Dusk is falling in the Indian capital, and the acrid smell of burning bodies fills the air. It’s the evening of April 26, and at a tiny crematorium in a Delhi suburb, seven funeral pyres are still burning. “I have lived here all my life and pass through this area twice a day,” says local resident Gaurav Singh. “I have never seen so many bodies burning together.”
Scenes of mass death are now unavoidable in what’s often called the world’s largest democracy. Social media is filled with images of body bags and urgent requests for medical aid. Indians gasping for breath are being turned away from overwhelmed hospitals, sometimes simply because they don’t have lab reports confirming COVID-19 infection. Health workers plead for basic supplies. “We feel so angry,” says Kanchan Pandey, a community health worker in Azamgarh, Uttar Pradesh. “At least give us some masks and gloves. Is there no value to our lives?"
Such devastation would have been hard to imagine just a few months ago. Children were back in school, politicians were on the campaign trail, and people were dancing at weddings. “Soon the winter of our discontent will be made glorious summer,” India’s usually staid central bank said in a Jan. 21 bulletin. The next day, Prime Minister Narendra Modi heralded the spirit of atmanirbhar Bharat (self-reliant India) that had helped India secure victories in two major battles: on the cricket field against Australia and in the pandemic.
Two months later, India’s crisis has blown well past the scale of anything seen elsewhere during the pandemic. For six of the seven days beginning April 21, India set new global records for daily COVID-19 infections, repeatedly surpassing the 300,000 tally previously set by the U.S. Its total confirmed cases—more than 18 million—are second only to that of the U.S. By official counts, more than 200,000 have now died, and some 3,000 are dying per day. The true daily death toll is at least two times higher, says Bhramar Mukherjee, an epidemiologist at the University of Michigan, from a caseload likely at least 10 times higher, based on modeling of data from the first wave.
India’s health system is on the brink of collapse. Hospitals across the country are running out of oxygen supplies, ventilators and beds. Indians are rushing to buy drugs like remdesivir, causing prices to surge, while labs struggle to process growing backlogs of COVID-19 tests. Its humanitarian crisis will not just be devastating for the country’s nearly 1.4 billion citizens. In the words of the director general of the World Health Organization, the pandemic is a global inferno: “If you hose only one part of it, the rest will keep burning.” In India, where crematoriums have been burning so long that their metal structures have started to melt, the hose isn’t even turned on yet
In the longer term, vaccinations are desperately needed to prevent a third wave. Only 9% of Indians have had at least one vaccine dose (some, like Covaxin, require two doses), and the current pace of inoculation is too slow. It’s also not realistic, says Dr. Prabhat Jha, an epidemiologist at St. Michael’s Hospital, University of Toronto, for India to try to rapidly vaccinate 1 billion people. With limited vaccine supply, the most effective way to reduce transmission may be to target hot-spot areas and higher-risk people—which means India needs better data, fastt. Large-scale immunization programs for diseases like polio and tetanus, first-rate scientists, highly trained doctors and powerful networks of community health workers. What has been lacking, experts say, is the political will to get ahead of the crisis—and to use data and science to its advantage. “Without data—on who is testing positive, where the hot spots of cases and deaths are, who is really vulnerable—there’s no easy way for India to walk out of the pandemic,” Prabhat Jha says.
Many say the government has lost sight of its priorities. As cases soared to record highs in April, the government ordered Twitter and Facebook to remove posts critical of the authorities. Independent journalists have scrambled to identify massive discrepancies between official figures and deaths. “Those who died will never come back,” the Chief Minister of Haryana said in response to questions on April 26 about whether COVID-19 deaths were higher than official figures. “There is no point debating if the number of deaths is actually more or less.”
Modi entered the pandemic with sky-high approval ratings of nearly 80%, and polls from as recently as January suggest those numbers have barely dipped. Now, anger is rising among those spending their days trying to find beds for relatives or caring for their communities. But for most Indians, whether Modi can survive this crisis is now less urgent than whether they can. “The cries for help are growing—but not our capacities,” says Usha Thakur, a community health worker in Najafgarh, Delhi. “The governments are fighting amongst each other. They don’t care about the people but it’s the people who are losing their loved ones.”
—With reporting by Nilanjana Bhowmick/New Delhi, Alice Park/New York and Billy Perrigo/London
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