second only to the US.

According to Our World In Data, there were 219,155 new coronavirus cases in India on Sunday, compared to 171,319 in the whole of Europe on the same day.

The country with the second highest daily total was the US, with 67,450. Brazil was next with 65,864 cases. In the UK, 2,635 cases were recorded.

Patients suffering from the coronavirus disease (COVID-19) get treatment at the casualty ward in Lok Nayak Jai Prakash (LNJP) hospital, amidst the spread of the disease in New Delhi, India April 15, 2021. REUTERS/Danish Siddiqui     TPX IMAGES OF THE DAY
Patients suffering from COVID-19 get treatment at the casualty ward in Lok Nayak Jai Prakash hospital in New Delhi, India. (Reuters)

Max Roser, Our World In Data founder and University of Oxford researcher, said the ratio between confirmed cases to real cases was estimated on 2 April to be about one to 20, meaning just 5% of actual cases are detected.

He tweeted: “If this is accurate, then the current number of infections in India is about 4.4 million per day (220,000 confirmed cases times 20).”

On Monday, Johnson said it was “only sensible” to cancel his India trip and that it is up to the UK Health Security Agency whether to add the nation to the travel “red list”.

He said: “I do think it’s only sensible to postpone given what’s happened in India, the shape of the pandemic there.”

The visit, aimed at fostering closer ties, was first scheduled for January, but was delayed due to the UK’s winter wave of infections.

File photo dated 25/08/19 of Prime Minister Boris Johnson meeting India PM Narendra Modi for bilateral talks during the G7 summit in Biarritz, France. Boris Johnson has cancelled his visit to Delhi next week, as the coronavirus crisis worsens in India and concerns grow over a new variant there. Issue date: Monday April 19, 2021.
Prime minister Boris Johnson has cancelled a meeting with his Indian counterpart Narendra Modi. (PA)

The variant of coronavirus first identified in India is likely to become a “variant of concern”, which could potentially lead to the country being put on the red list, according to Danny Altmann, professor of immunology at Imperial College London.

He told ITV’s Good Morning Britain that variants of the virus “do pose a threat” and that vulnerable people could be “caught out”.

Dozens of cases of the variant have been identified in the UK.

The variant, also known as B.1.617, is currently designated as a “variant under investigation” (VUI) rather than a “variant of concern” (VOC) such as those first identified in Kent, Manaus (Brazil) in South Africa.

Dr Jeffrey Barrett, director of the COVID-19 Genomics Initiative at the Wellcome Sanger Institute, told BBC Radio 4’s Today programme that the variant first identified in India should be “watched carefully” but is “probably not at the top tier of mutations that generate the most concern”.

Devotees take holy dips in the Ganges River during Kumbh Mela, or pitcher festival, one of the most sacred pilgrimages in Hinduism, in Haridwar, northern state of Uttarakhand, India, Monday, April 12, 2021. Tens of thousands of Hindu devotees gathered by the Ganges River for special prayers Monday, many of them flouting social distancing practices as the coronavirus spreads in India with record speed. (AP Photo/Karma Sonam)
Devotees take holy dips in the Ganges River during Kumbh Mela, or pitcher festival, one of the most sacred pilgrimages in Hinduism, in Haridwar, northern state of Uttarakhand, India, on 12 April. (AP)

In New Delhi, the new six-day lockdown was ordered as hospitals struggle with a shortage of beds, oxygen and key medicines.

Fewer than 100 critical care beds were available in the city, which has a population of more than 20 million people, officials said.

India’s government has been criticised for its handling of the pandemic, with religious festivals and election rallies being attended by thousands.

Watch: Calls for India to be put on UK's travel 'red list'