India is facing a deepening crisis of Covid-19 a year after entering one of the tightest blockades in the world.
But this time, the authorities are reluctant to re-impose a national order to stay at home. Add to this an ongoing vaccination campaign and the spread of new variants of the virus, 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 anywhere in the world, although it is probably still insufficient. A deficit of beds and oxygen tightens health care systems, especially in cities like Mumbai and Delhi.
People use social media in an attempt to care of public sources and share reports about people leaving hospital to hospital in search of treatment. Daily deaths have also risen to more than 1,700 on Tuesday, and crematoria cannot keep up with the number of bodies.
A tangle of factors is likely to fuel growth, making it difficult to pinpoint exactly what is happening. “Many of us are still scratching our heads about this. There is no concrete evidence, ”Manoj Mohanan, an associate professor of public policy, economics and global health at Duke University, told me. “What we know are a few pieces of the puzzle.”
The pieces of the puzzle include a decrease in cases at the beginning of the year and the promise of the vaccination campaign, both of which can give the public and even officials a false sense of security. Moreover, there was a general fatigue with the Covid-19 restrictions, which felt particularly burdensome when the cases were downstream.
People began to become obsessed with things like wearing a mask and social distancing. Many began to resume something like normal life, attending weddings and other holidays.
“There was a sense of relaxation in both public policy makers and the general public and there was a visible decrease in appropriate Covid behavior,” Chandrakant Lahariya, a public policy and health systems expert in Delhi, told me. .
Mass rallies fueled the perception that India had defeated the virus and probably intensified some of the spread. Millions of pilgrims crowded 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.
One year after the pandemic, some Indian states are also holding local elections, which is turning into a political test for Prime Minister Narendra Modi and his Hindu nationalist Bharatiya Janata Party (BJP). modified and other BJP officials hosted huge political rallies throughout the campaign, usually with masked crowds filled together. Nor did his opposition follow the Covid-19 protocols exactly.
“The public’s feeling is one 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 variants, although it is not yet known how these new strains drive the momentum or whether they are more transmissible or deadly.
But, as Mukherjee said, the more the virus spreads, the more it changes. And these changes may make Covid-19 harder to contain.
The challenge of trying to fight this second wave: fatigue and frustration
To slow its first Covid-19 wave in March last year, India imposed one of the most aggressive blockades in the world. One year after the pandemic, India is unlikely to continue that course. “Massive blockades are no longer feasible and have become politically unbearable,” Mohanan of Duke told me. “So it’s not something I can reasonably do.”
The first stalemate has hit the Indian economy, and political leaders are probably afraid of rejecting more comprehensive restrictions. Modi said this week that even states should use blockages as a last resort and instead focus on “microcontainment areas”.
But as some states and cities face an acute crisis, there are few options left to try to prevent the virus from spreading. In Delhi, where the positivity test rate is almost a quarter of the population, officials imposed a one-week break with a checkpoint from 10 p.m. to 5 p.m. Officials said people could be fined if they left their homes.
The state of Maharashtra, where Mumbai is located, has imposed strict measures for 15 days, including extinguishing and curbs for all but essential services. “I am not saying a blockade right now, but strict restrictions,” Maharashtra chief minister Uddhav Thackeray told a news conference announcing the changes, the BBC reported.
Even without a complete blockage, the new restrictions will create additional economic pain.
A survey by the Pew Research Center estimates that the coronavirus will push 32 million people in India from the middle class by 2020 and a second wave threatens to cause even more damage. This is especially true in areas that are heavily dependent on financial services and the hotel industry – such as Mumbai, where many such businesses are now closed due to the growth of Covid-19.
This is something the authorities are aware of: “I know that bread and butter are important,” Thackeray told the same news conference, “but saving lives is important.”
India cannot vaccinate its way out of this wave
Starting May 1, anyone over the age of 18 will be eligible for vaccination, Modi said this week. But expanding eligibility does not solve some of India’s other vaccination problems.
India’s vaccination program started with great promise, given the country’s experience in vaccination campaigns and its advantage as one of the most important in the world. dose manufacturers themselves.
Serum Institute of India has already been the largest vaccine manufacturer in the world, and its production is now essential in the global Covid-19 vaccination effort. It is contracted to produce billions of doses of AstraZeneca vaccine for India and the rest of the world.
As it began its own vaccination campaign, India donated its vaccine supplies to neighboring countries in a major show of vaccine diplomacy. Serum Institute has also contracted with Covax, the multilateral effort to deliver the vaccine supply, to make more than 1 billion doses of vaccine.
Many of the world’s poorest countries are dependent on these shipments, which are now delayed due to India’s growing demand. Problems at Europe’s AstraZeneca plants have also led richer countries, such as the United Kingdom and Canada, to enter into agreements with the Serum Institute and are facing delays in vaccine delivery.
But India’s own launch has been slow, and as Mukherjee said, India has really missed the window of opportunity to speed up vaccinations when the number of cases dropped earlier this year. So far, just over 120 million doses of vaccine have been administered in the country. It seems like a long time, until you consider that the country has set its ambitious goal of vaccinating 330 million people by summer. Only about 1% of the population is completely vaccinated.
And parts of India have begun to see dry vaccine consumption, forcing them to close vaccination sites. The Indian government is now desperately trying to import vaccines to support supply. The country has given general emergency approval to most foreign vaccines and expects to receive about 850 million doses of Russian Sputnik V vaccine.
However, multiple doses are not a cure. It is much harder to massively intensify a vaccination campaign in a country that is already facing a health crisis. The same nurses or technicians employed to vaccinate people are often the same staff who have to assist patients with Covid-19 or perform tests and follow-up contracts.
This could intensify the growth of the coronavirus, which could further stop the vaccination campaign, creating a dangerous cycle.
“I am concerned that the medical infrastructure must now deal with testing, hospitalization and vaccination,” Mukherjee said.
Even if India can find a balance between the Covid-19 emergency and vaccinations, it will not be able to simply inoculate its way out of this crisis. This will require the same public health measures that officials know work: masking, social distancing, avoiding mass gatherings, and so on.
“Everyone knew there would be a second wave,” said Lahariya, an Indian public health expert. “It simply came to our notice then [is] when will this wave come and how long will it last and what would be the 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.”