How Long Will The World Have To Wait For A Vaccine Against COVID-19? Experts Answer

How Long Will The World Have To Wait For A Vaccine Against COVID-19? Experts Answer

According to the experts, vaccine development is a complex process, there are various clinical trials and quality check; a vaccine against COVID-19 can be expected in 2021
Coronavirus Vaccine
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How Long Will The World Have To Wait For A Vaccine Against COVID-19? Experts AnswerCoronavirus outbreak: Three vaccine candidates have moved to the human trial stage
Highlights
  • A vaccine against COVID-19 should be ready in 12-18 months: Experts
  • The world has 70 vaccine candidates; three have moved to human trial stage
  • In the absence of COVID-19 vaccine, Delhi to begin trials of plasma therapy

New Delhi: On March 17, US National Institutes of Health (NIH) announced that a Phase 1 clinical trial evaluating an investigational vaccine designed to protect against coronavirus disease 2019 (COVID-19) has begun at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle. Though the trials for the vaccine called mRNA-1273 begin a month ago and raised hopes, it was clearly stated that it may take another year to 18 months before the vaccine becomes available. In India also six companies are working on a vaccine for COVID-19. Across the world, there are 70 vaccine candidates.

While some believe that a vaccine against COVID-19 will be available by September 2020 and some are of the opinion that nothing until 2021. NDTV spoke to experts to know about the status of the vaccine and understand the dynamics of developing a vaccine.

Also Read: Doctor’s Advice: Studies On BCG Vaccine’s Role In Preventing Coronavirus Not Yet Confirmed Through Trials

Speaking about by when we can expect a vaccine, Saad Omer, Director of the Yale Institute for Global Health (YIGH), said,

We have some really promising candidates for the vaccine but there is a lot of uncertainty. You don’t know how a vaccine will behave in the human population so it’s reasonable to expect something in 2021. There may be outliners that we get unexpected news. We should be realistic about our expectation specifically from a policy planning perspective.

Talking about the complex process of developing a vaccine and why can’t we expect a vaccine anytime soon, Dr Rommel Tickoo, Associate Director of Internal Medicine at Max Healthcare said,

Normally it takes 10-15 years to develop a vaccine and you need lots of funds for that but in this case, we are hopeful that it’ll take 1-1.5 years for us to develop a vaccine against COVID-19 because lots of researchers and scientists all over the world are working on it. Having said that, vaccine has its own stages of development like there is a pre-clinical stage, clinical stage which has phase 1, phase 2, phase 3 trials, regulatory review, approvals, manufacturing, and quality control. So, you have to go through all that. We also have to see how efficacious it is, the safety profile and how long will the immunity last. As of now, there are 70 vaccine candidates all over the world out of which three have moved to human trial stage. Two are from America which are in the first phase of trial and one is from China which is in the second phase of trial.

Also Read: Doctors, Healthcare Workers Deputed At COVID-19 Wards Share Their Challenges, Apprehensions As Crisis Deepens

The vaccine development will indeed take time and meanwhile, the Delhi government has announced the trials of plasma therapy. On Thursday (April 16), Delhi Chief Minister Arvind Kejriwal said the city has got the Centre’s approval to carry out clinical trials of plasma therapy to help critically ill coronavirus patients. The Chief Minister said,

Trial of Plasma Enrichment technique will begin in the next three or four days. If successful, we can save the lives of serious COVID-19 patients.

Also Read: Plasma Therapy Gives Positive Result In Delhi Hospital, Coronavirus Recovered People Can Become Donors

Plasma Therapy involves transfusion of plasma from a convalescent coronavirus patient to a critical patient. The blood of a convalescent patient is rich in antibodies that are expected to help the critical patient recover. Other countries like China, South Korea are also using this technique to save lives of people suffering from COVID-19.

Talking about whether or not India can depend on plasma therapy in the absence of a vaccine, Mr Omer said it’s promising but with a note of caution. He added,

There are two broad approaches of doing it – first, to throw the kitchen sink at the problem and try everything that exists; second, which seems to be happening with increasing frequency – which is to say, okay, these are the potential options based on the biology, based on the history from other infections, diseases and treatments and we are going to try out things systematically in trials, collect data, randomise people in certain situations. There can be non-randomised trials as well depending on the risk benefit calculus in a given situation and then we will improve our clinical practice. We will change our clinical repertoire based on those data. So using plasma has increasing evidence that’s been done the right way – generating evidence, quickly improving practice, broadening the use, looking at it again, so on and so forth.

Also Read: Stay Home, Stay Safe: In Andhra Pradesh’s Chittoor, Police Use Art To Create Awareness About Coronavirus

Sharing his opinion on plasma therapy and how successful it can be, Dr Guido Vanham, Virologist said,

Plasma therapy has been successfully used in Hepatitis B and unsuccessfully in HIV and Hepatitis C. There is data from china that about 30 per cent of people who have recovered do not develop neutralising anti-bodies that can block the virus. If that is the case, therapy will not be universally successful but you can expect 60-70 per cent success.

In Delhi, Max Hospital is the first one to perform plasma therapy and the results have been promising. Sharing the insights of the same, Dr Tickoo said,

Though the evidence is anecdotal, we need randomised large scale trials on this but again having said that, in Max, we used it on a patient on compassionate grounds called off-label indications. The family wanted us to do something to save the patient and anyway he was not doing well. After taking the family into confidence, taking consent, and considering ICMR guidelines, we sued plasma. The patient is doing well and we plan to wean him off the ventilator in the next few days but again we need more trials, there is a need for more evidence. Whatever evidence we have in this case, plasma has been used in the past as well with Ebola, Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). I think we can use it on compassionate grounds.

Also Read: The Decision To Lockdown India Was Taken Early And It Was Smart But Testing Needs To Scale Up: Expert On Country’s Fight Against Coronavirus

Further talking about whether India needs to ramp up testing, experts in unison nodded and said ‘yes’. Dr Omer believes that in order to control the spread of the virus, it was necessary to impose a lockdown but while we are in it, testing needs to be ramped up. He said,

Testing should be paired with mass contact tracing, early isolation and quarantine even if it’s at home. There is a possibility to ramp up testing within India to much more – may be not to the ideal level – but increase it especially during the period where you are buying social distancing.

Sharing the same thoughts, Dr Tickoo informed that ICMR is doing about 30,000 tests a day and plans to take the number to 1 lakh in next few weeks. He added,

ICMR is also doing rapid antibody test. Though it has its own limitations; it’s not a confirmatory test and can give false negatives in the first week. Also, since the last three days, the numbers are going down which is a good sign. With the lockdown, ramping up of the testing and healthcare facilities, and tracing the contacts and quarantining them, I think we will be able to contain it by the end of the month.

Also Read: With The Capacity To Accommodate 2000 Patients, Ahmedabad Creates The Largest COVID-19 Care Centre In The Country  

Countries like Italy have started releasing restrictions and lockdown. Sharing his views on whether it’s the right step especially at this juncture, Dr Guido Vanham said,

It depends on how fast and in what way restrictions are removed. We have to maintain certain number of measures to slow down and mitigate the pandemic. The main thing is social distancing and hand hygiene – washing hands with soap. Tests are not 100 per cent sensitive. There are a lot of asymptomatic people that can spread the disease.

Dr Vanhma also noted that the infectious disease will stay with the world for a long time and meanwhile regular handwashing and social distancing might become the normal thing. COVID-19 might turn out to be a seasonal issue but we don’t know yet.

With India under a lockdown, new cases and stories of the spread of the virus are turning up. Like on Thursday (April 16), in Delhi, a food delivery guy was tested COVID-19 positive following which 72 families have been quarantined. The case raises a safety concern especially when ordering food and groceries online. Taking about whether it’s safe to receive a package or order food online, Dr Tickoo said,

Yes, it’s okay to receive food but we have to take precautions like clean the outer surface of whatever package we are receiving, wear a mask, and maintain distance while accepting the package. In the case of food, warm it which will kill the virus. Simultaneously, employers should screen their employees.

Also Read: Stepping Out For Work Each Day, ‘Corona Warriors’ Maintain Isolation At Home

World

11,34,05,654Cases
4,69,42,202Active
6,39,46,277Recovered
25,17,175Deaths
Coronavirus has spread to 192 countries. The total confirmed cases worldwide are 11,34,05,654 and 25,17,175 have died; 4,69,42,202 are active cases and 6,39,46,277 have recovered as on February 27, 2021 at 4:03 am.

India

1,10,79,979 16488Cases
1,59,590 3604Active
1,07,63,451 12771Recovered
1,56,938 113Deaths
In India, there are 1,10,79,979 confirmed cases including 1,56,938 deaths. The number of active cases is 1,59,590 and 1,07,63,451 have recovered as on February 27, 2021 at 2:30 am.

State & District Details

State Cases Active Recovered Deaths
DistrictCases
Mumbai45,478
Thane13,660
Pune9,920
Mumbai Suburban5,363
Aurangabad1,974
Nashik1,575
Raigad1,462
Palghar1,421
Solapur1,291
Jalgaon1,039
Akola757
Nagpur692
Kolhapur646
Satara629
Ratnagiri350
Amravati291
Dhule228
Hingoli208
Jalna201
Ahmednagar190
Nanded176
Yavatmal150
Sangli145
Latur139
Osmanabad125
Sindhudurg114
Buldhana88
Parbhani78
gondia69
Beed54
Nandurbar42
Gadchiroli42
Bhandara41
Chandrapur32
Washim13
Wardha11

21,38,154 8,333

68,810 3,349

20,17,303 4,936

52,041 48

DistrictCases
Kannur357
Kasaragod333
Palakkad224
Malappuram119
Kollam118
Thrissur106
Thiruvananthapuram104
Pathanamthitta98
Kozhikode90
Alappuzha76
Kottayam73
Ernakulam60
Idukki40
Wayanad36

10,52,357 3,671

51,679 485

9,96,514 4,142

4,164 14

DistrictCases
Udupi1,176
Kalaburagi669
Yadgir538
Bengaluru Urban529
Raichur369
Mandya346
Belagavi337
Bidar219
Hassan205
Davangere204
Vijayapura201
Dakshina Kannada179
Chikkaballapura149
Mysuru107
Bagalkote103
Uttara Kannada95
Shivamogga67
Dharwad61
Ballari60
Gadag45
Bengaluru Rural40
Tumakuru36
Kolar29
Haveri24
Chikkamagaluru19
Chitradurga14
Koppal5
Kodagu4
Ramanagara3
Chamarajanagara0

9,50,207 571

5,520 75

9,32,367 642

12,320 4

DistrictCases
Kurnool795
Krishna557
Guntur511
Anantapur428
East Godavari356
Chittoor319
Sri Potti Sriramulu Nell*296
Y.S.R.205
West Godavari199
Srikakulam183
Prakasam104
Visakhapatnam103
Vizianagaram23

8,89,681 96

635 24

8,81,877 71

7,169 1

DistrictCases
Chennai23,324
Chengalpattu1,314
Thiruvallur774
Villupuram509
Kanchipuram503
Tiruvannamalai496
Cuddalore477
Ariyalur444
Tirunelveli433
Tuticorin333
Kallakurichi324
Madurai322
Salem258
Coimbatore188
Virudhunagar185
Dindigul175
Perambalur133
Ranipet133
Thanjavur130
Theni129
Tiruchirappalli119
Ramanathapuram119
Tiruppur116
Kanniyakumari110
Tenkasi103
Nagapattinam99
Karur88
Namakkal83
Erode75
Vellore71
Thiruvarur67
Pudukkottai53
Sivaganga46
Tirupathur45
Krishnagiri43
The Nilgiris17
Dharmapuri15

8,50,577 481

4,046 7

8,34,043 483

12,488 5

DistrictCases
North West5,463
Central4,817
West4,768
New Delhi3,405
North3,059
East2,472
South East2,446
South West2,391
South2,329
North East1,914
Shahdara1,580

6,38,849 256

1,231 62

6,26,712 193

10,906 1

DistrictCases
Gautam Buddha Nagar1,119
Agra933
Ghaziabad794
Meerut504
Lucknow386
Saharanpur298
Kanpur Nagar286
Moradabad252
Varanasi243
Hapur225
Aligarh215
Basti214
Amethi206
Rampur203
Jaunpur194
Firozabad190
Barabanki168
Gorakhpur166
Bulandshahr166
Siddharth Nagar159
Ghazipur159
Bijnor157
Deoria143
Azamgarh138
Sant Kabeer Nagar132
Mathura129
Ayodhya120
Muzaffarnagar117
Sambhal116
Sultanpur97
Ambedkar Nagar92
Maharajganj85
Amroha80
Rae Bareli78
Bahraich73
Kheri72
Kannauj69
Baghpat68
Kushi Nagar67
Bhadohi60
Ballia60
Gonda59
Etah52
Hardoi49
Balrampur49
Mau48
Mainpuri46
Etawah46
Hathras43
Unnao42
Jalaun41
Jhansi41
Shamli40
Chandauli38
Auraiya37
Farrukhabad36
Sitapur32
Prayagraj30
Banda27
Shahjahanpur25
Shravasti23
Budaun23
Mirzapur22
Bareilly17
Kasganj16
Pratapgarh15
Pilibhit15
Sonbhadra10
Kaushambi6
Kanpur Dehat4
Chitrakoot4
Lalitpur3
Hamirpur3
Mahoba3
Fatehpur3

6,03,350 118

2,184 2

5,92,441 114

8,725 2

DistrictCases
Kolkata2,777
Howrah1,435
24 Paraganas North1,031
Hooghly604
24 Paraganas South281
Maldah235
Dinajpur Uttar216
Coochbehar210
Birbhum206
Medinipur West159
Medinipur East153
Nadia139
Purba Bardhaman130
Murshidabad125
Bankura116
Darjeeling97
Jalpaiguri88
Paschim Bardhaman70
Purulia66
Dinajpur Dakshin50
Alipurduar39
Kalimpong18
Jhargram9

5,74,716 216

3,343 10

5,61,110 223

10,263 3

DistrictCases
Ganjam581
Jajapur322
Khordha238
Baleshwar190
Kendrapara164
Cuttack155
Bhadrak137
Balangir129
Puri103
Sundargarh102
Jagatsinghapur91
Nayagarh86
Mayurbhanj73
Nuapada69
Gajapati61
Dhenkanal36
Boudh34
Kendujhar34
Deogarh33
Kalahandi33
Sonepur29
Kandhamal28
Anugul26
Malkangiri20
Bargarh16
Koraput16
Sambalpur16
Jharsuguda8
Nabarangpur2
Rayagada2

3,37,018 94

640 31

3,34,463 63

1,915

DistrictCases
Jaipur2,177
Jodhpur1,748
Udaipur724
Bharatpur563
Kota503
Nagaur500
Ajmer379
Dungarpur374
Pali352
Jhalawar329
Bhilwara250
Sikar231
Chittorgarh188
Tonk171
Jalore164
Rajsamand140
Sirohi130
Bikaner112
Banswara91
Alwar90
Churu81
Jhunjhunu64
Dausa61
Dholpur60
Baran59
Jaisalmer53
Barmer34
Hanumangarh31
SawaiMadhopur26
Karauli17
Pratapgarh14
Ganganagar8
Bundi5

3,20,078 149

1,231 23

3,16,061 125

2,786 1

DistrictCases
Bilaspur100
Korba100
Mungeli87
Baloda Bazar85
Jashpur77
Janjgir-Champa56
Mahasamund54
Rajnandgaon52
Kabirdham52
Raigarh47
Raipur46
Balod41
Korea39
Durg31
Bemetara21
Kanker19
Balrampur17
Surguja14
Gariyaband10
Surajpur9
Dhamtari6
Bijapur2
Bastar2
Dantewada0
Kondagaon0
Narayanpur0
Sukma0

3,12,179 279

2,827 38

3,05,524 310

3,828 7

DistrictCases
Hyderabad2,475
Ranga Reddy183
Suryapet87
Jagitial77
Nizamabad76
MedchalMalkajgiri75
Mancherial43
YadadriBhuvanagiri40
Jogulamba Gadwal40
Vikarabad40
Nalgonda33
Warangal Urban32
Mahabubnagar30
Sangareddy26
Khammam26
Adilabad22
Nirmal21
Karimnagar17
RajannaSircilla16
Medak11
Kamareddy11
Mahabubabad10
Jayashankar Bhupalapally9
Nagarkurnool8
Kumuram Bheem Asifabad8
Jangoan8
Siddipet7
Peddapalli5
Bhadradri Kothagudem5
Warangal Rural4
Mulugu3
Narayanpet3
Wanaparthy1

2,98,631 178

1,939 29

2,95,059 148

1,633 1

DistrictCases
Gurugram2,950
Faridabad867
Sonipat404
Rohtak145
Palwal120
Jhajjar114
Karnal104
Hisar98
Ambala93
Panipat78
Nuh68
Bhiwani60
Rewari56
Kurukshetra55
Sirsa50
Kaithal48
Mahendragarh47
CharkiDadri43
Panchkula39
Fatehabad38
Jind38
Yamunanagar19

2,70,411 148

1,103 49

2,66,264 98

3,044 1

DistrictCases
Ahmadabad17,125
Surat2,311
Vadodara1,555
Gandhinagar410
Mahesana159
Banas Kantha147
Bhavnagar146
Rajkot135
Arvalli134
Mahisagar125
Anand107
PanchMahals107
Patan105
SabarKantha101
Kachchh99
Kheda98
Jamnagar63
Bharuch56
Botad55
Surendranagar55
Valsad47
GirSomnath45
Dohad43
Chhotaudepur37
Naysari35
Junagadh31
Narmada25
DevbhumiDwarka22
Amreli16
Porbandar11
Tapi6
Dang5
Morbi4

2,69,031 460

2,136 145

2,62,487 315

4,408

DistrictCases
Patna279
Bhagalpur266
Rohtas256
Khagaria253
Begusarai243
Madhubani199
Munger188
Jehanabad178
Katihar175
Darbhanga143
Samastipur139
Siwan139
PurbiChamparan138
Purnia135
Banka134
Buxar134
Nalanda123
Gopalganj123
Nawada122
Sheikhpura118
Gaya115
Kaimur (bhabua)105
Bhojpur103
Saran101
Muzaffarpur96
Saharsa88
Supaul87
Vaishali87
Madhepura82
Kishanganj75
Aurangabad75
Sitamarhi73
Lakhisarai72
Araria68
Pashchim Champaran57
Arwal52
Jamui47
Sheohar20

2,62,464 46

431 47

2,60,493 92

1,540 1

DistrictCases
Indore3,839
Bhopal1,880
Ujjain799
Burhanpur351
Neemuch319
Jabalpur276
East Nimar266
Sagar228
Gwalior211
Khargone196
Dewas140
Dhar132
Mandsaur112
Morena109
Bhind87
Raisen71
Barwani60
Ratlam51
Rewa39
Shajapur39
Hoshangabad37
Vidisha37
Chhatarpur35
Betul35
Rajgarh31
Dindori29
Sheopur26
Damoh26
Satna24
Anuppur22
Panna20
Tikamgarh18
Sidhi17
Narsinghpur17
Chhindwara16
Agar Malwa15
Mandla15
Shivpuri15
Jhabua14
Shandol14
Singrauli13
Ashoknagar13
Datia12
Sehore12
Umaria10
Balaghat9
Guna8
Harda4
Alirajpur3
Katni3
Seoni2
Niwari0

2,61,013 332

2,518 83

2,54,633 246

3,862 3

DistrictCases
Kamrup Metro276
Golaghat203
Nagaon143
Hojai89
Dima Hasao86
Karimganj85
Tinsukia84
Cachar80
Dibrugarh61
Hailakandi57
Lakhimpur57
Marigaon50
Dhemaji47
Kamrup42
Kokrajhar37
Dhubri30
Charaideo29
Barpeta28
Udalguri28
Sonitpur27
Jorhat24
Nalbari23
Darrang20
Sivasagar20
Goalpara19
Biswanath16
Baksa14
KarbiAnglong13
Bongaigaon12
Chirang6
West KarbiAnglong5
South SalmaraMancachar4
Majuli2

2,17,518 34

1,634 11

2,14,792 22

1,092 1

DistrictCases
Amritsar485
Jalandhar297
Ludhiana293
Tarn Taran163
Gurdaspur154
Hoshiarpur140
S.A.S Nagar137
Patiala132
Sangrur107
Shahid Bhagat Singh Nagar (Nawanshahr)99
Pathankot86
Rupnagar (Ropar)74
Faridkot74
Sri Muktsar Sahib71
Moga65
Bathinda60
Fatehgarh Sahib57
Fazilka53
Firozepur50
Kapurthala44
Mansa31
Barnala25

1,81,004 622

4,222 352

1,70,968 255

5,814 15

DistrictCases
Anantnag395
Srinagar300
Kulgam295
Baramulla271
Shopian255
Kupwara231
Bandipora175
Udhampur155
Ramban151
Jammu138
Budgam110
Pulwama108
Kathua53
Rajouri39
Ganderbal37
Poonch35
Doda27
Reasi26
Samba25
Kishtwar10
Mirpur0
Muzaffarabad0

1,26,286 85

803 17

1,23,527 101

1,956 1

DistrictCases
East Singhbum170
Ranchi148
Hazaribagh110
Garhwa80
Ramgarh75
Koderma58
Simdega48
Dhanbad32
Gumla28
Palamu27
West Singhbhum21
SaraikelaKharsawan20
Giridih19
Bokaro16
Latehar14
Khunti10
Lohardaga8
Deoghar5
Dumka5
Pakur4
Jamtara2
Godda2
Chatra1
Sahebganj0

1,19,863 68

492 25

1,18,284 43

1,087

DistrictCases
Dehradun370
Nainital323
Tehri Garhwal110
Haridwar94
Udam Singh Nagar83
Almora71
Champawat45
Pithoragarh43
Chamoli36
PauriGarhwal36
Bageshwar31
Rudraprayag30
Uttar Kashi24

97,031

490 1

94,850

1,691 1

DistrictCases
Hamirpur117
Kangra105
Una41
Solan32
Chamba29
Bilaspur21
Mandi21
Sirmaur11
Shimla10
Kullu4
Kinnaur2
Lahaul And Spiti0

58,543 44

261 17

57,287 27

995

DistrictCases
South Goa69
North Goa57

54,871 100

587 56

53,490 41

794 3

DistrictCases
Pondicherry111
Mahe4
Karaikal2
Yanam0

39,697 20

194 2

38,836 22

667

DistrictCases
Dhalai196
Sepahijala174
Gomati74
South Tripura53
Unakoti49
West Tripura45
Khowai24
North Tripura14

33,407

32 0

32,984

391

DistrictCases
Churachandpur32
Kangpokpi26
Imphal West21
Thoubal18
Imphal East10
Tengnoupal9
Bishnupur7
Senapati6
Chandel5
Kamjong5
Ukhrul4
Jiribam3
Pherzawl3
Kakching2
Tamenglong2
Noney1

29,260 7

37 3

28,850 10

373

DistrictCases
Chandigarh313

21,659 69

322 43

20,986 26

351

DistrictCases
Changlang31
Papum Pare8
Lohit3
Namsai2
West Siang1
East Siang1
Upper Siang1
Tawang1
PakkeKessang1
West Kameng0
Upper Subansiri0
Tirap0
Siang0
Shi Yomi0
Anjaw0
Lower Subansiri0
Lower Dibang Valley0
Longding0
Leparada0
KurungKumey0
KraDaadi0
Kamle0
East Kameng0
Dibang Valley0
Lower Siang0

16,836

3 0

16,777

56

DistrictCases
East Khasi Hills22
West Garo Hills5
South West Garo Hills4
North Garo Hills1
West Jaintia Hills1
West Khasi Hills1
East Garo Hills0
East Jaintia Hills0
Ribhoi0
South Garo Hills0
South West Khasi Hills0

13,961

19 1

13,794 1

148

DistrictCases
Dimapur20
Mon8
Kohima7
Kiphire3
Tuensang3
Peren2
Phek1
Longleng0
Mokokchung0
Wokha0
Zunheboto0

12,198

9 4

12,098 4

91

DistrictCases
Kargil77
LehLadakh43

9,816 2

54 2

9,632 4

130

DistrictCases
East District3
South District3
North District0
West District0

6,135 2

45 2

5,955

135

DistrictCases
South Andamans33
Nicobars1
North And Middle Andaman1

5,017 1

3 1

4,952

62

DistrictCases
Kolasib11
Aizawl10
Mamit8
Lawngtlai2
Lunglei2
Saitual1
Champhai0
Hnahthial0
Khawzawl0
Saiha0
Serchhip0

4,422 3

26 1

4,386 4

10

DistrictCases
Dadra And Nagar Haveli20

3,406 1

4 1

3,400 2

2

DistrictCases
Lakshadweep District0

333 2

80 6

252 8

1

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