How India’s coronavirus trauma is being made worse by vaccine challenges and feckless decisions

India is vaccinating at top speed and approving more vaccines but is still struggling with the challenge of its massive population, while also letting huge crowds gather
With hospitals already overwhelmed, experts expect the latest wave of infections to peak in May, or later

C. Uday Bhaskar

Published: 9:45am, 17 Apr 2021

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India’s daily Covid-19 cases hit successive record highs this month to reach nearly 200,000 new cases a day as a rapid resurgence in infections pushed the country’s caseload to over 14 million, prompting experts to warn of a public health catastrophe.

In just a week, India has overtaken Brazil in total cases and is now second only to the United States, which has more than 32 million cases, though with a stable and much lower daily infection rate.

Experts worry that India’s abrupt surge in Covid-19 infections may soon acquire alarming proportions and become unmanageable for the Modi government. The peak may only come next month, or later, and the projections are grim, said Dr Bhramar Mukherjee, professor of epidemiology at the School of Public Health, University of Michigan.

Most models predict that daily cases could hit 300,000-500,000 at the peak, which translates, she said, to “20,000-25,000 hospitalisation[s] and 3,000-4,000 deaths every day. This will surely overwhelm the health care infrastructure.”

Already, many parts of India are reporting that hospitals have run out of beds, ventilators and oxygen cylinders. Covid-19 testing and vaccinations have also yet to scale up to levels appropriate for a country with a population of 1.3 billion.

Health workers shift patients from a dedicated Covid-19 hospital to another hospital, to make space for new patients in Ahmedabad, India, on April 13. Photo: AP

The complexity of the challenge facing India is reflected in the Covid-19 metrics used globally. On the one hand, India has done well to keep its death rate down to 125 per million of population, compared with the US at more than 1,700, and Britain and Italy at about 1,900 each. In terms of total deaths, India also comes out better at just over 170,000, compared to about 578,000 for the US, 362,000 for Brazil and nearly 211,000 for Mexico.

But if the expert projections about India unfold as envisioned, then its testing and vaccination rates are cause for alarm. The US has done 1.27 million Covid-19 tests per million in its population, France 1.08 million, Russia 854,000 and Turkey nearly 500,00 – while India has managed just over 188,000.

With mass inoculation accepted as the way ahead in curbing the spread of Covid-19, India’s vaccination numbers are woefully inadequate. India has reason to be proud that it took a record time of just 85 days to achieve 100 million vaccinations – which took the US 89 days and China 102 days – but the country’s demographic challenge remains daunting.

Despite its blistering speed, India has managed to fully vaccinate just 1 per cent of its population, compared to front runner Israel at 57 per cent, the US at nearly 23 per cent and Brazil at 3.5 per cent – three countries with a combined population of less than half that of India. Put differently, India has administered about 8 vaccine doses per 100 of its people, while the US has managed more than 57 doses and the much smaller Israel, about 120 doses.

One early constraint for India is that it had approved just two Covid-19 vaccines: Covishield, which is what it calls the locally produced AstraZeneca-Oxford vaccine, and the home-grown Covaxin.

To augment its vaccine stocks, which are being consumed rapidly, India took a significant policy decision to approve Russia’s Sputnik V vaccine for emergency use, announcing that it would grant the same to vaccines authorised for use by the US, Britain, the European Union, Japan and the World Health Organization.

Even as India copes with multiple challenges such as the emergence of new and more infectious Covid-19 strains, the lack of hospital beds and the tragic rush on cremation facilities – two anomalies merit notice.

India has provided more than 60 million Covid-19 vaccine doses to as many as 80 needy countries and, while this is commendable, the prudence of denying its own citizens its limited stock is debatable. The pandemic is a global challenge and more affluent nations with far more abundant stocks need to step up and find a more equitable vaccine distribution policy.

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Hindu pilgrims need Covid-19 tests before bathing in holy river at Kumbh Mela festival

More incongruously, India has continued to allow vast numbers of people to assemble for political and religious events. Crowds of thousands, possibly more, have gathered for state election rallies across the country. Alarmingly, millions of devotees congregated at Haridwar in the northern state of Uttarakhand to take a dip in the sacred Ganges River and celebrate the Kumbh Mela festival, which takes place once every 12 years, and which coincides with the Indian new year in many parts of the country.

Such feckless decisions to allow mass crowds to gather despite a spike in Covid-19 infections could prove very costly. The Covid-19 numbers in May will testify to the scale of this folly.

Meanwhile, many other parts of the country are resorting to partial lockdowns and hapless migrant workers are once again preparing to leave urban centres. The colossal impact of such measures, so tragically exposed in 2020, may well repeat itself as India’s Covid-19 trauma unfolds over the next few months.

Commodore C. Uday Bhaskar is director of the Society for Policy Studies (SPS), an independent think tank based in New Delhi