India faces a deepening Covid-19 crisis a year after going into one of the world’s toughest exclusions.
But this time, the authorities are reluctant to reintroduce a nationwide home order. Add to that a dormant vaccination campaign and the spread of new virus variants, and India’s immediate future looks bleak.
For almost a week, the country has recorded more than 200,000 cases of coronavirus daily – one of the highest rates in the world, although it is probably still an understatement. A shortage of beds and oxygen stress healthcare systems, especially in cities like Mumbai and Delhi.
People use social media in an effort to care of the resources and to share reports from people coming from hospital after hospital seeking treatment. Daily deaths have also increased, surpassing more than 1,700 on Tuesday, and crematoria cannot keep up with the number of bodies.
A jumble of factors can probably fuel the boom, making it difficult to determine exactly what’s going on. ‘Many of us are still scratching our heads over this. There is no concrete evidence, ”Manoj Mohanan, associate professor of public policy, economics and global health at Duke University, told me. “What we do know is some pieces of the puzzle.”
The puzzle pieces contain a decline in cases early in the year and the promise of the vaccination campaign, which could give both the public and even officials a false sense of security. In addition, there was a general tiredness with Covid-19 restrictions, which felt particularly heavy when the cases dropped back.
People started getting lax about things like mask wear and social distance. Many began to resume something like normal life while attending weddings and other celebrations.
“There was a sense of relaxation in both public policy makers and the general public, and there was a noticeable decrease in Covid-appropriate behavior,” Chandrakant Lahariya, an expert on public policy and health systems in Delhi, told me.
Mass rallies fostered the perception that India had defeated the virus – and probably strengthened its spread. Millions of pilgrims flocked along the Ganges River as part of Kumbh Mela, a major Hindu festival in India and one of the largest religious gatherings in the world.
A year into the pandemic, some Indian states are also holding local elections, which are becoming a political test for Prime Minister Narendra Modi and his Hindu nationalist Bharatiya Janata Party (BJP). Modi and other BJP officials offered major political rallies throughout the campaign, usually filled with maskless crowds. His opposition also does not exactly follow Covid-19 protocols.
“Public sentiment is of denial, fatigue and fatalistic surrender,” Bhramar Mukherjee, a biostatistician and epidemiologist at the University of Michigan, told me in an email.
Experts are also concerned about the spread of new varieties, although it is not yet known how these new strains drive the spike and whether they are more transmissible or deadly.
But as Mukherjee put it, the more the virus spreads, the more it changes. And these changes could potentially make Covid-19 more difficult to contain.
The challenge of trying to fight this second wave: fatigue and frustration
Delaying its first Covid-19 wave last March, India imposed one of the most aggressive exclusions in the world. After a year in the pandemic, India is unlikely to follow the course again. “The massive exclusions are no longer feasible, and they have become politically untenable,” Mohanan van Duke told me. “So it’s not something they can reasonably do.”
The first closure has hurt the Indian economy, and political leaders are likely to fear the setback of more drastic restrictions. Modi said this week that even states should use exclusions as a last resort and instead focus on ‘microcontrolling zones’.
But as certain states and cities face an acute crisis, there are few options to try to limit the spread of viruses. In Delhi, where the test positivity rate is almost a quarter of the population, officials set a weekly closing with a curfew from 10pm to 5pm. Officials said people could face fines if they left their homes.
The state of Maharashtra, where Mumbai is located, has imposed strict measures for 15 days, including a curfew rule and complains about all the essential services. “I am not saying an exclusion right now, but strict restrictions,” Maharashtra’s prime minister, Uddhav Thackeray, told a news conference announcing the changes, the BBC reported.
Even without a complete exclusion, the new restrictions will create extra economic pain.
A survey by the Pew Research Center estimates that the coronavirus pushed 32 million people out of the middle class in India in 2020, threatening a second wave to do even more damage. This is especially true in areas that are heavily dependent on financial services and hospitality industries – such as Mumbai, where many such businesses are now being closed due to the rise in Covid-19.
This is something authorities are well aware of: “I know bread and butter are important,” Thackeray said at the same press conference, “but saving lives is important.”
India can not vaccinate the way out of this boom
From May 1, anyone over the age of 18 will be eligible for vaccination, Modi said this week. But expanding the suitability does not solve other Indian problems.
India’s vaccination program has started with great promise, given the country’s experience with vaccination campaigns and its advantage as one of the largest worldwide manufacturers of the doses themselves.
The Serum Institute of India was already the largest manufacturer of vaccines worldwide, and its production is now essential in the global vaccination effort Covid-19. There are contracts to produce billions of doses of the AstraZeneca vaccine for India and the rest of the world.
As its own vaccination campaign began, India donated supplies of its vaccine to neighboring countries in a grand display of vaccine diplomacy. The Serum Institute has also contracted with Covax, the multilateral effort to deliver vaccine supplies, to make more than 1 billion doses of vaccines.
Many of the poorest countries in the world are dependent on shipments, which are now being delayed due to the increased demand in India. Issues at AstraZeneca plants in Europe have also led to richer countries such as the UK and Canada agreeing with the Serum Institute, and they are also seeing delays in vaccine delivery.
But India’s own crackdown was slow, and as Mukherjee said, India really missed its chances of speeding up vaccinations when the number of cases was low earlier this year. So far, just over 120 million doses of vaccines have been administered in the country. That sounds like a lot, until you think the country sets the ambitious goal of vaccinating 330 million people by the summer. Only about 1 percent of the population is fully vaccinated.
And some parts of India are starting to see the vaccine supply dry up, forcing them to close vaccination sites. The Indian government is now desperately trying to import vaccines to boost supplies. The country has approved most foreign vaccinations emergency and is expected to receive about 850 million doses of Russian Sputnik V vaccine.
However, more doses are not a cure. It is much more difficult to launch a large-scale vaccination campaign in a country that is already plagued by a health crisis. The same nurses or technicians deployed to vaccinate people are often the same staff who have to look after Covid-19 patients or perform contrast detection.
This can intensify the coronavirus surge, which could further halt the vaccination campaign and create a dangerous cycle.
“I am concerned that the health infrastructure now has to provide tests, hospitalization and vaccination,” Mukherjee said.
Even if India can find a balance between the emergencies and the vaccinations of the Covid-19, it will not be able to graft the way out of this crisis. It requires the same social health measures that officials know: work, masking, social distance, avoiding gatherings, and so on.
“Everyone knew there would be a second wave,” said Lahariya, India’s public health expert. ‘What they did not know [is] when this wave would come, and how long it would last, and what would be its effect. ”
“We are in the second wave now,” he continued. “So it’s time to do all the things that have been done in the past.”