Author: Sparhawk Mulder
Just recently, India has begun to experience one of the worst second-wave COVID-19 outbreaks of any country. Hospitals are running out of oxygen, turning away patients for lack of beds, and mass cremations are commonplace. However, earlier just this year, the country was doing surprisingly well for a non-authoritarian country with an enormously high urban population density; what changed?
The blame seems to mostly lie in the country putting its guard down too early and a lack of proper surveillance. The new strain of the virus is deadly, but it would not have hit so hard if the country was more prepared, especially as far as rapid policy decisions.
India was doing quite well earlier this year, with an almost miraculous drop in cases from 100,000 new cases a day to fewer than 10,000. ICU utilization had indeed gone down; the drop seemed miraculous. Experts are still unsure as to what happened. Many epidemiologists now suspect that this was a reporting error (probably not a deliberate one), and that there were far more cases rising earlier this year, but in more rural areas or with fewer "hospitalizable" symptoms.
People were celebrating an early decline and going out more, which is to be expected, and the Indian government - whose policy is (or should be) advised by experts - didn’t push back, despite the fact that many other countries were experiencing a second (or third, in the U.S’s case) wave around the same time. This early return to normalcy was helped by the fact that India is one of the primary producers of vaccines, some areas were reportedly close to reaching herd immunity, and the country’s average age skews fairly young; people were feeling confident.
All of the above are understandable mistakes; it is local governments’ decisions to encourage (or at least not discourage) crowd congregations which might have tipped the scales. Holi week, an enormous Hindu celebration, took place at the end of March, at the same time that five states were holding election rallies. Various other religious congregations were also widespread, leading to further crowding, and increasing the chance of the development of a new strain of COVID.
Then of course, a new variant hit, spread undetected rapidly through large crowds, and cases exploded across the country. India’s second wave is one of the worst in the world right now.
What is clear from the story of India’s second wave is that public health policy must be informed first-and-foremost by public health experts, and not by politicians with optics agendas. All of the case-patterns and second waves of other countries pointed towards another surge appearing in India, which many doctors pointed out. However, desires to keep the nation looking “strong," overconfidence in vaccination distribution, and especially prime minister Narendra Modi’s insistence that lockdown be a last resort lead to a brutal second wave.
COVID and other diseases will always take advantage of surveillance blind-spots. It is important we remain aware of our systems’ blind-spots and failings; boasting about our countries’ testing and vaccination rates is alright, but only when we’re truly prepared. Overconfidence saves no-one; it only gets people killed.
Great article! Although some restrictions were relieved when a drop in cases was observed, the general public still needs to be cautious and take the advice and information from actual public health experts and not just their politicians. The spike in COVID-19 cases in India is also due to the lack of appropriate leadership from the government as they've been more focused on governmental elections than providing aid for hospitals and frontline healthcare workers.