Politic?: A Global Disaster

Waiting to receive Covid-19 vaccinations in Mumbai, India, on Monday.

Credit...Divyakant Solanki/EPA, via Shutterstock

"The current wave is particularly dangerous."
"It is supremely contagious and those who are contracting it are not able to recover as swiftly. In these conditions, intensive care wards are in great demand."
Delhi Chief Minister Arvind Kejriwal

"[The world is entering a critical phase of the pandemic and needs to have vaccinations available for all adults as soon as possible]."
"This is both an ethical and public health imperative."
"As variants keep spreading, this pandemic is far from over until the whole world is safe."
Udaya Regmi, South Asia head, International Federation of Red Cross, Red Crescent Societies

"As India did that, [halting vaccine exports to retain supplies to inoculate its population], the pipeline of vaccines dried up for COVAX."
"I don't know who did the maths, but someone did the maths wrong."
"And the decision to go exclusively with the Serum Institute of India and not provide the license to more manufacturers has proved deadly for the developing world [in a shortage of vaccines for re-distrition]."
Leena Menghaney, Médecins Sans Frontières, New Delhi

"The ferocity of the second wave did take everyone by surprise."
"While we were all aware of second waves in other countries, we had vaccines at hand, and no indications from modeling exercises suggested the scale of the surge."
K. Vijay Raghavan, principal scientific adviser to the Indian government

"The situation is horrible, absolutely terrible ... Everyone is afraid, every single person."
"People are afraid that if I am talking to a person, maybe I won't get to talk to them tomorrow or in the near future."
Manoj Garg, resident, New Delhi

AstraZeneca doses manufactured in India arriving in Kathmandu, Nepal, in January.

Credit...Niranjan Shrestha/Associated Press

In January, when the Indian government appeared satisfied that it would be able to control the initial outbreak of the SARS-CoV-2 virus, it enacted strict orders for its population to remain at home to venture so far and no further from their homes, and only for essential business. The infection rate in India's largest cities wasn't as disastrous as it might have been, given crowded living conditions and matters appeared to be well in hand. As one of the world's largest producers of vaccines, India also magnanimously began donating vaccines to its less-well-off neighbours.

It's a familiar scene; countries that succeeded in gaining a level of control over the global pandemic looked outside their borders at neighbours struggling to achieve what they did, and generously offered assistance. Some countries when China was in the throes of the first infections with the pathogen that originated in Wuhan, sent respirators, masks and anything else they had to give assistance, at a time when their own countries had not yet been engulfed by the fast-spreading virus that all too soon hit Europe and North America, sending Italy and Spain into a headspin.

Things have not proceeded well for India. To a good degree perhaps it was predictable; in fact India with its great population of 1.35 billion people was initially thought of as a potential tinderbox of opportunity for any threatening virus, and it seemed puzzling at first that it hadn't exploded into a firestorm of cases. It's almost as though the virus has a sense of dramatic timing, keeping the world in suspense, and then striking. It has struck India through a second venomous wave that seems unstoppable.

India is now experiencing what Italy did a year ago, in the shortage of hospital beds and medical oxygen. Italy became a symbol of the worst that the SARS-CoV-2 virus could inflict on humanity, but worse was to come when the U.S. and Brazil began their own epic struggles for survival against a beast of a virus. The world was given a hopeful boost of encouragement at early news that vaccines were in development, and then a vision of recovery as a handful of pharmaceutical manufacturers saw their products succeed in third level trials leading to approvals for mass inoculations.

Confidence was high for those countries with vaccine-producing facilities and the logistics of production and distribution and contract-signing proceeded apace. With India's own national vaccine producer on contract with AstraZeneca and the assurance that it could handle the demand for its product both at home and abroad. Now, however, for a week of succeeding days hundreds of thousands of new COVID cases have been logged for the world's second largest population. There are now 18 million in India infected with COVID-19.

Each day over 300,000 people test positive for the virus. The health facilities and crematoriums are working on overdrive and they are still being overwhelmed. On Wednesday alone, 360,960 new cases of COVID were tallied, horrifying India itself and the world around it, impelling other nations to begin sending relief to India, medical equipment, medical oxygen, respirators, personal protection equipment. The numbers are staggering, but according to experts these are not true numbers which are in fact, many times greater than the official tallies.

Yesterday alone, 3,293 Indians died of COVID-19. There is one death from COVID reported in Delhi state every four minutes. Ambulances convey bodies of COVID-19 victims to temporary crematorium facilities set up in public parks, parking lots and anywhere else they can be installed to relieve the pressure. Bodies are burned on funeral pyres set up in row after row.

A mass cremation this week in New Delhi for people who died from the virus.

Credit...Atul Loke for The New York Times

In the Delhi suburb of Gurgaon, Genesis hospital informs families they must take their family members elsewhere in view of its supplies of oxygen fast depleting. "The hospital is trying to get fresh oxygen but we are told we have to make alternative arrangements", stated Anjali Cerejo who must now attempt to find another bed elsewhere for her father who had been admitted to the hospital which now is unable to keep him as a patient.

There is a burgeoning black market in operation however, where scarce supplies, including medical oxygen can be had at prices far, far in excess of what their usual rate is. For those who can afford those astronomical prices there may be a hope, but for the vast numbers of other afflicted people when the public hospitals and clinics are unable to respond, there is no hope.

It is a scene of bedlam as people are lined up on trolleys, in cars and rickshaws with their family members holding oxygen cylinders for them, desperately awaiting an empty bed in the hospital.

India, according to the World Health Organization's weekly epidemiological update, accounts for 38 percent of the 5.7 million cases of COVID-19 reported worldwide last week. The B.1.617 variant of the virus that surfaced in India has a higher growth rate than other variants in the country, according to early modelling, suggesting increased transmissibility.

India's best hope lies in vaccinating its vast population, in experts' opinion. Registrations were open for everyone in the population above age 18 to be vaccinated. Ironically and tragically, the world's biggest producer of vaccines is vastly short of stocks to inoculate the estimated 600 million people now eligible, added to the efforts to inoculate India's elderly, and those with other compromising medical conditions.

Several states in India have reported a shortage of coronavirus vaccine doses. AP Photo: Rafiq Maqbool

"I think the highest priority, you know, to be quite frank, has to be India."
"I mean, their situation is so desperate and the cases continue to rise [validating the decision to retain vaccines produced in India to be used in India]."
"This is a crisis now at a global level [but countries in Africa awaiting doses supplied to COVAX by India must wait]."
Salim Abdool Karim, epidemiologist, Columbia University