India In Collapse

Health workers carry bodies of Covid-19 victims outside the Guru Teg Bahadur hospital in New Delhi, India, on April 24.

"I've been ... trying to say to them, 'If everything goes very well, things will be horrible for the next several weeks. And it may be much longer'."

"[The focus  needs to be on 'classic' public health measures: targeted shutdowns, more testing, universal mask-wearing and avoiding large gatherings]."

"That is what's going to break the back of this surge."

Dr. Ashish Jha, dean, Brown University's School of Public Health, U.S

 

"When the first wave was tapering, that's when they should have prepared for a second wave and assumed the worst."

"They should have taken an inventory of oxygen and [the drug] remdesivir and then ramped up manufacturing capacity."

"[Other states should have also taken similar steps] to avoid the suffering. Learning means someone else has done it and you can do it now, but that means it will take time."

Mahesh Zagade, former health secretary, Maharashtra state 

"No one saw the extent of the surge."

"As the previous wave came down, there was in all of us a feeling that this was something which had been dealt with substantially."

"We saw signs of a next surge, but the scale and the intensity of it was not clear."

K. VijayRaghavan, principal scientific adviser for the Indian government

"The virus and its second wave is hitting the younger people, and even children, in a way it had not in its first wave."

"We've met 18-day-old babies that are fighting for their lives inside ICUs."

Barkha Dutt, author and journalist, New Delhi

People wait to receive Bharat Biotech's COVAXIN vaccine for COVID-19 at an indoor stadium in Gauhati, India, on April 22. The inactivated vaccine has been in use in India since January. It released interim results of Phase 3 trials in March and April. (Anupam Nath/The Associated Press)

India, it appears, committed the cardinal sin -- like many other countries around the world, including those of wealthy nations who ignored warnings of an impending global pathogen wreaking havoc globally -- of failing to invest in modernizing and upgrading its health system. This, while it is recognized as being the world's leading producer of pharmaceuticals. Ironically, it was India's giant neighbour China where the SARS-CoV-2 virus leaped the species barrier from animal to human and began its deadly trajectory around the world.

China had failed to secure its borders to ensure that the pathogen could be confined if at all possible, while it surged in Wuhan City then moved into other parts of China which Beijing ordered into lockdown. This, while initially denying the presence of the strange new 'pneumonia' that had surfaced, puzzling doctors in Wuhan who were punished for 'spreading false rumours'. When the world was finally alerted to the nature of the virus and steps were taken to stop Chinese nationals from entering other countries, China called it racism in action.

Now, China is returning to normal, its economy is pumped, while its neighbour India rivalling China for huge population numbers is struggling to vaccinate its citizens even as COVID-19 ravages the country. China's sympathy for the plight of its neighbour while it placidly gets on with life, could be seen in vibrant living colour when a state-controlled account on Twitter compared Beijing's success in space rocketry being fired up, to India's firing up of countless sites for the cremation of thousands of COVID-19 dead.

Medical supplies, ventilators, medical oxygen, drugs and vaccines are all in short supply, leaving affected people scrambling to try to find necessary supplies for their horribly ailing family members. A black market by enterprising profiteers has arisen where all the necessary supplies can be bought at explosively inflated prices by those that can afford them, emphasizing the gap between those who can and those who cannot fend for themselves in a desperate situation where hospital admissions fail in an absence of available beds.

 

Family members of COVID-19 patients wait in queue to refill their oxygen cylinders at Mayapuri area in New Delhi, India, Monday, May 3, 2021. (AP Photo/ Ishant Chauhan)

The government has, in its desperation to act, to bring more medical workers on line, suspended exams for health workers; trainee doctors and nurse -- authorizing them to join other frontline health workers as fully commissioned health care professionals to battle the world's largest coronavirus infections surge. This, in response to the health system nationwide, crumbling under the onslaught of new cases and dire hospital shortages of beds and oxygen. 

India, with its population of 1.35 billion people has surpassed 20 million cases of COVID, resulting from the 12th straight day of over 300,000 new cases daily. And though this massive number of people being stricken is difficult for the mind to grasp, it is widely held not to reflect true numbers of infections. Medical experts claim with good reason, that the actual numbers could very well be five to ten times greater than those reported. 

The international community is responding to the urgent need expressed by India for assistance during this grave period of immense peril for a vulnerable population. Where hospitals are full beyond capacity, where medical oxygen supplies have run out, and where morgues and crematoria are overloaded with corpses. A country where patients are drawing their last breaths in hospital beds, in ambulances, and in parking lots, awaiting admittance to hospitals. Other countries that have managed to control their outbreaks and those still struggling to do, are sending ventilators, drugs, oxygen.

"Every time we have to struggle to get our quota of our oxygen cylinders. It's a day-to-day fight", declared B.H. Narayan Rae, a district official in the southern town of Chamarajanagar. And then there are the volunteer groups. In New Delhi, outside a gurdwara, Sikh volunteers provide oxygen to patients who lie on benches within makeshift tents, hooked up to a single giant cylinder dispensing medical oxygen. Every 20 minutes a new patient arrives.

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"No one should die because of a lack of oxygen. It's a small thing otherwise, but nowadays, it is the one thing everyone needs", observed Gurpreet Singh Rummy, the operator of the volunteer service administering medical oxygen. Positive cases relative to the number of tests began to fall slightly on Monday, the first time this has occurred since around April 15, offering a glimmer of hope that should that trend continue, India might have experienced the worst of the wave.

A team of government advisers had produced modelling which shows the potential for coronavirus cases to peak in several days' time this week, earlier than a previous estimate.  Eleven states and regions ordered curbs on movement to stem infections. The Modi government itself has been criticized widely for permitting mass religious festivals to proceed, to encourage masses of people -- unmasked, not observing social distancing -- to attend political rallies. Prime Minister Narendra Modi remains reluctant to impose a national lockdown, even as some states call for one.

"In my opinion, only  national stay-at-home order and declaring medical emergency will help to address the current health-care needs", stated Bhramar Mukherjee, an epidemiologist with the University of Michigan.

"A team at the Indian Institute of Science in Bangalore used a mathematical model to predict about 404,000 deaths will occur by June 11 if current trends continue."

"A model from the Institute for Health Metrics and Evaluation at the University of Washington forecast 1,018,879 deaths by the end of July."

Bloomberg News

Funeral pyres burn in New Delhi as families wait to cremate their dead on April 23