Why was India overwhelmed by the second wave of coronavirus and can the country come out of it?

In November, the health committee of the Indian parliament said that the country did not have enough oxygen and that the beds in public hospitals were “completely inadequate”.

In February this year, experts told the BBC they feared a new “COVID-19 tsunami” after an outbreak of the virus was detected in the vicinity of Amarwati.

And a group of scientists-experts created by the government in early March warned government officials about the spread of a more contagious variant of the coronavirus in the country, but no significant steps had been taken to stop the spread of the strain, one of the causes of the group. investigators told the BBC.

Despite all this, on March 8, India’s Health Minister Harsh Vardhan announced that India was nearing the end of the pandemic.

Why and when were things so bad?

Guilty of government hypocrisy and negligence?

During the first wave of the first wave in September, new cases reached 90,000 each. per day, and in January and February the number of new cases in the country decreased to 20 thousand. Indian Minister Narendra Modis later announced that the fight against the coronavirus had been won. Meeting places were opened: markets, offices, supermarkets, public transport was fully operational, large festivals, weddings and election rallies were held.

Soon, people began to fail to comply with security requirements, in part due to confusing pandemic solutions.

While Indian Prime Minister N. Modis encouraged people to wear masks and maintain the necessary safety distance from each other, he himself appealed to the large crowds of people who did not wear masks during his election campaign in the five states of the country. Several of his ministers were also seen addressing crowds of people not wearing masks. The Kumbh Mela religious festival, which has more than one million participants, was also allowed.

“There was a complete gap between how they behaved and what they said,” said public policy and health systems expert Dr. Chandrakantas Lahariya.

The renowned virologist dr. Shahid Jameel told the BBC that “the government just didn’t see the second wave and started celebrating too early.”

“Faulty” health system

But there are even more reasons: the tragic situation in India today has revealed the lack of funding and neglect of the public health system.

The heartbreaking moments of people dying on the streets next to hospitals because there is not enough space in them show the sad reality of India’s healthcare infrastructure.

According to one expert, “India’s public health infrastructure has always been broken, and the rich and the middle class are only now finding out.” Those who could afford it always relied on private hospitals, and at that time it was difficult for the poor to even get a referral to a doctor.

New approaches, such as health insurance and reimbursable medicines for the poor, are not helping, as little progress has been made in recent decades to increase the number of medical staff or hospitals.

India’s spending on health care, both in public and private institutions, has been around 3.6% over the past six years. GDP of the country. In terms of the BRICS, an organization that unites new emerging economies, India’s share of health spending is the lowest of the five countries in 2018. Brazil spent the most in this area, with 9.2% on health followed by South Africa with 8.1%, Russia with 5.3% and China with 5%.

Developed countries spend a much larger share of their GDP on health. For example, in 2018, the United States assigned it 16.9 percent. GDP, Germany: 11.2 percent. Even the smallest states, like Sri Lanka, allocate 3.76 percent. and Thailand, which represents 3.79%, spends more than almost 1.4 billion euros on health. population of India.

In India, 10,000. there are less than 10 doctors per capita, and in some states of India the figure is less than five, writes the BBC.

We had to prepare for the worst

Several government-mandated committees wondered last year how the country was prepared to deal with the next wave of coronavirus, confusing experts today with a lack of oxygen, beds and medicine.

“When the first wave hit, they had to prepare for the second wave and prepare for the worst. They had to do an oxygen inventory, the drug remdesivir and then increase production capacity, ”former Maharashtra state health secretary Mahesh Zagade told the BBC.

Officials say India is producing enough oxygen to meet growing demand and say it has faced transportation problems. Experts say that these problems should have been solved much earlier.

The government is now organizing special trains to transport oxygen from one state to another. The use of oxygen in industry was also stopped, but only after many people died of oxygen deficiency.

“The result is that desperate relatives spend thousands of rupees to get an oxygen cylinder on the black market and then queue for a few hours to fill it,” the BBC told Dr. Ch. Lahariya.

And those who can afford it also pay hefty sums to buy drugs like remdesivir and tocilizumab.

The director of a pharmaceutical company that makes remdesivir said demand had fallen in January and February. “If the government had placed an order, we would have accumulated stocks and there would be no shortage. [Dabar] we have increased production, but the demand has grown significantly, “he told the BBC.

Here in the south, the state of Kerala has predicted a possible coronavirus wave. Dr A. Fathahudeen, who is a member of the Kerala COVID-19 task force, says that there was no oxygen shortage in the state because the necessary measures were taken in October last year.

“We also buy enough stocks of remdesivir, tocilizumab, and other drugs in advance. We also have a plan in place if the number of cases increases again so that we can overcome any exponential increase in cases in the coming weeks, “he told the BBC.

Maharashtra state health secretary Mahesh Zagade told the BBC that other states had to take similar measures “to avoid suffering.” He said other states can learn from Kerala’s example, but it takes time.

And India does not have time, as the second wave is now spreading into villages where health care systems are not adapted to cope with such an increase in disease cases.

Very few genome sequencing studies

Viral genome sequencing studies are an important step in identifying new variants that may be more contagious and fatal. The Indian SARS-CoV-2 Genome Consortium was established last year and brought together 10 laboratories from the country.

According to the BBC, the group had difficulty obtaining funding. Virologist dr. Shahid Jameel says that India started seriously considering mutations in the virus quite late, and genome sequencing studies only started successfully in mid-February this year.

India currently conducts sequencing research at just over 1 percent. of all samples. “For comparison, in the UK during the peak of the pandemic, 5-6% of people conducted genome sequencing studies. Samples. However, it is not possible to create such a capacity overnight,” Shamel said. .

But India’s main hope has been and is vaccination.

The World Pharmacy has a shortage of medicines and vaccines

“Any public health professional will tell you that it is impossible to strengthen an already bankrupt state health system in a matter of months,” the BBC told a woman whose family runs a large private hospital in the Indian capital, Delhi.

“The best and most effective alternative to COVID-19 was to vaccinate the population as soon as possible so that most people do not need hospital care and therefore do not overload the health system,” he continued.

India initially planned to vaccinate 300 million in July. people.

“However, the government does not appear to have planned the vaccine supply well enough to carry out its planned program,” the BBC told Dr Ch. Lahariya, “In addition, the authorities have announced that all adults will be vaccinated. before they have had a sufficient supply of vaccines. “

To date, of the 1,400 million. Only about 26 million people in India have been fully vaccinated. people and about 124 million. people have received only one dose. India is expected to receive millions more doses, but it is still far from the amount it really needs.

The Indian government now needs 615 million. doses of the vaccine to fully vaccinate all patients over 45 years of age. the population is 440 million. people. Another 1.2 billion are needed. dose for the population of 18 to 44 years, which is 622 million in the country.

The government has asked other companies, such as Biological E and the state-run Haffkine Institute, to help make the vaccines. It also contributed 609 million. US dollars to support the Indian Serum Institute, which produces the Oxford-AstraZeneca vaccine, called Covishield in India, to increase production.

However, according to Ch. Lahariya, this funding had to reach the manufacturer first. In this way, the lives of the people of India could have been saved.

“It will be months before we have enough vaccines to accelerate the vaccination program. And millions of Indians remain at risk of contracting COVID-19,” Lahariya told the BBC.

Experts say it is ironic that India is known as the world’s pharmacy and now lacks vaccines and drugs.

Like dr. Mr Lariariya, this should be a signal both for the country as a whole and for individual states, which should invest much more in the healthcare sector, because “this is certainly not the last pandemic we will have to deal with.”

“The future pandemic may be sooner than anyone can predict,” he told the BBC.