How India allowed the virus to overwhelm its population

Deadly and rapid second wave of coronavirus pandemic has brought India’s healthcare systems to the brink of collapse and it endangers millions of lives and livelihoods.

On Sunday and Monday, the country recorded more than 270,000 and 259,000 cases of COVID-19, respectively, a staggering increase from the 11,000 daily cases in the second week of February. Reported coronavirus infections have risen from nearly 20,000 per day in mid-March to more than 200,000 in mid-April.

Newspapers and social media testify to the horror and failure of the health care system. There are reports of ambulance queues with patients waiting to enter the largest COVID center in Ahmedabad, western Gujarat, because beds with ventilators and oxygen have run out.

In the northern city of Lucknow on Friday, Vinay Srivastava, a 65-year-old journalist, shared his declining oxygen levels on Twitter and called on government officials for help. Overworked hospitals and laboratories did not accept calls from her family. Srivastava’s latest tweet described his oxygen saturation level at 52%, well below the 95% considered normal. Nobody helped him. Passed away saturday.

At a crematorium in the central town of Bhopal, residents reported that they had not seen so many cremations since 1984, when a gas leak from a Union Carbide pesticide plant in the town killed nearly 5,000 people. At around 11 a.m. on Tuesday in Delhi, the country’s capital with more than eighteen million inhabitants, only 40 intensive care unit beds were available for COVID-19 patients.

In India, a total of 15.3 million cases of coronavirus have been recorded so far, with 180,000 deaths. A survey funded by the government’s leading medical research agency indicated that there were around 30 infections corresponding to each reported case.

Most of the reports of the collapse of the health care system come from major Indian cities. Little is known about the devastation in rural India, where about 70% of India’s 1.3 billion people live and where there are far fewer hospital beds and medical staff. Federal officials have acknowledged that the pandemic is moving through small towns and rural areas.

How did things change so drastically between March and April?

India’s rapid fall into this unprecedented crisis is a direct result of government complacency and lack of preparedness. When the number of cases dropped dramatically in mid-February, the Indian government and several policymakers, encouraged by the docile and triumphant media, prematurely declared victory against the pandemic. In early March, senior government ministers spoke of the end of the pandemic in India.

Cricket matches were allowed in which tens of thousands of spectators filled the stadiums and cinemas were opened. The government has done nothing to prevent huge religious gatherings such as the Kumbh Mela, a festival held in Haridwar, in the northern state of Uttarakhand, where millions of Hindus gather to bathe in the Ganges. .. Unsurprisingly, cases of COVID-19 in Haridwar have exploded.

In India, elections were held in five states in different phases over a month. And one of the most intense political competitions has taken place in West Bengal, where elections are held in eight phases between late March and late April. Despite the increase in cases, many public rallies have taken place, with tens of thousands of people crowded without masks. Although precise data on the correlation between the political campaign and the peak of COVID-19 is not available, the number of cases in West Bengal increased tenfold from the beginning to mid-April, which is equivalent to several times the rates of infection of the crowded cities of Bombay and New Delhi.

Massive political, religious and sporting events, widely covered by Indian media, have sent mixed messages about the severity of the pandemic.. The popular impatience to return to the old life made matters worse. The Indians began to mix widely and downplay the threat, also because there is an unfounded feeling among large numbers of Indians that exposure to contamination and germs had given them superior immunity.

It was inevitable that the virus would wreak havoc again. Indians have been found to be just as susceptible to COVID-19 as everyone else. I was one of the researchers in the world’s largest COVID-19 contact tracing study last year, which involved more than 660,000 people in two southern Indian states. We found that the early lockdown – started when there were less than a thousand recorded cases – kept the virus under control.

The risk of getting infected from exposure to sick people with coronavirus is no different in India. The proportion of people who die after being diagnosed with COVID-19 is lower in India than in many other countries. However, this is simply because 65% of Indians are under 35 years old.

Indians with COVID-19 aged 40 to 70 were more likely to die in India due to the high prevalence of comorbidities such as hypertension, diabetes and respiratory disorders. COVID-19 patients in our 40-year-old study in India were twice as likely to die as COVID-19 patients in the corresponding age group in the United States. The rate was 75% higher in India than in the United States when we compared 50-year-old patients.

The first wave of Covid was concentrated in poor urban areas, from where it spread to rural population centers. Although we do not have concrete data on the socio-economic situation of those infected during the second wave, the cases now appear to have reached the middle and rural class of India.

Many Indian states, such as Delhi and Maharashtra, have different levels of lockdowns and curfews in place. The vaccination campaign in India is threatened by a shortage of supplies. As of Tuesday, despite the extension of the possibility of being vaccinated to those over 45, only 1.3% of the Indian population had been fully vaccinated against COVID-19.

The vaccination rate dropped last week and has even been halted in some states due to lack of supplies. At the current rate of vaccination, it will take until the end of 2022 to fully immunize 70 percent of India’s population, the approximate level needed to achieve community immunity.. India is in urgent need of investment to increase its vaccine production capacity to over 12 million daily doses. If the country succeeds, it will be able to immunize 70 percent of its population in six months.

Finally, there is the uncertainty that the new variants introduce and, with them, the risk of reinfection, which might not be stopped by vaccines. There is anecdotal evidence that the new wave of COVID-19 cases in India is attacking a younger population, including children, and leading to more rapid progression of the disease than before.

Systematic testing is needed to link the increased cases and the higher transmissibility and lethality of the new variants. A variant, B. 1.617, which may have originated in India, is spreading widely and has been found in other countries.

Can India get out of the current situation?

India no longer has the possibility of another national lockdown due to the crushing effect on the economy, but more local and state lockdowns are likely. Indians will need to protect themselves and the Indian government urgently needs to send consistent messages on the severity of the disease.

The Indian government must focus on the compulsory use of masks and act quickly to ban all mass gatherings. Without a consistent message and a scientific approach from the government, India risks losing the hard-won gains from the nationwide lockdown a year ago.

The relentless virus must be denied the opportunity to spread.

c. 2021 The New York Times Company