‘It’s much worse this time’: India’s devastating second wave

Every night, funeral pyres burn on the banks of the Ganges, a grim symbol of the ferocious wave of Covid-19 causing a health crisis and human tragedy in India that quickly surpass anything seen in the past year.

Patients are dying as their families search in vain for hospital beds. Oxygen and drug supplies are depleted, leading to theft of drugs from hospitals. Crematoriums and cemeteries cannot cope with the large number of corpses.

The devastation sparked outrage over the unpreparedness of officials who believed the worst of the pandemic was over. Only two months ago, India was reveling in its success in curbing the spread of the virus. Today, it reports around 260,000 infections and 1,700 deaths per day.

Narendra Modi, Prime Minister, and his Bharatiya Janata party have been accused of prioritizing domestic politics over public health by organizing mass political rallies with thousands of people and allowing the Kumbh Mela, a massive religious festival at which participated millions of people, to take place during the second wave.

With a new variant suspected of causing the outbreak, experts fear India may be on the same trajectory as Brazil, where a more contagious strain of the virus has hammered the country’s health system and economy.

“Health systems were not better prepared for this this time around. Many in the administration across the country weren’t expecting there to be a ‘this time’, ”said K Srinath Reddy, chairman of the Public Health Foundation of India, a charity. . “It was sort of presumed that we had passed the pandemic.”

While India’s death rate remains relatively low, other indicators point to a worsening crisis. The number of new cases and the percentage of positive tests are increasing at the fastest rate in the world, with the latter rising from 3% last month to 16%.

Chart showing infections rising faster in India than any other major country, accelerating past third wave in Europe and North America

In the capital Delhi, which, with around 25,000 people, records more new infections daily than any Indian city, the number of cases is doubling every five days.

Patients are invading hospitals in many parts of the country. The rate of intensive care patients in Nagpur, at 353 per million, is higher than anywhere in Europe during the pandemic. Mumbai, the financial capital, has 194 intensive care patients per million.

To meet growing demand, authorities have set up emergency coronavirus hospitals in banquet halls, train stations and hotels. India has taken urgent action to secure oxygen supplies, boost production of drugs such as remdesivir, and speed up vaccine approvals. It has also frozen vaccine exports, a move that will have far-reaching consequences for the developing world which depends on Indian manufacturing for its jabs.

Financial Times analysis also indicates underreporting of deaths. Local reports from seven districts in the states of Gujarat, Uttar Pradesh, Madhya Pradesh and Bihar show that while at least 1,833 people have died from Covid-19 in recent days, mostly on the basis of cremations, only 228 have been officially reported. .

Chart showing ICUs in India in crisis, with occupancy rates exceeding highs seen in worst outbreaks elsewhere

In the Jamnagar district of Gujarat, 100 people have died from Covid-19 but only one death from Covid has been reported.

The situation in Lucknow, the capital of Uttar Pradesh, a 200m state that is among the poorest in India, shows how health infrastructure has been pushed to the breaking point. Local media reported that at King George’s Medical University there was a queue of 50 people per hospital bed.

When Shivi Shah’s brother tested positive for Covid-19, she moved her parents to her house in Lucknow.

But it was too late for the couple, both in their sixties. After three days, her father developed blurry vision. The ambulance which arrived 45 minutes later was not equipped with medical equipment to treat him. He died last week on his way to the hospital.

They returned home after struggling to find a place to cremate her body, only for her mother to die in her sleep a few hours later. “We could have saved our father if we could have had a suitable ambulance,” said Shah, a 40-year-old schoolteacher, who, along with her son, is now awaiting the Covid-19 test results after developing a fever. “The situation is quite serious.”

Graph showing that in districts of India the official number of Covid deaths is several times lower than the number of people cremated at special Covid sites

“None of us have suffered the death and devastation that we are now witnessing. It’s much worse this time than last year, ”said Seema Shukla, a nurse at the government-run Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow. “The condition is so horrible that so many people are dying on the streets, in their homes, before they can see a doctor or even have a test.

“From early morning until midnight, my phone keeps ringing. Desperate friends and relatives cry for help: ‘Please help me find a ventilator, a bed, a nurse, an oxygen cylinder, some medicine.’ “

For the Shrivastava family, getting tested and treated has turned into a 900 mile odyssey. After his wife tested positive for Covid-19, the son, an IT professional, sent his 72-year-old father and 68-year-old mother back to their home in Deoria, in the eastern state.

After falling ill, they had to travel to another town, Gorakhpur, and three centers before they could be tested. They then drove about 400 miles through a Delhi suburb before finding hospital beds for both parents. The son, meanwhile, gets stuck in Lucknow awaiting his own Covid test report.

“These are the trials and tribulations of those of us who can afford private health care,” said a family member. “I can only imagine what happens to those who cannot.” The family did not want to be fully identified as long as their parents remained ill.

Chart showing Covid-19 on the rise again in India, with cases rising rapidly in all parts of the country

Officials are alarmed at the alleged role of new variants in driving the latest wave, particularly the B. 1.617 strain first detected in India last month. Scientists are still trying to figure out the variant, which has spread internationally, including in the UK, but some believe it is more infectious and evasive for vaccines.

Jeffrey Barrett, director of the Covid Genomics Initiative at the Wellcome Sanger Institute, the research organization, said the “number of cases” in India indicated a very grim picture, but “we don’t yet know if it’s because of this variant ”. .

“You have to look at these things without panicking,” he said, adding that there was not yet enough evidence to make B. 1.617 a worrying variant like those first discovered in South Africa. or in Brazil.

Experts also blame complacency for India’s skyrocketing, both among those who rushed to malls and weddings, and among the country’s leaders, including Modi, who sparked outrage. for their election campaign during the second wave.

Yogi Adityanath, the chief minister of the BJP of Uttar Pradesh, was a star election activist before he tested positive for Covid-19 last week. Cases in West Bengal, where many campaign rallies were held, have jumped.

Amit Shah, Indian Minister of the Interior, told the Indian Express that Modi and the government were “ready to fight [the virus] On all fronts. . . I am convinced that we will have a victory on this ”.

But Vineeta Bal, of the National Institute of Immunology, said the roots of the crisis run much deeper, revealing years of neglect of public health infrastructure. India’s healthcare spending has long lagged behind its global peers.

“This is my major problem not only with the current government, but also with the government health system of the past 50 years,” she said. “It cannot be resolved in a year in the event of a crisis. It has been a constant neglect for many, many years. “

Santosh Kumar, the son of a BJP leader in Lucknow, isolates himself at home with his family, all four of them suffering from Covid.

“The whole system broke,” he said. “All other members of the administration here are in quarantine. People find out what medications to take and do what they can. “

Additional reporting by Anna Gross