Why is India staring at a ‘second peak’ of COVID cases?

New Delhi, India – On Friday, India reported nearly 40,000 coronavirus cases, the highest daily rise since November 29, amid fears of a “second peak” of the pandemic in the world’s third worst-hit country after the United States and Brazil.

India’s health ministry said 39,726 new COVID-19 cases were recorded across the country on Friday, taking the total tally to 11,514,331.

At least 154 virus-related deaths were reported in the last 24 hours, while the total number of fatalities stands at 159,370 since the disease erupted a year ago.

The western state of Maharashtra has led the spike in cases, accounting for 25,833 or 65 percent of the new infections, with India’s financial capital Mumbai logging 2,877 on Friday.

Punjab, Kerala, Karnataka, Gujarat and capital Delhi are other states that recorded the highest single-day surge since Thursday, according to government data.

For more than a week, the South Asian nation has reported at least 20,000 new infections daily, after cases began to drop in September last year.

What has caused the spike?

So what has caused the latest spike, which even Indian Prime Minister Narendra Modi referred to as the “second peak” of the coronavirus?

Experts say inadequate government measures and people not adhering to public health guidelines, such as wearing face masks and maintaining social distancing, were the main reasons for India’s upward tick in infections.

“The fact is we have been lax on both the fronts. Many people thinking the danger is past, particularly since early January, and believing that since the cases and deaths have come down, they could go around and participate in crowded events … [It] gave an opportunity for the virus to spread,” K Srinath Reddy, president of the Public Health Foundation of India, told Al Jazeera.

“In addition, there had been a number of political, social and religious events and elections for local bodies in multiple states and preparation for assembly elections in others – all of this has created an opportunity for the virus to move fast.”

Reddy said he never believed India had attained herd immunity against the virus, as suggested by some experts. He hoped that maintaining caution both at the level of public health enforcement as well as personal measures could avoid another alarming situation.

“We opened up everything quickly. People now are having parties, funerals, dancing etc. If we don’t act, things will go out of control,” said Lalit Kant, former head of the department of epidemiology at the Indian Council of Medical Research (ICMR).

“Some amount of complacency crept in from the government’s side as well.”

‘Second wave was expected’

Asked why states such as Maharashtra have recorded a massive spike in cases, Reddy said, “These are states with a very high level of economic activity and cities with high crowd density. So the moment you start resuming normal life in crowded conditions – long commutes in trains, working in crowded factories – you are giving an opportunity for the virus to spread.”

Dr Giridhara R Babu, a public health expert and epidemiologist, told Al Jazeera he is “not surprised” by the increase in COVID-19 infections across India.

“It’s not surprising. A second wave was expected but what is surprising is why some states are not getting it,” he said, adding that it could be because of “low testing and poor health infrastructure in other states”.

Dr Anant Bhan, a researcher in global health, bioethics and health policy, said the infections are not limited to a few states and could spread to others.

India’s health ministry on Thursday said 400 coronavirus patients in the country have been found to be affected with three mutant variants first detected in the United Kingdom, South Africa and Brazil. Of these,158 cases were reported in the last two weeks, it said.

“Either we have those variants coming over or we have our own domestic variants which have developed and are more contagious,” Bhan said.

Amid the spike in cases, several Indian cities announced measures, including night curfews and banning religious and political gatherings, to contain the spread of the disease.

India started its vaccination drive for healthcare and other front-line workers in late January, with more than 35 million doses of the vaccine administered so far.

Health experts, however, say the country needs to do more, given its huge population.

“The pace of vaccination is slow. India has a large population and only a small segment has been vaccinated so far,” said Lalit Kant, former head of the department of epidemiology at the Indian Council of Medical Research (ICMR).

“Vaccination is not the reason for the increase of cases, but we need to speed up the vaccination to have better control,” he added.

But experts are also insisting on people adhering to coronavirus guidelines and wearing face masks. “We must go back to the basics,” said Reddy.

Bhan said India must take serious measures to avoid another lockdown. “But if the cases kept rising, this [lockdown] could be a possibility.”