COVID-19 in India

COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most common COVID-19 symptoms include coughing, shortness of breath, and fatigue. However, a significant proportion of those infected are asymptomatic. This, combined with its rapid spread on an international scale through air travel and the fact that symptoms, when they do present, can overlap with conditions such as the common cold or the flu, has allowed for COVID-19 to spread rapidly. Within a few short months, secondary hotspots had occurred, with the US, Brazil and Russia taking top spots for disease cases as of early June 2020. 

European nations such as Italy and Spain saw major outbreaks which have frequently been suppressed, only to show a resurgence in many cases. Tourism played a major role here, a phenomenon that led to the closing of international borders and the subsequent quarantine of citizens in many nations across the globe. 

Delayed imposition of quarantine and social distancing measures was cited as a major factor that resulted in many countries such as the US and UK having prolonged and heightened disease outbreaks compared to neighbouring nations. Nations such as the UK, which have shown high rates of vaccine delivery among the population are now showing far decreased cases.

In India, a total lockdown was enacted on March 25th — one that drew criticism due to considerable loss of jobs, particularly among day labourers and migrant workers, many of whom were left facing starvation having already been financially vulnerable and food-insecure. Despite the lockdown, cases still surged within the nation, rising from 606 cases on March 25 to over 200,000 by June 2nd. According to a report at the time drafted by epidemiologists, public health practitioners and experts in preventive and social medicine, “community transmission is already well-established across large sections or sub-populations in the country.” 

Following the removal of lockdown orders across much of the nation, cases continued to surge. By July 17th the total case count in India exceeded one million. Migrant workers flocking from cities to their hometowns and villages played a role in allowing the disease to permeate to all corners of India.

Cases surged to an all-time high in mid-September of 2019, hitting what was then a record point of more than 100,000 new daily cases. Following this, cases began to gradually fall, with the international community at the time hailing India as a clear case of handling and curtailing a crisis. Cases plateaued and remained at a low point — though still ever-present — until late February.

At this point, in sharp contrast to the progress India had made against COVID-19, cases again began to rise. This second wave has generated global records for daily cases, with consecutive days of more than 400,000 new cases. Likewise, daily deaths surpassed 4,000 a day, roughly double that of the first wave. As doctors on the ground described it, a “Pandora’s box” has now been opened.

Along with the issue of a rising number of cases there are ever growing fears of a number of new strains that have been first documented within India. The first of these was a “double mutant.” The double mutant, in which two base pairs of DNA are altered from the base strain — E484Q and L452R — was suggested by virologists to be both more contagious and capable of causing reinfection. Variants first identified in India have since been documented across the globe, with countries such as the UK citing the mutant variants as forming the biggest portion of new cases. 

The “Pandora’s box” situation has since subsided, with figures now decreasing to a point lower than the first wave. However, the damage has already been done, and thousands of lives have been lost. It would be wrong, indeed, to suggest the crisis is over. The death toll in just the few months since the beginning of the second wave has seen deaths in the country more than double, from roughly 160,000 before the start of the second wave, to more than 340,000. What makes this death toll worse is that many of these deaths were deemed preventable.

A lack of medical oxygen was noted as contributing to the deaths of hundreds, if not thousands of individuals who may have otherwise survived. “Not less than a genocide,” is how the Allahabad High Court described the lack of critical oxygen supplies in hospital wards in a scathing rebuke. This remark was directed at the authorities responsible for procuring oxygen supplies, describing their negligence as a “criminal act.’

Further issues, such as the outbreak of mucormycosis or “black fungus”, have arisen as a problematic occurrence during India’s attempts at handling the influx of hospital cases during the second wave. Overburdening of the health system, as well as the use of steroids in treating COVID-19, leading to diminished immune responses and spikes in blood glucose level have caused this condition to surge, taking the lives of thousands. 

With the second wave now consistently declining, it is important that the mistakes at the end of the first wave are not repeated. Complacency and “pandemic fatigue” need to be addressed. Vaccinations need to be increased. Failure to do so could see India fall into a third wave, with the potential for yet more lives to be lost.