The second wave of the Coronavirus pandemic is revealing the weakness of our health infrastructure like never before. There is a shortage of oxygen tanks, hospital beds, ventilators, vaccines, and in some cases medicine too. The virus has spread like wildfire, with 3,52,991 more cases recorded on the 25th of April 2021. This is nearly four times the peak number of single day cases recorded during the first wave.
India was on the path of a relatively quick and successful economic recovery from the effects of the pandemic. The vaccination drive had started with a strong impetus and life was just about beginning to return back to normal. The public’s concerns had relaxed. Over the past month, however, we have seen the virus spread at a rate that has totally overwhelmed our health sector. Images of sick patients waiting outside hospitals for treatment and cemeteries with 30-40 funeral pyres burning at a time are now being routinely published on social media. The nation’s capital recorded a death every 5 minutes just a few days back.
To say the situation is grim is to grossly under state reality. How did it get so bad? Is there anyone to blame? When the pandemic first broke out a little over a year ago, there were very real concerns about India’s capability to deal with such an outbreak.
Such a virus was expected to decimate a country as populated as ours, especially in the big cities where so many people live in such close quarters. The first wave which peaked sometime in mid-September managed to do a lot of damage in and of itself. The Prime Minister enforced a strict national lockdown back in March 2020 which helped limit the spread of the virus. Towards the end of the year, the situation began to improve, giving people the confidence to resume normal activities.
The first wave hit India a little later than many other countries. Just as India had begun to ‘flatten the curve’, countries in Europe and North America were starting to experience a second wave. This should have been a warning to the administrators of the country that the pandemic had not yet been dealt with entirely.
Instead, we saw politicians from all sides campaigning and holding rallies in West Bengal where even the Prime Minister, as late as the 17th of April when more than 2,50,000 cases were recorded, remarked that he had, ‘never seen such huge crowds at a rally’. He was maskless along with the many of the thousands in attendance.
In February of this year the BJP had announced that the virus had been defeated thanks to the efforts of its leader. In March, the BJP government in Uttarakhand had published a full page advertisement in a national newspaper welcoming people to the Kumbh Mela that was scheduled to take place in Haridwar. The Chief Minister appeared along with the Prime Minister to give assurances that the event would follow all the safety protocols and that it would be safe to attend.
There is no doubt that the callous attitude shown by the politicians rubbed off on the people of this country. The prevailing attitude was that the worst was behind us and as such there was no need for such a high level of caution. In such circumstances, it takes very little for a second wave to emerge.
On the other hand, there remain many questions to be asked about the lack of medical resources currently available in the country. The health infrastructure in India has always been lacking. We have a mere 0.55 government beds per 1000 people and of those, only 5%-8% are said to be ICU beds. We also only have 0.9 physicians per 1000 people which is lower than the world average of 1.5. Numbers like these illustrate just how vulnerable we are to an event such as a pandemic.
The image above shows us that the situation with respect to the availability of government hospital beds is pretty dire across the country with the small exception of a handful of states.
We are also facing a severe oxygen crisis at this moment in time where patients are literally struggling to breathe. This has in many cases led to their unfortunate deaths. Questions have popped up about the government’s lack of preparedness at least when it comes to medical supplies like oxygen tanks and ventilators. At the start of the first wave itself, health experts raised concerns about the lack of these supplies and yet it took until October for the government to invite bids for oxygen plants that were to be built into the hospital premises. Even so, of the 150 plants that were meant to be set up, only 33 have been established as of right now.
In January of this year, a group of 100 former civil servants had written to the Prime Minister criticizing the lack of transparency associated with the PM CARES Fund that was set up last year to deal with the crisis. More than $1.3 billion were collected from the public and yet there are no details regarding how this money is being used or where it is at all. There are doubts regarding its status as a government fund or a private entity, and even the government itself seems unsure.
The vaccination programme started strong in India and appeared to be a success but in recent weeks there has been a slowdown due to a shortage. The government seems to have overestimated India’s capacity for manufacturing vaccines. India does a great job of distributing vaccines to UNICEF where it accounts for 60% of its total vaccines received. These are mainly child vaccinations. However, within India, the capacity to manufacture adult vaccines is not as high.
Manufacturers basically need to convert their seasonal influenza vaccine manufacturing capabilities to manufacturing vaccines for the coronavirus. Since the market for the influenza vaccines is restricted to only just a few developed countries, the existing capacity itself is quite small. Manufacturers like the Serum Institute and Bharat Biotech are currently looking for more funding from the government to expand their capacity. The government only very recently announced that it would allow foreign vaccines which have already been approved in other countries to be imported and distributed here.
There is certainly a fair bit of accountability that remains with the government for its lack of preparedness for a second wave. Investments should have been made to ramp up supplies and hospital beds but they also should have maintained a high level of caution. Events like the Kumbh Mela, which has now become a super spreader, should have been postponed until next year. Election rallies should have been suspended too. Instead, the narrative employed was very much a self-serving one and clearly short-sighted. Now, lockdowns are beginning to be implemented again by state governments and we seem to have a repeat of 2020 on our hands. The one positive is that the vaccination programme has started with all adults being eligible for the first dose from the start of May. Still, it will be a while before everyone gets the vaccine. The government has a lot of work to do.