India's COVID-19 cases rising despite widespread belief in country's natural immunities
Country third-highest number of cases worldwide but much lower death rate than countries such as U.S., Canada
A crush of thousands upon thousands of people line the banks of the Ganges River in the holy city of Haridwar, in India's northern Uttarakhand state, pushing forward to enter the water to wash away their sins.
Steps away, a hand-sanitizing station sits empty.
This is the Maha Kumbh Mela pilgrimage, one of the most important Hindu festivals, which happens only once every 12 years. Its location rotates between several holy Indian cities, but Hindu pilgrims believe bathing in the Ganges will cleanse impurities and help free them from cycles of rebirth.
The festival goes until the end of April, but this time it's under the shadow of a pandemic. But you wouldn't know it, looking around.
There are few masks and little physical distancing. Large circles painted on the steps leading down to the river — meant to encourage standing apart from your neighbour — are mostly ignored.
The pilgrimage is taking place just as India is seeing some of its highest numbers of new infections so far this year — more than 25,320 as of Sunday.
WATCH | COVID-19 cases rise in India amid religious festival and vaccine hesitancy:
Minutes after he took a quick dip in the Ganges, Bhavesh Patel told CBC News he had zero worries about the virus spreading at this massive festival.
"Nobody's infected here, nobody. And even if they are, once they dip [into the Ganges], they are all pure," he said. "There is no COVID here."
'The river … sanitizes us'
Patel, 56, travelled to the festival from New York and said he was determined to attend, "COVID or no COVID." The feelings he expressed are prevalent here.
"I'm not worried about the virus, because I take care of myself," said Anita Verma, standing beside her father, Sitaram. They're both from Rajasthan, a 12-hour drive away.
Just then, her father interjected, and Verma repeated his sentiment: "The river itself sanitizes us from the COVID virus, so it's very pure. It saves us," she said.
The festival comes as India is seeing a spike in other large gatherings, namely political rallies in several states holding elections next month.
"[The gatherings] are religious, they're political, they're social," said Dr. Srinath Reddy, president of the Public Health Foundation of India, and a member of the country's COVID-19 task force. "Unfortunately, we are giving the virus free rein."
Reddy blames complacency over following public health guidelines on the marked decrease in infections at the beginning of this year, which saw India's daily case count fall to 10,000 a day from a mid-September high of more than 97,000.
"There was a general feeling [in early 2021] that the pandemic has receded, at least as far as India was concerned," Reddy said. "There was also the feeling that the mythical herd immunity had arrived, that we have achieved that nirvana and therefore people need not worry about it."
Hope for herd immunity
Those factors, plus the controversial approval of a homegrown vaccine, Covaxin, before efficacy data was fully available, led people to reconsider getting vaccinated, Reddy said. (Covaxin has since released data that shows an 81 percent efficacy rate, two months after it received emergency approval for use.)
The World Health Organization has established that herd immunity should be reached through vaccination and not simply by exposing people to the virus. WHO has also said that it doesn't know what percentage would achieve herd immunity when it comes to COVID-19.
Herd immunity in India is a "nebulous" concept and a myth, according to Reddy, who pointed to a lack of nationwide data proving a sufficient level of immunity.
"The 55 per cent rates that are being reported are in large metropolitan areas like Delhi and some pockets of Mumbai," he said. "So you're really not seeing all of India crossing even the 40 per cent threshold, and we do not know what the herd immunity threshold for this particular virus is."
In explaining the plunge in cases earlier this year, experts point to the fact that more Indians started following public health guidelines to mask up and physically distance after cases peaked.
But the sharpness of the drop was puzzling to many. That led to speculation that India's warmer climate and younger population were also contributing factors, as well as other innate advantages.
India's social demographic advantages
There's a theory, bolstered by two new studies done by Indian scientists — which have yet to be peer-reviewed — that Indians are less vulnerable to COVID-19 because they're exposed to more infectious diseases from birth, thus making their immune systems stronger.
India has the third-highest tally of COVID-19 cases in the world, at 11.36 million, but counts fewer deaths per capita than countries such as Canada, the United States and France, with 11.73 deaths per 100,000 people compared to 163.31 in the U.S. and 60.51 in Canada.
Reddy said there are some simple explanations.
"We must remember that India has social demographic advantages. We have two-thirds of the Indian population in rural areas, where there's less crowd density," Reddy said.
He pointed to the fact that rural homes are more ventilated, people largely work outside and their social bubbles are much smaller than those living in the city, leading to far less risk from the virus.
But India is now heading in the wrong direction, with cases spiking again in at least eight states and coronavirus variants spreading.
The country's vaccination drive has also been slow to ramp up, with only 1.5 per cent of the population having received a first dose. The current pace is far from what's needed to meet the government's goal to have 300 million Indians, about a quarter of its population, vaccinated by August.
"We are seeing a lot more opening up, a lot more commuting, a lot more superspreader events and the [variants]," Reddy said. "There is cause for worry."