NEW DELHI (AP) – The world’s fastest pace of spreading infections and the highest daily increase in coronavirus cases are pushing India further in a deepening and deadly healthcare crisis.
India is massive – it is the second most populous country in the world with almost 1.4 billion people – and its size presents extraordinary challenges for the fight against COVID-19.
About 2.7 million doses of vaccines are given daily, but it is still less than 10% of the people who got their first chance. Overall, India confirmed 15.9 million cases of infection, the second highest after the United States, and 184,657 deaths.
The latest boom has pushed India’s fragile health systems to the breaking point: Understaffed hospitals overflow from patients. Medical oxygen is in short supply. Intensive care units are full. Almost all fans are used, and the dead pile up at crematoria and cemeteries.
HOW DID WE ARRIVE HERE?
Authorities believe the worst was over when business began to decline in September.
Business plunged for 30 consecutive weeks before rising in mid-February, with experts saying the country had not seized the opportunity to replenish and inoculate health infrastructure aggressively.
“We were so close to success,” said Bhramar Mukherjee, a biostatistician at the University of Michigan who followed the India pandemic.
Despite warnings and advice that precautions are needed, authorities were unprepared for the scale of the boom, said K Srinath Reddy, president of the Public Health Foundation of India.
Critics have pointed out that the government decided not to interrupt Hindu religious festivals or elections, and experts believe that this may have exacerbated the upsurge.
“Authorities in India are invariably putting public health priorities in the background,” Reddy said.
As a result, India’s 7-day moving average of confirmed daily new cases has risen over the past two weeks from 6.75 new cases per 100,000 people on April 6 to 18.04 new cases per 100,000 people on April 20, possibly driven by new variants of the virus, including one first detected in India, say experts.
Rajesh Bhushan, India’s biggest health official, would not speculate on Wednesday as to why the authorities could be better prepared, saying: “Today is not the time to look into why we missed it, or did we miss it, or have we prepared? “
WHY COLLECT THE INDIAN HEALTH SYSTEM?
India spends only a fraction of its gross domestic product on its health care system, lower than most major economies.
As the virus took hold last year, India imposed a harsh, nationwide exclusion for months to prevent hospitals from being overwhelmed. It brought terrible suffering to millions, but also bought time to put in place measures to fill critical gaps, such as hiring additional health workers on short-term contracts, establishing field hospitals and installing hospital beds in banquet halls.
But authorities did not consider the pandemic in the long run, says Dr. Vineeta Bal, who studies immune systems at the Indian Institute of Science Education and Research in Pune.
Suggestions for permanent improvements, such as adding capacity to existing hospitals or introducing more epidemiologists to detect the virus, are widely ignored, she said. Now the authorities are trying to revive many emergency measures that were terminated as soon as the numbers dropped.
A year ago, India was able to avoid the shortage of medical oxygen plaguing Latin America and Africa. after converting industrial oxygen production systems into a medical network.
But many facilities have returned to supplying oxygen to industries, and now there are such shortages in several Indian states that the Ministry of Health has requested hospitals to do rationing.
The government started setting up new plants to produce medical oxygen in October, but now, about six months later, it is unclear if any has been started.
Oxygen tanks are being sent to hotspots across the country to keep up with demand, and several state governments have claimed that many have been intercepted by other states to be used to meet local needs.
WHAT COMES NEXT?
India faces the great challenge of trying to prevent its healthcare system from collapsing further until enough people can be vaccinated to significantly reduce the flow of patients.
The good news is that India is a major vaccine producer, but even after major exports of vaccines were halted in March to divert them to domestic use, there are still questions as to whether manufacturers can produce fast enough.
“Vaccination is one way to slow the spread – but it really depends on the speed and availability of the shots,” said Reddy of the Public Health Foundation.
Several states have already said they have vaccine shortages, though the federal government denies it.
India said last week that the use of all COVID-19 shots illuminated by the World Health Organization or regulators in the United States, Europe, Britain or Japan is permitted.
On Monday, he said he would soon expand his vaccination program from 45-year-olds to all adults, about 900 million people – more than the entire population of the entire European Union and the United States combined.
Meanwhile, Reddy said some states had to implement new closures, but it was up to individuals in the long run to do their part.
“As a society, it is crucial that we maintain measures for public health, such as masking, avoiding physical distance and crowds,” he said.
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The Associated Press Health and Science Division receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.