COVID Re-infection: 63% of Indians surveyed have had symptomatic COVID; 22% have had it multiple times; In 20% of cases the subsequent infection was more severe or persisting

September 1, 2023, New Delhi: Threat of a new COVID variant BA.2.86, nicknamed Pirola, is making waves in several countries across the globe including the USA, UK and China, making more people infected. The new COVID risk is a reminder that compliance to COVID norms must continue when people around us are unwell as the risk of getting re-infected is still there after having recovered from one or more previous infections. Despite most infected people recovering from COVID, there are still many who are yet to fully recover or have developed new health problems.

Although conventional wisdom held that most people would retain a certain level of protection against reinfection if they were vaccinated or had retained some level of natural immunity due to a recent contraction of the virus, this was not proven to be the case post the arrival of Omicron in December 2021. Health experts are also concerned about the possible long-term impact of the COVID infection on various organs of the body and new health conditions like Blood Pressure, Diabetes, Sleep Apnea, Liver Cirrhosis being reported in some individuals. Emerging evidence also suggests that Covid can trigger the auto-immune disorder in some individuals which can lead to vascular deterioration.

With almost zero compliance to COVID norms like masking and social distancing, Indians have practically given up on COVID compliance. Even the school children, who was the most compliant of all in the population till mid 2022 have given up on following norms and many of them have been falling sick to COVID and other viral illnesses far too frequently as compared to pre-COVID. As a nation, we do not fear COVID infection or re-infection anymore but the question that some of the immunologists are raising is “What if every COVID re-infection is wiping our T-cells and lowering our immunity to fight COVID and other viral illnesses?”

To understand COVID re-infection and its impact a little better, LocalCircles reached out to citizens across the country to know from them firsthand about their experience with COVID in the past 4 years. The survey received over 32,000 responses from citizens located in 319 districts of India. 67% were men while 33% respondents were women. 43% respondents were from tier 1, 36% from tier 2 and 21% respondents were from tier 3, 4 & rural districts.

63% of respondents confirmed having got the COVID infection once or more; and 22% confirmed being impacted with multiple infections

The survey first sought to know the magnitude of COVID reinfections. It asked respondents, “How many times have you been infected with COVID in the last 40 months?” The query received 11,682 responses 63% confirming having got the infection once or more; and 22% confirmed being impacted with multiple infections. It must also be noted that these are only instances of symptomatic COVID infections or cases when someone got tested due to a family member being impacted or travel reasons. The survey findings show that 34% of respondents got COVID once; 11% got it twice, 7% got it 3 times; 2% got it 4 times and another 2% got COVID 5 times or more. In addition, 7% indicated that though they have had COVID like symptoms, “but never tested so don’t know”; while 5% stated that they have “been lucky” despite some others in the family having got COVID and 32% of respondents stated “not been infected till date”. At an aggregate level, 63% of the respondents indicated being infected with the virus once or more in the last 4 years.

Of the people surveyed who had COVID infection multiple times, a quarter of them had it in 2022 and again in 2023

While COVID started in 2020 with the alpha variant followed by the beta and the severe delta variant in 2021, majority of the population in India did not actually get infected till Omicron arrived in late 2021 into 2022. The next survey question sought to understand in which year did people get infected and re-infected with COVID. It asked respondents, “If you had multiple COVID infections, what were the years in which you got them?” This survey question received 10,727 responses with 27% in indicating 2022 and 2023 the latest spell; 25% in in 2021 and 2022; and 20% indicated in 2020 and 2022. In addition, 7% of the respondents indicated two bouts of COVID in 2021 and 2023; 7% had three bouts of infection in 2021, 2022, and 2023; another 7% had it in 2020, 2022 and currently in 2023; there is another group of 7% who had COVID multiple times in 2022. In all, of the people surveyed on LocalCircles platform who had COVID infection multiple times, a quarter of them had it in 2022 and again in 2023.

Of those who have had COVID till date, 46% of the respondents claim to have been infected in 2023

Analyzing the data of those who got COVID infections multiple times, 93% had it in 2022 or the third wave; 48% of respondents had it in 2021; In 2020 when it was first detected in India 27% of the respondents got the infection and in the current year 46% of respondents claim to have already been infected. It must be noted here that a large majority of people are not getting RT-PCR tests done to validate COVID and hence these numbers are not reflected in any State or Central Government reported COVID positive data. Government data has been reporting that India has less than 100 cases a day for several months now.

20% of respondents who had COVID multiple times had a severe, persisting or long COVID infection during the re-infection

The survey then sought to know from people who have been infected with COVID multiple times, “the severity of the infection”. A severe infection is defined as one that causes severe symptoms or persisting long COVID conditions. This query received 10,571 responses with 15% of respondents sharing that the first bout of Covid was severe for them, while 2nd and subsequent bouts were mild; 5% shared that the 1st bout was severe so also were the second and subsequent infections; 25% had a mild spell in the first and all subsequent bouts; 20% indicated that while the first infection was mild, the second and subsequent bouts were severe; In addition 35% of the respondents stated “can’t say”. Of those surveyed, who had had multiple rounds of COVID infections, 20% had a severe, persisting or long COVID post their experiencing mild infection the first time and for 5% the severity was similar in the following infections of COVID. The findings indicate that for 1 in 4 having a repeat infection meant similar or higher severity in the subsequent infection and not reduced severity. It must also be noted that this finding is despite many calling Omicron a milder version of COVID as compared to the alpha, beta and delta variants.

In summary, the survey finds that 63% of the citizens have had one or more COVID infections since 2020 and 22% of them have been impacted with multiple infections. It also learns that 2022 was the year when highest number of Indians contracted COVID followed by 2021 when Beta and Delta variant were active till mid 2021 followed by Omicron which arrived in Dec 2021. It is also noteworthy that of those who have had COVID, 46% of them have stated that they have already contracted it in the first 8 months of the year indicating that while official Government data doesn’t reflect the spread of the COVID virus due to near zero RT-PCR testing, people are still getting infected with it. The survey also learned that re-infection isn’t necessarily milder or has lower risk. 20% of the respondents in the survey explicitly indicated that their second or subsequent infection was more severe than the first one and 5% indicated that it was as severe as the first one. It must also be noted that this is just the short-term experience of people, without really understanding the implications of repeat COVID infections in the medium to long term. As new COVID variants like BA.2.86 with over 35 mutations rise around the world, the wise thing to do is to follow COVID norms and protect oneself from a COVID re-infection. However, with no Government mandates on COVID compliance, no real case data and almost all writing off COVID and its impact, it is going to be a lot harder than it has been ever before.