NEW DELHI (AP) – The world’s fastest pace of spread of infections and the highest daily rise in coronary virus cases are pushing India further into a deeper and deadly healthcare crisis.
India is huge – it is the world’s second most populous country with almost 1.4 billion people – and its size presents extraordinary challenges to fight COVID-19.
About 2.7 million vaccine doses are given daily, but that’s still less than 10% of its people who have had their first shot. All in all, India confirmed 15.9 million cases of infection, the second highest after the United States, and 184,657 deaths.
The latest surge has driven India’s fragile health systems to the breaking point: Unmanned hospitals are overflowing with patients. Medical oxygen is scarce. Intensive care units are full. Nearly all breathing machines are used, and the dead pile up in crematoria and cemeteries.
HOW DO WE GET HERE?
Authorities were believed to be the worst behind when cases began to recede in September.
Cases fell for 30 consecutive weeks before rising in mid-February, and experts say the country failed to seize the opportunity to augment healthcare infrastructure and aggressively vaccinate.
“We were so close to success,” said Bhramar Mukherjee, a biostatistician at the University of Michigan who has been tracking the Indian pandemic.
Despite warnings and advice that precautions were needed, authorities were not prepared for the magnitude of the surge, said K Srinath Reddy, president of the Institute of Public Health of India.
Critics have pointed to the government’s decision not to delay Hindu religious holidays or elections, and experts say these may have exacerbated the surge.
“Authorities across India are invariably putting public health priorities on the back burner,” said Reddy.
As a result, India’s 7-day rolling 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 after ‘ u driven by new variants of the virus, including one first detected in India, experts say.
India’s chief health officer Rajesh Bhushan would not speculate on Wednesday why authorities might have been more prepared, saying: “Today is not the time to go into why we failed, or did we fail , did we prepare? ”
WHY DO THE INDIA HEALTH SYSTEM COLLABORATE?
India spends only a small proportion of its gross domestic product on its health system, which is lower than most major economies.
As the virus caught on last year, India imposed strict, nationwide lockouts for months to prevent hospitals from becoming overwhelmed. This brought terrible hardship for millions, but also bought time to implement measures to fill critical gaps, such as hiring additional healthcare workers on short-term contracts, setting up field hospitals and installing hospital beds in banquet halls.
But authorities did not take a long-term view of the pandemic, says Dr. Vineeta Bal, who studies immune systems at the Indian Institute of Science Education and Research in the city of Pune.
Suggestions for permanent improvements like adding capacity to existing hospitals or hiring more epidemiologists to help track the virus were ignored, he said. Now authorities are scrambling to resuscitate many emergency measures that ended once numbers dropped.
A year ago, India avoided the medical oxygen shortage that plagued Latin America and Africa after he converted industrial oxygen manufacturing systems into a medical degree network.
But many facilities went back to supplying oxygen to industries and now many Indian states are facing such shortages that the Ministry of Health has urged hospitals to implement rationing.
The government started building new medical oxygen production plants in October, but now, some six months later, it remains unclear whether any have come online, with the Ministry of Health saying they are are “closely reviewed for early completion.”
Oxygen tanks are being shut down nationwide to hotspots to keep up with demand, and several state governments have claimed that many have been intercepted by other states on the way to being used to meet local needs.
WHAT IS NEXT?
India faces the huge challenge of trying to prevent further collapse of its healthcare system until enough people can be vaccinated to significantly reduce patient flow.
The good news is that India is a major vaccine producer, but even after halting large exports of vaccines in March to divert it to domestic use, questions remain about whether manufacturing can produce fast enough.
“Vaccination is one way to slow the spread – but it really depends on the speed and availability of shots,” said Reddy of the Institute of Public Health.
Already several states have said they have a shortage of vaccines – though the federal government denies it.
India said last week that it would allow use of all COVID-19 shots that have been set green by the World Health Organization or regulators in the United States, Europe, Britain or Japan.
On Monday, it said it would soon expand its 45-year-old vaccination program to include all adults, some 900 million people – far more than the entire EU and US population combined.
In the meantime, Reddy said some provinces have had to implement new locksmiths but in the long run, doing their part was also a matter for individuals.
“As a society, it is vital that we maintain public health measures such as masking, physical distance and avoiding crowds,” he said.
The Associated Press Department of Health and Science is supported by the Science Education Department of the Howard Hughes Medical Institute. The AP is entirely responsible for all content.