Covid-19 cases in India started increasing in February 2023, less than a year since the country's third wave of Covid-19 ended in March 2022. On April 8, 2023, India reported 6,155 fresh Covid-19 cases, the highest in over six months. 


Since SARS-CoV-2 infections have surged despite over 90 per cent of India's eligible population being fully vaccinated against Covid-19, people are worried about the possibility of a fourth wave of Covid-19. 


Is a fourth wave of Covid-19 possible?


According to experts, the likelihood of a fourth wave of Covid-19 depends on many factors. If SARS-CoV-2 mutates into variants which are more transmissible or resistant to the current Covid-19 cases, a fourth wave may emerge.


“The possibility of a fourth wave of Covid-19 depends on many factors such as vaccination rates, public health measures, and virus variants. Even with vaccination programs, there is still a risk of new variants emerging that may be more transmissible or resistant to current vaccines,” Dr Shuchin Bajaj, Founder Director, Ujala Cygnus Group of Hospitals, told ABP Live.


However, he added, the risk of a fourth wave of Covid-19 can be mitigated through widespread vaccination and continued public health measures such as mask-wearing and social distancing.


“It is crucial to keep monitoring the situation and follow the advice of health authorities to help prevent further spread of the virus,” Dr Bajaj said.


According to an expert, a fourth wave of Covid-19 is unlikely, but not impossible. There are three reasons behind this.


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“A fourth wave of Covid-19 is unlikely but not impossible. Reasons are manifold. Firstly, most of us have received two doses of Covid-19 vaccine, even if not the booster dose. Secondly, many people have already had Covid-19 and there is herd immunity. Thirdly, new variants do not cause severe disease, deaths and hospitalisations. Still, we should be very careful and vigilant in order to avoid any such eventuality,” Dr Sanjay Dhall, Director, Internal Medicine, Max Super Speciality Hospital, Shalimar Bagh, told ABP Live.


Should India be worried about the rise in Covid-19 cases?


According to some experts, Indians should not be worried about the rise in Covid-19 cases. However, one expert claimed that India should be worried about the recent surge, despite a majority of the population being vaccinated against Covid-19. This is because Covid-19 vaccines are not completely effective at reducing the risk of infection or transmission.


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“Despite the fact that many people have received vaccinations, there is cause for worry regarding the recent increase in COVID-19 cases. The vaccines are very effective at reducing the risk of serious illness, hospitalisation, and mortality, but they are not completely effective at reducing the risk of infection or transmission,” Dr Anurag Saxena, HOD, Internal Medicine, Primus Super Speciality Hospital, New Delhi told ABP Live.


SARS-CoV-2 keeps evolving, not everyone is vaccinated


Dr Saxena also said that not everyone is vaccinated, and SARS-CoV-2 keeps evolving in new ways that could make it more infectious or less susceptible to the immunity conferred by vaccination. “As a result, there is still a chance that Covid-19 will spread and cause damage, especially in places with low vaccination rates or where people are not taking the appropriate safety measures, like donning masks and keeping a distance from others.”


He added that to stop the spread, it is critical that everyone continues to abide by public health recommendations and gets immunised. 


Concerns persist due to breakthrough infections, long-term health effects


An expert has warned that concerns regarding the rising Covid-19 cases persist due to potential new variants and breakthrough infections, among others.


“Despite Covid-19 vaccines, improved treatments and public health measures, concerns persist due to potential new variants, vaccine hesitancy, breakthrough cases, and long-term health effects,” Dr Dipu TS, Associate Professor, Division of Infectious Diseases, Amrita Hospital, told ABP Live.


Vulnerable populations must be protected


Dr TS warned that it is crucial to remain vigilant, and protect vulnerable populations, especially the elderly and those with comorbidities because they are particularly prone to develop severe infections.


According to Dr Dhall, there is no need to panic. However, people should be very careful to ensure that the number of Covid-19 cases do not increase, and the government is not forced to announce a lockdown again, he said.


“Although XBB.1.16 is very infectious, it causes mild disease in most of the patients. Deaths and hospitalisations are miniscule. So, there is nothing to panic about. However, we should be careful because the variant can infect a large number of people in a very short period of time. So, Covid-appropriate behaviour is the need of the hour,” Dr Dhall said.


Covid-19 has reached an endemic stage in India


According to Dr Babina NM, Chief Medical officer, Jindal Naturecure Institute, Bangalore, the recent surge in Covid-19 cases is not a cause for concern because the disease has reached an “endemic” stage in India. 


“This means that it is consistently present with predictable rates of transmission, rather than an uncontrolled pandemic with skyrocketing transmission rates. The good news is that the severity of the Omicron subvariant XBB.1.16 is lower than other variants,” Dr NM said.


She also said that new strains of the virus are constantly emerging and becoming less severe.