NANDKUMAR M. KAMAT
On March 29, 2020, Goa recorded its first SARS-CoV-2 fatality. Six years on, this anniversary demands a scientifically honest chronological reckoning — from that first death through the closure of the state’s COVID-19 dashboard in October 2024, and forward to the threats now assembling on the horizon.
As someone who warned the Government of Goa on January 7, 2020 about the new Coronavirus and within just 21 days of hospitalised cases in Wuhan, China, my mind goes back to the virology class I took in December 2019 for my M.Sc. students at the Goa University for whom virology was just 20% of their plant microbiology and pathology credit course. I informed them about a suspected outbreak of new viral disease in China and how it could spread. At that moment the students didn’t believe me, but as the situation worsened, they agreed to create a WhatsApp group with 24 M.Sc. students on the new virus. It was created on February 1, 2020, and was one of the first such dedicated groups on COVID-19 in Goa, India, and the world. It is still active today. Due to a flood of information, they created another group exclusively for Goa on March 14, 2020, which is also active. The first group had 2,000 posts, and the second, 1,100, over the past six years.
Since even after they completed their post-graduation the students (2019-2021 batch) didn’t leave their groups I dedicate this article to the members and moderators Asma Kidiyoor, Samantha Pinto, Siddhi Parab, Alria Fernandes, Archana Shirodkar, Diksha Gaonkar, Disha Barreto, Kalpita Gaonker, Krutika Mardilkar, Lizen Gomes, Namrata Achari, Nutan Gaonkar, Pranjali Gaonkar, Prerna Naik, Saishree, Savita Koli, Sneha Shirodkar, Sonu Malik, Sunita Sharma, Sweta Haldankar, Teja Divkar, Teja Murgodi, and Vrunda Gaude. They helped thousands of people in Goa by transmitting valuable information during the three waves -alpha, delta,
and Omicron.
Goa’s relationship with epidemic disease is neither new nor unfamiliar. For over three centuries, the territory endured waves of cholera, smallpox, plague, influenza, dysentery, typhoid, and meningitis, each carving demographic scars across its talukas. Cholera was the most relentless, striking repeatedly from 1670 through 1933 — in 1777, 1818, 1845, 1849, 1854, 1857, 1869, 1870, 1878, 1882, 1883, 1884, 1887, 1892, 1921, 1924, 1928 and 1933 — consistently peaking during monsoon months and devastating Salcete, Bardez, Ilhas, Ponda, Quepem, and Sanguem with grim regularity. Smallpox was scarcely less persistent, erupting in 1705, 1825, 1836, 1856, 1882–83, 1888, 1893, 1919, 1921, 1924, 1925–26, 1927, 1933, and 1941, with the 1925–26 outbreak consuming all of Goa. Plague claimed Panaji and Ilhas repeatedly between 1919 and 1930. Influenza, coinciding with the global Spanish Flu in 1918, swept through Bardez, Salcete, and beyond. Meningitis and dysentery punctuated the early 20th century.
But the SARS-CoV-2 pandemic was categorically different from all that came before: a beta coronavirus with no prior population immunity, amplified globally by air travel within weeks of emerging in Wuhan, and arriving in Goa on March 25, 2020 through three international travellers. Four days later came the first death. The state briefly declared itself COVID-free, only for the virus to return in mid-May 2020 via the Maharashtra border. The first wave, driven by the ancestral lineage, was contained by aggressive testing and quarantine. By August 2020, cumulative cases had crossed 10,000 with 91 deaths. Goa’s cumulative case fatality rate of 1.32% and 358 deaths per million population at this stage were already among the worst in India.
The second wave began between February 23 and March 1, 2021, triggered by the Delta variant B.1.617.2 entering through open borders and seeded by Carnival celebrations the government had permitted despite active community transmission. Active cases rose from 464 on February 22 to 6,643 on April 18, — a 1,400% increase in under two months. April 2021 alone recorded 338 deaths. The peak of the second wave was identifiable on May 13, 2021, just 74 days from onset, less than half the duration of the first wave’s ascent — consistent with Delta’s substantially higher transmissibility.
The most morally consequential episode of Goa’s entire pandemic history occurred between May 11 and 16, 2021 at Goa Medical College and Hospital in Bambolim. Approximately 75 to 80 patients died over five days following the collapse of the medical oxygen supply — corroded pipelines, failed procurement logistics, and institutional denial combining into a preventable mass casualty event. Throughout this period, the Goa government compounded the surveillance crisis by combining RT-PCR, TrueNat, and Rapid Antigen test results into a single daily total, inflating apparent testing numbers and distorting the real TPR. RT-PCR detects live viral RNA; Rapid Antigen tests detect antibodies from past infection. They measure fundamentally different things and cannot be combined.
The third wave, driven by the Omicron BA.1 variant, arrived as predicted in January 2022. Its epidemiological character was distinct: case counts briefly surpassed those of any previous wave, but hospitalisation rates and case fatality were substantially lower, reflecting the variant’s tropism for upper respiratory epithelium, accumulated hybrid immunity from prior infection and vaccination, and the protective effect of Covishield and Covaxin, progressively administered since January 2021. By February 2022, the acute Omicron wave had resolved. By August 2022, Goa’s confirmed cumulative death toll stood at 3,955 against 253,336 confirmed cases and over 2,030,000 tests conducted. From mid-2022 through 2024, successive Omicron sublineages circulated globally and in India with diminishing lethality. BA.2 and BA.5 dominated through 2022, producing mild surges.
The recombinant XBB lineage and its descendant XBB.1.16 drove a fourth wave across India in early 2023, prompting Prime Minister Modi to convene a national preparedness review in March 2023 as active cases reached a five-month high. In Goa, intermittent spikes in TPR and active cases were recorded through this period, though deaths remained low. The highly immune-evasive BA.2.86 derivative JN.1 emerged globally in late 2023, becoming dominant through December 2023 and January 2024 and associated with a notable increase in cases, though not in severe mortality. The FLiRT variants KP.2 and KP.3 followed in mid-2024. Each successive sublineage demonstrated greater immune evasion while retaining reduced intrinsic virulence compared to Delta, a pattern reflecting ongoing co-evolutionary adaptation between SARS-CoV-2 and a globally immunised human population. In Goa, the Directorate of Health Services continued issuing periodic bulletins through 2023 and into 2024. The COVID-19 dashboard was shut down in October 2024.
SARS-CoV-2 continues to circulate, reinfect, and cause morbidity in elderly and immunocompromised populations. No formal excess mortality analysis covering the full pandemic period, 2020 to 2024, has been published for Goa. No systematic post-COVID condition surveillance exists in the state. No dedicated post-COVID clinics have been established to manage the estimated tens of thousands of Goans who may be experiencing Post-Acute Sequelae of SARS-CoV-2 infection, characterised by persistent fatigue, cognitive impairment, dyspnoea, and autonomic dysfunction lasting months to years after the acute infection.
The 3,955 Goans whose deaths are recorded in the official tally — and the larger uncounted toll in excess mortality and Long COVID burden — deserve not a closed dashboard but a permanent memorial in the form of a functional, honest, and science-driven public health surveillance system. The next pandemic, in all probability wearing the face of an influenza virus with catastrophic case fatality potential, will not announce itself with the six weeks of warning that SARS-CoV-2 afforded in early 2020.
Science-based memory is not morbid retrospection. It is the only rational foundation for pandemic preparedness. Goa has had six years to build that foundation. The work
remains unfinished.
