India's Devastating, Heart-wrenching Second Wave
India's surge in cases now account for almost half of all new cases of COVID-19 globally
Hi there, I’m Aman Thakker. Welcome to Indialogue, a newsletter analyzing the biggest policy developments in India. The aim of this newsletter is to provide you with quality analysis every week on what’s going on in India.
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India's Devastating, Heart-wrenching Second Wave
It has been an overwhelming and tough few weeks, seeing the surge of COVID-19 cases in India. The top-line numbers are heart-wrenching.
India has now registered more than 300,000 new cases of COVID-19 in the last few days, contributing almost half of the total number of new cases registered globally each day. Confirmed deaths per day have also exceeded 2,000 per day. And by all accounts, these numbers capture only a fraction of the true reality of the spread of COVID-19. Evidence from, both, public health experts and journalists on the ground, suggests that the true reality of cases and deaths could be from between 2x to 5x the reported numbers.
All indications suggest that we’re not yet at the peak of the crisis. Modeling from the Indian Institutes of Technology suggests that cases will peak on or around May 15, with India possibly registering 1 million cases per day during the peak.
The grim situation in India has led to India’s hospital and health systems to become completely overwhelmed. Hospitals have reported shortages of oxygen, ventilators, and beds to provide care to COVID-19 patients. Symptomatic patients have had to wait days to receive an RT-PCR test, and days again to receive results as testing labs were overwhelmed.
In the face of such incredible stress to the country’s health system, Indian citizens have turned to social media - Twitter and WhatsApp in particular - for assistance in finding necessary supplies.
For almost every Indian I know, including myself, the situation in India has become all too personal in the last few weeks. I have had family members and friends test positive in India, and I’m sure several readers have too. NRIs such as my self have been filled with a feeling of helplessness seeing what was happening with our families and friends, and with the country we consider home.
On a personal note, I will be honest that, in the face of this distress, I unfortunately am just so filled with a deep-seated worry that has overwhelmed everything else that this newsletter may not provide the same level of analysis or detail as usual editions do. For that, I apologize.
However, I do want to focus on a few important things.
First, it is clear that this second wave and the ensuing stress on India’s hospital systems is a by-product of poor policymaking and governance decisions, driven in large part by a desire to declare victory early. Examples from around the world were clear that even as caseloads reduced and the daily numbers of new confirmed cases of COVID-19 drop, countries cannot drop their guard. Countless countries have seen cases spike in second and third waves, and it was clear that India would be no exception to such a risk. Maintaining preparedness and ensuring that citizens complied with COVID-safe protocols would need to be a priority even as the number of new cases fell.
However, what we saw instead was the governments at all levels, but particularly at the central level, were all too eager to declare victory over the virus at the tail end of the first wave. India’s health minister boasted on January 28, 2021 that “India has successfully contained the pandemic,” and boasted yet again on March 7, 2021 India was in the “end game of the Covid-19 pandemic.” The ruling party declared in an official resolution that “it can be said with pride that India not only defeated Covid under the able, sensitive, committed and visionary leadership of Prime Minister Shri Narendra Modi.” Mass gatherings - from political rallies where thousands gathered unmasked to religious gathers, such as the Kumbh Mela, where over 3.5 million unmasked people arrived at the banks of the Ganga river on one day - continued despite the risk of the virus.
This is not to say that the central government or the ruling party at the center was exclusively to blame for the second wave. State governments, too, dropped the ball on ensuring their citizens continued to follow COVID-safe protocols such as masking and maintaining social distance to prevent the virus from transmitting. Every political party held rallies that saw thousands of unmasked attendees. However, the responsibility of managing a nationwide pandemic falls on the national leadership, and the buck stops with the Prime Minister and his Cabinet.
Even now, the government continues to make poor policy choices in responding to the virus. To be sure, important decisions have been taken on increasing the availability of oxygen by de-prioritizing use of oxygen in industry so it can be redirected to hospitals and by sourcing oxygen from outside India. However, the central and state governments have wrongly prioritized decisions such as demanding Twitter remove content from opposition politicians, journalists, and activists who have criticized the government’s handling of the pandemic, or directing police to take action against citizens using social media to find oxygen because they insist, contrary to facts, that “there was no shortage of oxygen supply” and that such posts “spoil the atmosphere.”
Others have also pointed out how the government’s vaccine policy, which opens up to all adults above the age of 18 beginning May 1, 2021, remains opaque, inequitable, and fragmented. Under the new vaccine policy, the center would receive only 50% of vaccines manufactured to be used to inoculate those over 45, health care workers and frontline workers. Meanwhile, India’s states can negotiate acquisitions of the remaining 50% of the vaccines with the manufacturers to vaccine the 18-45 year old group of the population, thereby forcing states to either pay for the vaccines out of their already stretched budgets or pass the cost on to the citizens. For more on the negative externalities of this vaccine policy, please read this excellent piece by Rohan Venkataramakrishnan of Scroll.in.
Outside of India, the ongoing second wave in India also tested the growing partnership between India and the United States. Over the past few weeks, the issue of the Biden administration’s decision to invoke the Defense Production Act came to the forefront. Under the DPA, manufacturers of vaccine raw materials are required to fulfill domestic demand first before exporting those materials, affecting vaccine production in India. When asked, the Biden administration initially stuck to vetted, standard responses, highlighting their focus on domestic vaccination, which largely came across as tone-deaf given India’s worrying surge in cases. Worse still was the slow response in issuing even a statement of solidarity, or taking intermediate steps to send oxygen, therapeutics, testing kits, or PPE to India while the more complex discussion on the DPA and its impact on India continued.
After a week of frustrating and slow responses, the Biden administration has come out in full force. Several high-ranking officials, from the President and the Vice President to the Secretaries of State and Defense, to the National Security Advisor and Surgeon General, issued statements of solidarity. The United States also took action, promising to make available specific raw materials that India had requested, and sending over additional material (such as medicines, therapeutics, PPE) in short order.
All in all, however, it is clear that India is in the throes of a nightmarish second wave, and I want to end here with some final parting thoughts and resources that we can all share or contribute to.
Firstly, for all those in India, please wear your mask, please get vaccinated as soon as you can, and please take care to maintain social distance to reduce the transmission of the virus. Secondly, if you have the resources, please donate to institutions on the ground that are doing great work to provide oxygen, food, and other necessities to COVID-19 patients and families who have lost a breadwinner. Two major resources that have been collated into Google docs are available here and here, and you can also give via the GiveIndia platform (which is open to donations from outside India) here.
Finally, things are incredibly tough at a personal level for everyone, from Indians to NRIs to friends of India in general. Let’s help each other wherever and however possible. If I can help, please let me know. You can reply to this email or reach out to me on Twitter. If you know someone who is struggling, please reach out to them.
The second wave looks like it will get worse before it will get better, and it has already been a tough time for all of us. However, together, we can take steps to limit the transmission of the virus, support organizations doing good work on the ground, and help each other get through this difficult time.
Apologies again that this edition of Indialogue has fewer links and analysis than normal. We’ll return to the regular structure of the newsletter next week.
Thanks for reading this latest edition of Indialogue. Please let me know if you have any thoughts or feedback by emailing me at aman@amanthakker.com.