Why India is breaking global infection records

People in personal protective suits are waiting outside a mortuary to collect the body of their relative who died of a coronavirus, in New Delhi, India, on Monday, April 19, 2021. New infections are rising faster in India than any elsewhere in the world, shocking authorities and capping its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (AP Photo / Manish Swarup)

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.

While India is huge – it is the world’s second most populous country with nearly 1.4 billion people – its size also presents formidable challenges to fighting 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. Overall, India has 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.

EXPLANATION: Why India is breaking global infection records

Health workers carry the body of a COVID-19 victim for cremation, in New Delhi, India, on Monday, April 19, 2021. New infections are rising faster in India than anywhere else in the world, shocking authorities and seize its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (AP Photo / Manish Swarup)

“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 all over India, without exception, are putting public health priorities on the back burner,” Reddy said.

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.

EXPLANATION: Why India is breaking global infection records

The multiple funeral portals of those patients who died of COVID-19 disease are seen burning on land that has been converted into a crematorium for the mass cremation of coronavirus victims, in New Delhi, India, on Wednesday, April 21, 2021. (Photo AP)

India’s chief health officer, Rajesh Bhushan, would not speculate on Wednesday why authorities could have been more prepared, saying: “Today is not the time to enter 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 not only brought terrible hardship to 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.

EXPLANATION: Why India is breaking global infection records

An employee orders oxygen cylinders before loading them into a truck for delivery to various hospitals at a gas supply facility in Bengaluru, India, on Wednesday, April 21, 2021. New infections are rising faster in India than anywhere another world, by shocking authorities that capped its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (Photo AP / Aijaz Rahi)

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 it 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 are “closely reviewed for early completion.”

EXPLANATION: Why India is breaking global infection records

A man reads a holy book before the cremation of his deceased relative of COVID-19, in New Delhi, India, on Monday, April 19, 2021. New infections are rising faster in India than anywhere else in the world, shocking authorities and capping it on a fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (AP Photo / Manish Swarup)

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.

  • EXPLANATION: Why India is breaking global infection records

    People wearing masks as a precaution against the coronavirus stand in queues to board trains at Terminus Lokmanya Tilak in Mumbai, India, on Wednesday, April 14, 2021.New infections are rising faster in India than any elsewhere in the world, shocking authorities and capping its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (Photo AP / Rafiq Maqbool)

  • EXPLANATION: Why India is breaking global infection records

    A COVID-19 patient wearing an oxygen mask remains inside a specialized COVID-19 hospital in Noida, a suburb in New Delhi, India, on Wednesday, April 21, 2021. New infections are rising faster in India than anywhere else in the world, shocking authorities and capping its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (Photo AP / Altaf Qadri)

  • EXPLANATION: Why India is breaking global infection records

    Health worker sits on bench after helping to cremate victims of coronavirus, in New Delhi, India, on Monday, April 19, 2021. New infections are rising faster in India than anywhere else in the world, shocking authorities and captures its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (AP Photo / Manish Swarup)

  • EXPLANATION: Why India is breaking global infection records

    A health worker takes a human mouth swab sample to test for COVID-19 while others wait their turn to be tested at a hospital in Hyderabad, India, on Monday, April 19, 2021. New infections are rising faster India than anyone else anywhere in the world, shocked authorities and seized its fragile health system. Overall, India has more than 15.6 million cases, the second highest after the United States, with 182,553 deaths. (AP Photo / Mahesh Kumar A.)

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 distraction and avoiding crowds,” he said.


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