A Country Gasping for Air
Indians Pay the Price of Government Inaction as COVID-19 Surges
April 28, 2021
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MANDAKINI GAHLOT is an independent journalist and filmmaker based in New
Delhi.
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It feels like the end times in New Delhi.
Ambulance sirens blare through the night, a constant reminder of the
unbelievable tragedy unfolding in the city. India is currently experiencing a
devastating, record-breaking second wave of COVID-19, with the capital
especially hard hit. Every night ushers in a now sadly familiar ordeal.
Desperately sick patients go from hospital to hospital, begging for oxygen. The
hospitals, with only hours of oxygen to spare for their own patients, turn the
afflicted away. Relatives and friends post urgent pleas on social media, trying
in vain to source the third most abundant element in the universe. But not for
love of God or money is there any oxygen to be had in the city.
By morning, a long line of corpses trails
outside the Nigambodh crematorium. Relatives of the deceased, many of them
infected with COVID-19 themselves, wait for four hours or more in the scorching
summer heat for an overworked priest to become available to perform the last
rites. In one crematorium, the heat of the ovens burning uninterrupted for so
long has melted iron grills. In another, workers are burning bodies on the
pavement. Friends in other cities and states—Lucknow, Mumbai, Gujarat—share
similar horror stories. That grim detail is the human face of a statistical
catastrophe.
India is now breaking records for new
cases of COVID-19 every day. Over 350,000 cases were recorded on April 26.
According to the World Health Organization, one of every three new COVID-19
cases in the world is currently in India. But even that staggering figure is
likely an undercount, as the real total of new COVID-19 infections in India is
thought to be much higher.
Likewise, the current count of around 2,000 deaths per day is in all
probability a gross underestimation. Experts predict that India will reach a
peak of one million cases per day (and thousands of deaths) by mid-May. This is
the nightmare scenario envisioned by public health officials around the world
at the beginning of the pandemic: the disease rampant and devastation at an
unimaginable scale.
It didn’t have to be this way. The
government of the ruling Bharatiya Janata Party (BJP) invited this carnage
through its obfuscations, missteps, and complacency. In February, the party
passed an internal resolution congratulating “its
leadership for introducing India to the world as a proud and victorious nation
in the fight against Covid.” But Prime Minister Narendra Modi and his
government ignored numerous red flags in the first three months of the year and
disregarded scientific opinion. Many factors have contributed to this
gargantuan second wave, but at the heart of the disaster is the government’s
refusal to see it coming.
LOST TIME
At the end of September 2020, India was
recording some of the lowest case totals in the world, despite the immense size
of its population. Many Indians were convinced that the pandemic was on its way
out, that the country’s relative youth protected it from the scale of death
apparent, for example, in European countries with older populations, and even
that people in India possessed natural immunities that helped stave off the
virus. Hospitalization and death rates had fallen, and the government promised
that an indigenous vaccine was just around the corner.
Indians watched in horror as patients
flooded hospitals in the United States over the winter, unable to imagine that
their own hospitals would soon witness far worse scenes. The news from Brazil
angered and frustrated Indians—why wasn’t President Jair Bolsonaro taking
COVID-19 seriously? At least Modi was still wearing a mask and saying all the
right things about fending off the disease. Even Modi’s habitual critics
acknowledged that the country had fared reasonably well under his watch—India
had been spared the worst.
But unbeknownst to many Indians, a new
strain of the virus had emerged in the country in October 2020. The government
watched the B.1617 variant take
root but didn’t allocate the funds required to support COVID-19 testing with
the necessary genome sequencing to track it. Officials made little attempt to
understand this new foe.
The numbers of new cases and deaths
remained low as autumn gave way to winter. Unperturbed, many Indians donned
their finery and began gathering in large numbers for the famed wedding season in
northern India. The government halfheartedly put caps on the number of guests
permitted at weddings but did not warn people of the dangers of this new
strain.
INACTION AND
COMPLACENCY
Instead, the government doubled down on
triumphalism, buoyed by the development and manufacture of COVID-19 vaccines in
India. It inaugurated the largest vaccination drive in the world in January. At
the end of that month, Modi addressed the virtual World Economic Forum, looking
gleeful as he told the attendees that their predictions about India were wrong;
the country had dealt with COVID-19 swiftly and was now poised to help end the
pandemic around the world by exporting millions of vaccine doses.
The prime minister did urge vigilance and
insisted that it would be necessary to prepare for a second wave. But that
rhetoric did not match his actions. In 2020, Modi had set up a fund to battle
the pandemic called PM Cares, which received donations from around the world.
Officials insisted that the fund would be used to set up 162 plants that would
manufacture oxygen cylinders. It took the government over six months to start
inviting bids for the construction of these plants; as of this month, the
government has built only 33.
India also exported twice as much oxygen between April 2020 and March 2021 than
in the previous year; it did not generate sufficient stockpiles for domestic
consumption in anticipation of a second wave.
Modi’s bravado at the forum had damaging
consequences. Certain government-friendly media networks and newspapers
amplified the notion that India had vanquished COVID-19. To the horror of
scientists and medical professionals, Indians began shedding their masks and
ignoring social-distancing guidelines. As a result, new COVID-19 cases ticked
up; India recorded over 11,000 cases on February 1, and the curve has risen
upward ever since.
The Hindu nationalist government did not
heed the warnings of the scientific community; it consistently dismissed actual
scientific opinion in favor of quackery. On February 19, Harsh Vardhan, the
health minister, appeared alongside a maskless spiritual leader named Baba
Ramdev to launch Coronil, a supposed cure for COVID-19 produced by Ramdev’s
company. Case numbers continued to rise as the government dithered. The
journalist Vidya Krishnan revealed in a recent investigative
report in The Caravan magazine that the
country’s national scientific task force on COVID-19, which is supposed to
advise the central government on its response to the pandemic, did not meet
even once between February and mid-April.
The government exacerbated the spread of
the disease by allowing large religious festivals and pilgrimages to proceed.
On March 11, when new daily cases had reached nearly 50,000, Modi welcomed, via
tweet, pilgrims to the banks of the Ganges River in the state of Uttarakhand
for the Kumbh Mela. The Kumbh Mela is an important festival that, on certain
days, draws millions of pilgrims who crowd in close quarters on the banks of
the sacred river. Predictably, COVID-19 ripped through the gathering. A top
seer died of the disease, thousands of pilgrims tested positive, and the
authorities in the BJP-run state insisted they could do little to arrest the
spread.
This approach contrasted starkly with the
government’s reaction to a Muslim convention in March 2020, at the outset of
the pandemic. That meeting was a superspreader event (at a scale smaller than
that of the ongoing Kumbh Mela) and spurred fierce government action;
authorities arrested attendees and held some in detention for over a year.
Certain parts of the media and the BJP’s own representatives cast COVID-19 as a
Muslim disease. A year later, as daily cases crossed the 200,000 mark in
mid-April, Modi could muster only the weakest of pleas, urging the organizers
of the Kumbh Mela to make the event a “symbolic” one.
COMPOUNDING
CRISES
Political imperatives also brought on the
second wave. By early March, the government’s attention had shifted to
elections in five key states. Modi himself zipped from state to state
addressing massive rallies, often without a mask. In mid-April, when India was
recording over 200,000 new cases a day, the prime minister boasted about the
size of his rallies in West Bengal. His deputies and allies appeared on
national television to dismiss any connection between the second wave and these
large public rallies. The BJP was the last party to suspend campaigning in West
Bengal, calling things off only when it became impossible to ignore the fact
that thousands of Indians were dying daily for want of oxygen.
India’s current public health crisis is
compounded by an epistemological one: the government’s data cannot be trusted.
Experts claim that India is underrepresenting the scale of its tragedy,
something that is abundantly clear to those of us on the ground. The Financial
Times reported in
late April that local news reports in seven districts across the states of
Bihar, Gujarat, Madhya Pradesh, and Uttar Pradesh showed that at least 1,833
people were known to have died of COVID-19 over a period of several days, but
only 228 COVID-19 deaths were officially reported in that time; in Gujarat’s
Jamnagar district, for instance, 100 people died of COVID-19, but only one
death was reported.
Epidemiologists have projected an actual
mortality rate that is ten times as high as the one reported and are
forecasting that India will reach the grim milestone of a million COVID-19
deaths by the end of August. The real toll of the pandemic may never be clear,
making it all the harder to hold the government to account.
The government’s inaction in tracking the
B.1617 variant means that scientists are only now starting to study it and
determine its transmissibility, lethality, and response to available vaccines.
Virologists and epidemiologists believe that it has fueled this second wave of
COVID-19. More troubling still, the variant seems able to circumvent immunities
to the disease. Many people currently hospitalized in Delhi with COVID-19 had
received either one or two shots of the AstraZeneca vaccine, a worrying fact that
does not bode well for containing the evolving disease.
Vaccination nevertheless remains the best
way to stave off escalating hospitalization and death rates in a crowded
country where social distancing and lockdowns are difficult to enforce—and
deeply unpopular politically. The virus is now spreading rapidly through urban
and rural areas. The city of Kolkata, for instance, reported a 50 percent test
positivity rate last week. The Modi government has committed to making COVID-19
vaccines available to all Indians above the age of 18 after May 1. A sensible
government policy would be to mandate free universal vaccination, but Indians
can access vaccines for free only in particular places. Many Indians will end
up having to pay for one of the two vaccines available in the country—the
indigenously developed Covaxin and Covishield, the Indian-produced version of
the AstraZeneca vaccine—under a confusing pricing regime. That system
exacerbates the already enormous inequalities in the country. Rich Indians will
get vaccinated, but India’s poorest may find themselves waiting for a long
time.
Paying the price for their government’s
mistakes is something Indians have come to know fairly well. When the prime
minister locked down the country with only four hours notice in March 2020,
thousands of homeless and daily wage laborers went hungry. In the absence of
immediate government assistance, ordinary citizens had to band together and
help each other.
Now, too, as people die from want of
oxygen, citizens have come together to support one another. They make thousands
of calls to find oxygen, lug heavy cylinders around from one refilling point to
the other, deliver cylinders to people’s homes, and, when needed, bring people
to hospitals and bodies to crematoriums. They cook meals for those recovering
at home. They stand in interminable queues at pharmacies to try to find
perpetually out-of-stock medicines. Many of these activists say they no longer
know the difference between day and night, and their phones never stop ringing.
The light at the end of this long, dark tunnel is the grace of India’s people.
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