India is being pulverized by a second Covid-19 wave

India has been battered by a second wave of the coronavirus, turning the country into a new global hotspot for the Covid-19 pandemic, alongside the United States and Brazil. With India’s healthcare system collapsing and states demanding more oxygen and medication, Prime Minister Narendra Modi’s government seems both unperturbed and ill-prepared for the public health disaster.

Desperate patients queue outside hospital emergency rooms in major Indian cities, waiting for beds and oxygen. Those who do make it in are often crammed two to a bed, which fill the halls and lobbies. Families wail in cemeteries and cremation centres full to overflowing. Long lines of ambulances transport gasping patients, while mortuaries battle to cope with the influx of the dead. On social media, people post last-ditch requests for hospital beds, ventilators, critical medication and Covid-19 tests.

India reported a staggering 315 660 new coronavirus cases on 22 April, the world’s largest single-day rise since the pandemic began, bringing the country’s total infections to 15 924 914. On the same day, 2 019 new deaths were reported, taking the toll to 184 662. This was the eighth day in a row the country reported more than 200 000 new infections. Experts say a new variant is driving the rapid spike in cases, in particular a variant first described in India as B.1.617 that contains two mutations associated with increased infection rates.

The western state of Maharashtra, the country’s most economically developed state, is the epicentre of the new wave, forcing the state government to impose statewide restrictions till 1 May. Modi, in a televised address on 20 April, urged the states to use lockdown only as a last resort. “They should earnestly try to avoid lockdown and focus on micro-containment zones,” he said.

The opposition criticised the Bharatiya Janata Party (BJP) government, saying Modi’s dispensation has put the onus on non-governmental organisations, children and the youth. “[Modi] … has announced the abdication of his responsibility. Not a single word on what his government is going to do to tackle this grave health emergency and save peoples’ lives,” tweeted Sitaram Yechury, the general secretary of the Communist Party of India (Marxist).

According to an April 2021 report by The Lancet Covid-19 Commission, if the runaway infections are not stopped, India could lose between 1 750 and 2 320 lives daily by the first week of June. “Disruptions to regular health services, such as routine immunisation and delivery care, could have devastating consequences for maternal and child survival,” the report says. Indian virologist Shahid Jameel said the second wave of the coronavirus could last till the end of May, and the daily count of infections might go up to 300 000.

Gasping for oxygen

India is also reportedly experiencing an acute shortage of oxygen, even as several states have redirected all industrial oxygen production for medical purposes. At least six coronavirus patients reportedly died because of low pressure in a liquid oxygen tank at a government medical college in central India’s Madhya Pradesh state. As many as 168 patients, including 40 who were critical, had to be moved on 17 April from six Mumbai hospitals that had exhausted their oxygen supply. 

An oxygen tank leak at a hospital in Maharashtra on 21 April caused 22 patients on ventilators to die. The superintendent of the Nalanda Medical College and Hospital in the northern state of Bihar asked the government to relieve him of his post, citing lack of oxygen supply in the Covid-19 medical facility. The western state of Gujarat, Modi’s native state, also reported a shortage of oxygen and the antiviral medication Remdesivir. 

Maharashtra chief minister Uddhav Thackeray said on 13 April that there is a shortage of medical oxygen, beds and an increased demand for Remdesivir. He said he had asked the Modi government to assist. Delhi chief minister Arvind Kejriwal also said the capital was facing an “acute shortage of oxygen”.

22 April 2021: Workers load filled oxygen tanks into a vehicle at a refill station in Mumbai. (Photograph by Dhiraj Singh/ Bloomberg via Getty Images)

Modi’s government placed the onus of tackling the situation on state governments, with union minister Piyush Goyal urging the states to keep oxygen demand under control. “If cases continue to rise … then it will pose a major challenge for the healthcare infrastructure of the country,” he said. 

Despite oxygen being critical for Covid-19 patients, the Modi administration reportedly took eight months to accept bids for new oxygen-generation plants. Facing a backlash over the shortage of medical oxygen, India’s union health minister announced on 18 April that 162 pressure swing adsorption oxygen plants have been approved for installation in public health facilities across the country.

The government also said the supply of medical-grade oxygen would be doubled, and 50 000 tonnes of oxygen would be imported. It also announced “oxygen express” trains that will carry tankers through a special corridor following requests from Maharashtra and Madhya Pradesh.

Vaccine mismanagement 

When cases began to fall late last year, there was a feeling of relief among the public and people resumed life as normal. There was an even greater complacency from the Modi government, which seemed to believe the outbreak had come to an end. India’s health minister, Harsh Vardhan, declared in early March that the country was “in the endgame” of the Covid-19 pandemic. 

India began shipping vaccines to other countries from January as part of its “vaccine diplomacy”, while accelerating its immunisation drive domestically. India has administered more than 100 million vaccine doses to its citizens since the immunisation drive began on 16 January. It supplied more than 48 million doses of Covid-19 vaccine to more than 80 countries across the world under the “vaccine maitri” (vaccine friendship) initiative.

But several states had begun reporting vaccine shortages by the end of March, and the Modi administration urged the Serum Institute of India and Bharat Biotech, India’s main vaccine producers, to prioritise domestic consumption of vaccines over exports.

22 April 2021: A medical worker administers a Covid-19 vaccine at a district hospital on the outskirts of New Delhi. (Photograph by Anindito Mukherjee/ Getty Images)

The Modi government also proposed a slew of new policies on 20 April that would effectively liberalise vaccine sales and deregulate vaccine costs, which critics say would make vaccines unaffordable and prevent millions of impoverished Indians from receiving doses.

The opposition parties attacked the government’s new vaccine policy, calling it “discriminatory, inequitable and haphazard”. “This is not going to mitigate the pandemic or resolve the huge public health emergency that our people face. On the contrary, such a discriminatory policy will only make India more vulnerable to the pandemic surge,” said the Communist Party of India (Marxist).

Gandhi termed the government’s vaccine strategy as no less than the 2016 demonetisation of banknotes. “The common people will stand in queues, will suffer loss of wealth, health and life and in the end only a few big industrialists will benefit,” he tweeted.

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