“I have never seen a nightmare like this. I can’t believe this is happening in the capital of India,” says the BBC’s Jyoti Malhotra. “People are not getting oxygen and they’re dying like animals.” He volunteers at one of Delhi’s crematoriums.
The city’s hospitals are overwhelmed by an unprecedented surge in coronavirus infections. The country has been setting world records for the number of new cases every day for the past week. At the same time, China, the United States, most of Western Europe, and some regions of Africa and Southeast Asia have seen declines in mortality statistics over the past two weeks. Some countries are easing or lifting restrictions altogether. The EU has even indicated that it will allow vaccinated U.S. citizens back into the country this summer. But won’t the catastrophic situation in India affect the rest of the world and become a huge problem for other countries?
The country’s crematoria have resorted to mass cremation of the bodies of the deceased due to the unprecedented number of Covid-19 victims being received daily. In February, the daily death toll in India was in the hundreds, with about 12,000 cases of infection, and many hoped that the country had avoided the worst scenario of the pandemic’s development. At the peak of the first wave, an average of 93,000 residents fell ill every day, and it was hard to imagine that this number could double or triple. However, starting on April 17, the daily statistics skyrocketed to over 200 thousand cases, and in the last week it has consistently exceeded 350 thousand cases every day. The mortality rate has also doubled compared to the first wave, with an average of 2336 people dying in India in the last week. “Covid-19 can be deadly even in a well-functioning health system, but when hospitals are overwhelmed, even those who could have been saved die,” recalls BBC science and medicine correspondent James Gallagher. The situation is worst in Delhi, where hospitals do not have enough beds with ventilators.
Some hospitals in Delhi are so overcrowded that they cannot even accept new patients. Many hospitals have been forced to turn away patients, and at least two patients began to die when the oxygen supply in the building ran out. Relatives of the infected are looking for oxygen masks and respirators through social networks, while trying to find an open space in any hospital. In addition to the general crisis, laboratories are overburdened and it takes up to three days to get test results. Crematoriums work around the clock.
This is how crematoriums work in India – a bonfire of firewood is simply placed over the body of the deceased. Some believe that the country’s mortality statistics are grossly underestimated. In other major cities, the situation is similar to Delhi. According to official statistics, nearly 17 million people in India have been infected and 192,000 have died since the pandemic began. However, some experts believe that these figures may not be accurate. The large population of the country and its constant movement do not allow effective testing for Covid-19, as well as accurate tracking of mortality. Thus, it is only possible to approximate the true extent of the crisis in India, unlike in European or US countries.
Many patients who could have been saved die from lack of oxygen. We explain quickly, simply, and clearly what happened, why it matters, and what will happen next. Episodes The End of the Story – Podcast Advertising. “Unfortunately, the situation will worsen significantly in the coming weeks,” Gallagher warns. “The lesson we have to learn time and time again is that a spike in infection rates is followed by a spike in mortality.” Even if India succeeds in stopping the spread of infection overnight, the death toll will continue to rise exponentially because so many people are already infected. There are no signs that the infection rate is stabilizing, and how high it will rise will depend on the effectiveness of the quarantines and the extent of vaccination. It should be noted that India is not a leader in terms of number of cases and deaths. Nor is the situation in India the worst in terms of deaths per million population – in many European and Latin American countries this indicator is much higher. But the size of India’s population and the huge increase in infectiousness raise very serious concerns. “We’ve never seen a situation like this, where the health system is unable to cope with the current situation and the number of cases continues to rise,” says Gotham Menon, a professor of physics and biology and an expert in infectious disease modeling, in an interview with the BBC. When the system collapses, people start dying in large numbers from various causes, and these deaths are not included in the COVID statistics. Doctors in India face a much more difficult task because of the sheer number of people they serve. And many people in India have no access to medical care at all. A pandemic is a global threat.
No borders could contain Covid-19, because the world could not completely abandon flights and travel and economic ties. Travel restrictions did little to stop the spread of the disease, as it is impossible to close borders forever. Therefore, whatever happens in India now will undoubtedly affect the rest of the world, especially considering that Indians are the largest diaspora in the world. “The pandemic has taught us that one country’s problem is a common problem,” says BBC correspondent James Gallagher. “The coronavirus that started in one Chinese city is now everywhere. The record number of cases may spread beyond India, which is why many countries have banned air travel to and from that country.” In addition, a high-prevalence environment is ideal for the emergence of new viral strains. The emergence of new Covid-19 variants is facilitated by living conditions in India, and this is bad news for everyone, without exception, as it undermines the successes achieved in the fight against the virus. “India’s high population and density create a perfect breeding ground for the virus to experiment with its mutations,” says Ravi Gupta, Professor of Clinical Microbiology at the University of Cambridge. If the virus is given enough time to remain in such ideal conditions for mutation, the global pandemic may become significantly longer and more destructive. Then even those who have been vaccinated will not be protected from infection.
The size and density of India’s population make it highly vulnerable to epidemics. The new strains that have emerged in Britain, Brazil and South Africa have caused many problems for other countries and are spreading rapidly around the world. Professor Menon warns that India could develop its own variant of the virus. “It is known that some mutations are associated with changes in the spike proteins that allow viruses to better attach to cell walls and repel antibodies,” he explains. “It is really impossible to stop the spread of new variants. For example, the B.1.617 variant (first detected in India) has already been observed in several countries outside India, and it is likely that it has been imported there. Menon believes that viruses will continue to mutate and look for ways to evade the immunity that humans have through vaccination or previous disease. The question is how fast it will happen. “We know that SARS-CoV-2 can mutate to spread faster and be more contagious, and we have already seen several variants around the world. We currently believe that vaccines will be effective against these strains, but this may change in the future,” says Professor Gotam Menon. The global community is taking steps to help India cope with the crisis. The United Kingdom has sent respirators and supplies of concentrated oxygen, and the United States has temporarily lifted a ban on the export of raw materials to allow India to produce as much of AstraZeneca’s vaccine as it needs.
A lack of oxygen has caused many deaths in Delhi hospitals. Many countries offer assistance in the form of trained personnel and cargoes of personal protective equipment. The Indian government has approved a plan that will increase the output of more than 500 oxygen production plants. But these are measures to prevent deaths, not infectivity. The world needs India to succeed in vaccination because the key to solving the situation is to stop the spread of infection. And India does have some advantages. For example, it is a major producer of vaccines. It has six major pharmaceutical plants that produce up to 60% of the world’s vaccines. The country also has a large population vaccination program.
India is trying to organize the world’s largest vaccination campaign. But according to the BBC’s India correspondent Sutika Biswas, the large-scale vaccination program faces significant difficulties. The world’s largest program began on January 16 and aims to reach 250 million people by July. So far, an estimated 118 million people have received the first dose of the vaccine, less than 9% of the country’s population. Initially, only medical personnel and those who worked directly with the sick were vaccinated. Later, however, the vaccination was extended to everyone over the age of 45. However, the task is complicated by the scale of vaccinating such a large population, as well as logistical and infrastructure issues. According to experts, the pace of vaccination will have to be significantly accelerated in order to complete the task on time. “However, it is still unclear whether the country has enough vaccines and whether it is possible to speed up the process and expand coverage by including young people in the program,” Biswas points out.
Indian authorities plan to vaccinate 250 million people by July. Unless such a populous nation is successfully “inoculated,” it will pose a threat to the entire world. “The problem of infectious diseases like Covid-19 is truly a global phenomenon, not the prerogative of individual countries,” says Professor Menon. “We need to continue to combine efforts in areas such as testing, vaccination and research for the benefit of the entire world.” As various epidemiologists and policymakers repeatedly emphasized during the pandemic, “no one can feel safe until everyone is safe.”