Tag Archives: Coronavirus

Autoimmune-disease drugs may reduce vaccine response; antibody treatments ineffective vs Brazil variant

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Autoimmune disease treatments may reduce vaccine responses

Immunosuppressive drugs for inflammatory diseases like rheumatoid arthritis, multiple sclerosis, and ulcerative colitis can impair the body’s response to the COVID-19 vaccines from Pfizer/BioNTech and Moderna, according to new data. In 133 fully vaccinated people with such conditions, antibody levels and virus neutralization were about three-fold lower than in a comparison group of vaccinated individuals not taking those medicines, researchers reported on Friday on medRxiv ahead of peer review. Most patients in the study “were able to mount antibody responses in response to SARS-CoV-2 vaccination, which is reassuring,” said coauthor Alfred Kim from Washington University School of Medicine in St. Louis. It is not clear yet whether reduced antibody levels will result in decreased protection from infection or hospitalization, Kim said. Particularly concerning, he said, is the 10-fold reduction in vaccine-induced antibody levels seen in patients who routinely use steroids such as prednisone and methylprednisolone and a 36-fold reduction seen with drugs that deplete B cells, including Roche’s Rituxan (rituximab) and Ocrevus (ocrelizumab). Reductions in antibody levels were more modest with widely used rheumatoid arthritis drugs in the class known as TNF inhibitors such as Abbvie’s Humira (adalimumab) and Amgen’s Enbrel (etanercept); antimetabolites like methotrexate and sulfasalazine; JAK inhibitors like Pfizer’s Xeljanz (tofacitinib), gut-specific agents such as Takeda Pharmaceutical Co’s Entyvio (vedolizumab), and IL-12/23 inhibitors including Johnson & Johnson’s Stelara (ustekinumab).

Most antibody drugs ineffective against Brazil variant

The coronavirus variant first identified in Brazil, known as P.1, is resistant to three of the four antibody therapies with emergency use authorization in the United States, according to a laboratory study. In test-tube experiments, researchers exposed the P.1 variant to various monoclonal antibodies, including the four currently being used to treat U.S. COVID-19 patients – imdevimab and casirivimab from Regneron Pharmaceuticals, and bamlanivimab and etesevimab from Eli Lilly and Co. Only imdevimab retained any potency, researchers found. The neutralizing ability of the other three were “markedly or completely abolished,” according to a peer reviewed report available on bioRxiv and provisionally accepted by the journal Cell Host & Microbe. The researchers also exposed P.1 to plasma from COVID-19 survivors and blood from recipients of vaccines from Pfizer/BioNTech or Moderna. Compared to their effects against the original version of the coronavirus, the plasma and the vaccine-induced antibodies were less effective at neutralizing P.1. In earlier studies, however, they were even less effective against the B.1.351 variant first identified in South Africa. This suggests that the Brazil variant might not pose as great a threat of reinfection or decreased vaccine protection as the South Africa variant, said coauthor David Ho from Columbia University. Real-world evidence is needed to confirm the lab results, he said.

South Africa variant can ‘break through’ Pfizer vaccine

The B.1.351 coronavirus variant discovered in South Africa can “break through” Pfizer/BioNTech’s COVID-19 vaccine protection to some extent, Israeli researchers have found. They compared almost 400 people who had tested positive for COVID-19 after one or two doses of the vaccine, against the same number of similar people with COVID-19 who were unvaccinated. The prevalence of the variant in Israel is low, and overall, it accounted for about 1% of all the COVID-19 cases in the study. But among those who received both doses of the vaccine, a larger proportion of COVID-19 infections were caused by B.1.351. The “disproportionately higher rate” of the South African variant in the fully vaccinated group (5.4%) compared to the rate in the unvaccinated group (0.7%) “means that the South African variant is able, to some extent, to break through the vaccine’s protection,” said Tel Aviv University’s Adi Stern. In a report posted on Friday on medRxiv ahead of peer review, Stern’s team said the research was not intended to deduce overall vaccine effectiveness against any variant, since it only looked at people who had already tested positive for COVID-19, not at overall infection rates in the community.

(Reporting by Nancy Lapid and Maayan Lubell; Editing by Bill Berkrot)

More therapeutics but no surge in vaccine for Michigan, Biden administration says

By Jeff Mason and Carl O’Donnell

WASHINGTON (Reuters) -The White House said on Monday it was prepared to send additional therapeutic treatments to the state of Michigan, which is experiencing a worrying number of COVID-19 cases, but declined to promise more vaccine as the state has sought.

White House coronavirus adviser Andy Slavitt told reporters the U.S. government would work to ensure that states such as Michigan were ordering the full amount of vaccine that was available to them but said that shifting distribution was not in line with the administration’s public health strategy.

“We have to remember the fact that in the next two to six weeks, the variants that we’ve seen … in Michigan, those variants are also … present in other states,” he told reporters on a conference call.

“So our ability to vaccinate people quickly … (in) each of those states rather than taking vaccines and shifting it to playing Whack-a-Mole isn’t the strategy that public health leaders and scientists … have laid out,” he said.

Michigan Governor Gretchen Whitmer, a Democrat, has pleaded with the federal government to increase the number of vaccines allotted to her state to address a dangerous surge in cases but, despite close ties to the White House, has been rebuffed.

Whitmer was on President Joe Biden’s list of potential running mates before he chose now Vice President Kamala Harris. Michigan is a political battleground state that Biden won in 2020, helping to secure his victory over former President Donald Trump, a Republican. It is likely to be decisive in the 2024 White House race as well.

The Biden administration has highlighted an increase in vaccination rates across the country while warning Americans to continue wearing masks, maintain social distance, and follow other health protocols to prevent another major COVID-19 surge.

U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said more vaccine was not the answer to Michigan’s problem. She said the state needed to “go back to basics” and shut down.

“I think if we tried to vaccinate our way out of what is happening in Michigan we would be disappointed that it took so long for the vaccine to work,” she said. “Similarly we need that vaccine in other places. If we vaccinate today we will have, you know, impact at six weeks and we don’t know where the next place … is going to be that is going to surge.”

Whitmer has faced fierce political backlash from conservatives in her Midwestern state for her COVID-19 restrictions, including armed groups entering the state capitol and a foiled plot to kidnap her. She was a frequent target of criticism from Trump.

Slavitt said that Johnson & Johnson is on track to deliver around 24 million COVID-19 shots to the United States in April whether or not it receives U.S. regulatory clearance for its Baltimore vaccine production plant, which is owned by contract manufacturer Emergent BioSciences Inc.

J&J has faced delays on vaccine shipments because of challenges at its Emergent plant, which ruined 15 million doses in recent weeks due to manufacturing error.

Jeff Zients, the White House’s COVID-19 response coordinator, said last week J&J would ship relatively few shots each week until the Emergent plant received authorization from the U.S. Food and Drug Administration.

(Reporting by Jeff Mason and Carl O’Donnell; additional reporting by Susan Heavey and Caroline HumerEditing by Chizu Nomiyama and Marguerita Choy)

Moderna vaccine antibodies last at least 6 months; lung transplant can save some COVID-19 survivors

By Nancy Lapid

(Reuters) -The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Moderna vaccine antibodies last at least 6 months

A follow-up study of 33 people who received Moderna Inc’s COVID-19 vaccine in early trials show the antibodies it induced are still present six months after the second dose. “Antibody activity remained high in all age groups,” researchers said. They confirmed the findings using three different tests, according to a report on Tuesday in The New England Journal of Medicine. Earlier this month, Pfizer Inc and partner BioNTech SE said their vaccine using similar messenger RNA (mRNA) technology remained highly effective for at least six months.. The researchers conducting the Moderna vaccine study will continue to follow the same volunteers to see whether the antibodies last longer than six months. They are also evaluating the potential for a booster dose to extend the duration of the antibodies and improve their potency against new more contagious variants of the coronavirus.

Lung transplants can save some COVID-19 survivors

Surgeons worldwide have been performing lung transplants in COVID-19 survivors with irreversible lung damage, and an international group of transplant experts has proposed guidelines for selection of eligible patients. To possibly qualify for a transplant, COVID-19 survivors with complete lung failure should be younger than 65, nonsmokers, and have no pre-existing medical conditions, or only manageable ones, they advise. They said transplants should be performed at least four weeks after a diagnosis of irreversible lung damage. In the United States alone, more than 50 double lung transplants have been performed on COVID-19 survivors, and all the patients are alive, said Dr. Ankit Bharat of Northwestern Medicine in Chicago, who has performed a dozen of them. A study published in The Lancet Respiratory Medicine that examined 12 of the first double-lung transplants performed in COVID-19 patients in the United States, Italy, Austria and India showed that all but two survived and are doing well, said co-author Bharat. “It’s a really remarkable outcome, given how critically ill these patients were,” he said. “Without the possibility of transplant, the medical team and the families were ready to withdraw care.”

Pfizer/BioNTech vaccine safe during cancer immunotherapy

The mRNA COVID-19 vaccine from Pfizer and BioNTech is safe for patients being treated with cancer immunotherapies like Merck & Co’s Keytruda and Opdivo sold by Bristol Myers Squibb, Israeli physicians said in a report published in The Lancet Oncology. They studied 134 vaccine recipients who were being treated with the so-called immune-checkpoint inhibitors, including some who were also receiving chemotherapy. The vaccine was “safe from both sides: we did not see immunotherapy-related side effects and did not see severe side effects from the vaccine itself,” said the report’s co-author Dr. Ido Wolf of the Tel Aviv Sourasky Medical Center. “We believe that the vaccine should be given to these patients … especially in areas of an active COVID-19 outbreak.” However, questions still need to be answered for these patients, including whether there are any long-term issues. “We looked at our patients only a few weeks from the second dose and cannot rule out the possibility of long-term side effects,” Wolf said. His team is also looking into whether other cancer drugs, such as chemotherapies, may reduce the efficacy of the vaccine.

Skin reactions to mRNA vaccines have not been serious

A wide range of skin reactions has been documented in recipients of the mRNA vaccines from Pfizer/BioNTech and Moderna, but none have been serious, according to researchers who analyzed 414 cases in a registry run by dermatology societies. The majority (83%) were associated with the Moderna shot. Most started the day after, or often several days to a week, after vaccination, said Dr. Esther Freeman of Massachusetts General Hospital in Boston, who coauthored a report published on Wednesday in the Journal of the American Academy of Dermatology. Fewer than half of patients who experienced a delayed skin reaction after the first dose experienced a recurrence with the second dose. Furthermore, no patients in the registry developed serious adverse events after the first or second dose. “If the patient develops a delayed-onset rash more than four hours after vaccination, while the rash may be uncomfortable, our data suggest they … should feel comfortable proceeding with the second dose of their vaccine,” Freeman said. However, she added, hives that start within four hours after vaccination “should be taken very seriously,” as that may be a sign of an immediate allergic reaction. The U.S. Centers for Disease Control and Prevention recommends referral to an allergist-immunologist in those cases.

(Reporting by Nancy Lapid, Marilynn Larkin, Megan Brooks, and Ronnie Cohen; Editing by Bill Berkrot)

COVAX vaccines reach more than 100 countries, despite supply snags

By Stephanie Nebehay

GENEVA (Reuters) -The COVAX vaccine facility has delivered nearly 38.4 million doses of COVID-19 vaccines to 102 countries and economies across six continents, six weeks after it began to roll out supplies, according to a statement on Thursday.

The program offers a lifeline to low-income countries in particular, allowing them in the first instance to inoculate health workers and others at high risk, even if their governments have not managed to secure vaccines from the manufacturers.

But there have been some delays, the GAVI vaccine alliance and World Health Organization said in a statement.

Reduced availability of delayed some deliveries in March and April, and much of the output of the Serum Institute of India, which makes the AstraZeneca vaccine, is being kept in India, where daily infections surpassed 100,000 for the first time on Monday.

The Caribbean island of St. Lucia became the 100th country to receive vaccines through COVAX. Iran, also battling a record rate of infection, is another recent recipient.

The 102 countries reached so far include 61 benefiting from a mechanism essentially financed by donors.

WHO Director-General Tedros Adhanom Ghebreyesus on Monday called it a “travesty” that some countries still did not have enough vaccines to begin inoculating health workers and the most vulnerable.

GAVI said last month that it planned to deliver 237 million doses of the AstraZeneca vaccine – which has been produced at cost for a few dollars a dose, and does not require the advanced refrigeration of some other coronavirus vaccines – to 142 countries by the end of May.

“COVAX may be on track to deliver to all participating economies in the first half of the year, yet we still face a daunting challenge as we seek to end the acute stage of the pandemic,” GAVI chief executive Seth Berkley said in the statement.

Nonetheless, COVAX still expects to deliver at least 2 billion doses this year 2021, and to diversify the offering beyond the AstraZeneca/Oxford and Pfizer/BioNTech shots it is currently supplying.

(Reporting by Stephanie Nebehay; Editing by Kevin Liffey)

U.S. delivering about 3 million COVID-19 vaccines per day, up 8%: CDC director

WASHINGTON (Reuters) – The United States has delivered about 3 million COVID-19 vaccine doses per day on average over the past week, up 8% over the previous 7-day average, U.S. Centers for Disease Control and Prevention Director Rochelle Walensky said on Wednesday.

Still, daily U.S. cases of novel coronavirus are averaging 63,000 over the past seven days, up 2.3% from the previous 7-day average, she told reporters at a White House briefing.

(Reporting by Susan Heavey, Jeff Mason and Carl O’Donnell)

Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients

By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) – Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada’s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”

The ECMO situation is under control for now, but things can change very quickly, Cypel cautioned.

When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff – seven or more people to start the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada’s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.

‘SEEING BURNOUT’

In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada’s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

Vaccinating adults appears to protect children around them; bar opening event linked to 46 COVID-19 cases

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Vaccinating adults appears to protect children as well

New data from Israel, where health officials moved quickly to distribute the COVID-19 vaccine from Pfizer Inc and partner BioNTech SE, suggests that the vaccination of adults also protects unvaccinated people living around them. Roughly one third of Maccabi Healthcare Services (MHS) 1.95 million members – all above the age of 16 – had received at least a single vaccine dose by Jan. 30. In analyzing outcomes in 223 communities, researchers found that as the number of vaccinated adults went up, infection rates among unvaccinated MHS members in the same community went down – particularly among children. MHS is Israel’s second largest healthcare maintenance organization. “While the observed vaccine-associated protection of unvaccinated is encouraging, further studies are required to understand whether and how it might support the prospect of herd immunity and disease eradication,” the researchers concluded in the study posted on Wednesday on medRxiv ahead of peer review.

Illinois bar-opening event linked to 46 cases of COVID-19

An indoor celebration of a bar opening in rural Illinois in February led to 46 new cases of COVID-19 and wider ramifications, according to a U.S. study that serves as a caution about how such events can affect local communities. Four attendees had COVID-19-like symptoms that day. Of the 46 coronavirus infections linked to the party, there were 26 cases among patrons, three in staff members and 17 “secondary cases” in people infected by them, according to a report published on Monday in the Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention. The secondary cases included children and residents of long-term care facilities. “Transmission associated with the opening event resulted in one school closure affecting 650 children (9,100 lost person-days of school) and hospitalization of one long-term care facility resident with COVID-19,” researchers said. “These findings demonstrate that opening up settings such as bars, where mask wearing and physical distancing are challenging, can increase the risk for community transmission of SARS-CoV-2,” researchers said. Businesses should “work with local health officials to promote behaviors and maintain environments that reduce the risk for SARS-CoV-2 transmission and develop strategies for reopening safely to prevent outbreaks in the community, such as modifying layouts and operating procedures,” they said.

Congenital heart disease does not worsen COVID-19 risks

Adults with congenital heart defects are not more likely than the average person to have severe COVID-19, or to die from it, according to an international study. Risk factors associated with poor outcomes in these individuals are the same as those associated with poor outcomes in the general public – older age, male gender, a history of heart failure, irregular heart rhythm, kidney problems, diabetes, and need for extra oxygen before becoming infected with the coronavirus, said study coauthor Dr. Jamil Aboulhosn of the UCLA Adult Congenital Heart Center. Researchers analyzed data from 1,044 adults with COVID-19 from 58 congenital heart disease centers worldwide. Even people with very complex heart defects did not appear to have an increased risk of severe COVID-19 as long as they did not already have severe signs and symptoms of heart disease, Aboulhosn said, calling the finding, “somewhat surprising.” The study was published in the Journal of the American College of Cardiology.

Stroke patients with COVID-19 have worse outcomes

Among patients who went to a hospital because they were having a stroke, those who tested positive for COVID-19 had higher odds of dying there, a new study shows. The patients with COVID-19 were also more likely to have more severe stroke and to suffer another stroke while hospitalized, researchers reported in the journal Stroke. They studied close to 42,000 patients who arrived at 458 hospitals with ischemic stroke, caused by blockages in arteries that carry blood to the brain. About 3% of the patients tested positive for COVID-19. On average, they got to the hospital as quickly as patients without coronavirus infection. After that, things slowed down. “Likely due to the need for personal protective equipment use and other precautions” by hospital staffers, it took longer for COVID-19 patients to get clot-busting treatments that reopen the clogged vessels, said study coauthor Dr. Gregg Fonarow of the University of California, Los Angeles. The study cannot prove that treatment delays caused the worse outcomes. However, Fonarow said, “these findings suggest there is a need to further enhance stroke protocols to provide more timely diagnosis and treatment for patients with (ischemic stroke) to speed care while still protecting healthcare workers from exposure.”

(Reporting by Nancy Lapid, Marilynn Larkin and Megan Brooks; Editing by Bill Berkrot)

U.S. says 165 million doses of COVID-19 vaccine been administered so far

(Reuters) – The United States has administered more than 165 million doses of COVID-19 vaccines in the country as of Sunday morning and distributed nearly 208 million, the U.S. Centers for Disease Control and Prevention (CDC) said on Sunday.

That is up from the 161,688,422 vaccine doses the CDC said had gone into arms by Saturday out of 207,866,645 doses delivered.

The agency said 106,214,924 people had received at least one vaccine dose, while 61,416,536 people have been fully vaccinated as of Sunday.

The CDC tally includes two-dose vaccines from Moderna Inc and Pfizer/BioNTech,, as well Johnson & Johnson’s one-shot vaccine as of 6:00 a.m. ET on Sunday.

A total of 7,742,126 vaccine doses have been administered in long-term care facilities, the agency said.

(Reporting by Aishwarya Nair in Bengaluru; Editing by Bill Berkrot)

U.S. COVID-19 cases rise for third straight week, hospitalizations also up

(Reuters) – New cases of COVID-19 in the United States rose 5% to more than 450,000 last week, the third week in a row that infections have increased, according to a Reuters analysis of state and county data.

The average number of COVID-19 patients in hospitals rose 4% to more than 37,000 in the week ended April 4, breaking a streak of 11 weeks of falling admissions.

Health officials have expressed concerns about the increase in travel around the Easter holiday and school spring breaks, at a time when more infectious variants of the coronavirus are circulating.

While flu viruses tend to be seasonal, with cases falling as the weather warms, health officials said they have not seen similar trends with the novel coronavirus, pointing to a surge in COVID-19 cases in some regions last summer.

“I don’t think we should even think about relying on the weather to bail us out of anything we’re in right now,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said at a news briefing on Monday.

Twenty-seven out of 50 states reported increases in new cases last week compared with the previous seven days, according to the Reuters analysis.

Per 100,000 people, Michigan, New Jersey and New York reported both the highest number of new cases and the highest number of hospitalizations.

Deaths from COVID-19, which tend to lag infections by several weeks, fell 17% to about 5,800 last week, or about 834 per day. Health officials have said the country’s vaccination effort could limit deaths even with rising cases.

For a sixth week, vaccinations set a record, with an average of 3.1 million shots given per day last week. As of Sunday, 32% of the U.S. population has received at least one dose and 19% was fully vaccinated, according to the CDC.

(Graphic by Chris Canipe, writing by Lisa Shumaker, editing by Tiffany Wu)

India’s daily virus cases breach 100,000; mutants, behavior blamed

By Neha Arora and Rama Venkat

NEW DELHI (Reuters) -India reported a record rise in COVID-19 infections on Monday, becoming the second country after the United States to post more than 100,000 new cases in a day, as politicians stage massive election rallies raising fears of further spreading the virus.

Hospitals in the worst affected state, Maharashtra, are being overrun by patients. India’s richest state, home to its commercial capital Mumbai and numerous industries, reported a record 57,074 new cases overnight.

The country’s daily infections have risen about 12 fold since hitting a multi-month low in early February, when authorities eased most restrictions and people largely stopped wearing masks and following social distancing.

With 103,558 new infections, India has now reported 12.6 million cases, the highest after the United States and Brazil, data from the health ministry showed. Deaths jumped by 478, still one of the lowest fatality rates in the world, raising the total to 165,101.

India has recorded the most number of infections in the past week anywhere in the world. More infectious variants of the virus may have played a role in the second surge, some epidemiologists say.

“The new variant, or variants of concern, probably explains a lot of it, rather than simplistic explanation of behavior,” said Rajib Dasgupta, head of the Center of Social Medicine & Community Health in New Delhi’s Jawaharlal Nehru University.

India has found hundreds of cases of the virus variants first detected in the United Kingdom, South Africa and Brazil.

Subhash Salunke, a former WHO official who advises Maharashtra on its COVID-19 strategy, said cases in the state would continue to rise for another couple of weeks. He said a way out was vaccinating all adults in its hardest-hit cities such as Mumbai, Pune and Nashik.

“If we start doing this, by the end of April we will see a downward trend,” he said.

VACCINE RAMP-UP

India, the world’s biggest maker of vaccines, has injected 77 million doses at home since starting its campaign in the middle of January – the third highest after the United States and China.

India’s per capita COVID-19 vaccinations, however, are lower than many other countries, including that of more populated China that started giving shots to its citizens much earlier.

India is currently vaccinating only people above the age of 45, having covered health and front-line workers first with the AstraZeneca shot and a government-backed one.

In a meeting held by Indian Prime Minister Narendra Modi on Sunday, officials discussed raising the country’s vaccine output further. The government has in recent weeks slowed vaccine exports, after shipping more than 65 million doses.

“It was highlighted that all efforts are underway to secure adequate quantities of vaccines to meet the rising domestic requirements as well as to meet the genuine needs of other countries,” his office said in a statement.

Though cases have risen exponentially in nearly a dozen states, politicians and ministers are still addressing election rallies attended by tens of thousands of mask-less people jostling for space.

The health minister in the northeastern state of Assam, currently voting to elect a new government, was ridiculed on social media on the weekend after saying there was no need for masks in his state and that wearing one hurts businesses like beauty parlors.

Maharashtra will start shutting shopping malls, cinemas, bars, restaurants and places of worship from Monday evening. Authorities will also impose a complete lockdown at weekends, as experts worried about a shortage of critical-care beds in hospitals, especially in its smaller cities.

The rise in cases has pulled down the stock market.

(Reporting by Rama Venkat Bengaluru and Neha Arora in New Delhi; Writing by Krishna N. Das; Editing by Himani Sarkar and Michael Perry)