India’s handling of COVID-19 is a disaster

India’s handling of COVID-19 is a disaster


  • How India mishandled the pandemic

India is heading for a major disaster because of its poor handling of the covid-19 pandemic. According to a BBC story titled: ‘Coronavirus: India becomes third country to pass two million cases’, the country confirmed the last million cases in just 20 days, faster than the USA or Brazil which have higher numbers. Despite the fact that testing has been expanded considerably in India in recent weeks, the situation continues to deteriorate. Some major faux pas in governance have led to the catastrophe to get out of hand. Spurred by a low death rate, India continues to reopen even as new hotspots drive the surge in cases.

India is now the third country to cross the two million mark. It reported 62,170 cases in a single 24-hour period, with its total tally up to Thursday reaching 2,397,403. Experts are accusing the Indian government of undercounting Covid-19 deaths due to a variety of reason, from lags in reporting to rules on how India determines if a death was caused by the virus. Meanwhile, India has been steadily “unlocking” its economy since early June after a grueling lockdown that lasted nearly two months. Gyms and fitness centres are the latest to reopen. The rate of testing is also inconsistent. While testing has gone up but it remains patchy, as some states are doing as many as 40,000 tests per million, and others as few as 6,000. Case numbers are rising rapidly, for instance, in the southern state of Andhra Pradesh. It shot up the list this past month, and now accounts for India’s third-highest caseload.

According to BBC, India was a “slow burning coil” for a long time when it came to the spread of the coronavirus. In that sense, it was different from the USA and Brazil, the two other big countries badly hit by the pandemic. Now it has taken 20 days for the country to progress from a million to two million cases. That is faster than the time the US (43 days) and Brazil (27 days) took to double from a million cases. However, India has recorded fewer fatalities than both these countries, which is dubious.

India’s response to the virus has so far been centralized, and that necessitates revisiting. India would have to be “broken down into districts” to implement a successful strategy against coronavirus, “because another national lockdown could be even less effective than the last one.” Covid-19 is a global pandemic but the disaster in India is homegrown

India is also generating the highest number of daily new cases in the world. What is making it difficult to contain the infection is the country’s size, population and heterogeneity. In what has become a “patchwork pandemic”, infections are waxing and waning in different states at different points.

India is lacking a robust federal strategy to contain a virus that is going to affect the world for a long time. The country needs to bring together “public health, health care, social support and financial sectors together” with strong political leadership at every level to forge a national containment strategy, says epidemiologist Bhramar Mukherjee. Also, the strategies need to be different for different parts of India. The country simply cannot afford another grinding lockdown. But, as Dr Mukherjee says, “We cannot let our guards down and surrender to destiny”.

The coronavirus took hold slowly in India, but six months after its first confirmed infection it has overtaken Russia to record the world’s third largest caseload. With the world’s second-largest population, much of which lives packed into cities, the country was perhaps always destined to become a global hotspot.

But the data behind its case numbers is questionable, because India is not testing enough, and an unusually low death rate has baffled scientists. The factors that must be taken into consideration are that India’s cases are rising fast. India has seen a series of record spikes recently, adding tens of thousands of cases daily. It recorded most of its confirmed cases in June, within weeks of reopening after a rigid lockdown. In the first week of July, India had 742,417 confirmed cases.

But the true scale of infection rates in the population is unclear, according to virologist Shahid Jameel. The government conducted a random sample of 26,000 Indians in May, which showed that 0.73% had the virus. Some experts have reservations about the sample size, but others, such as Dr Jameel, say it’s the only country-wide indicator they have to work with.

Given that confirmed cases in India have been doubling every 20 days, that would put the current total between 30 and 40 million. The gap between confirmed cases and actual infections exists in every country, but to different degrees. Testing is the only way to bridge it.

India’s emphasis on test and trace early on limited the pool of people it was testing to high-risk cases and their contacts– and kept it from expanding to the wider population. Test and trace is insufficient once the infection starts to spread rapidly, said Himanshu Tyagi and Aditya Gopalan, mathematicians who have studied covid-19 testing strategies. It helps with containment, but it does not discover new cases that have emerged undetected in the community, Mr. Tyagi and Mr. Gopalan said.

India has to test a broad swathe of people for that to happen. But how do we know who India is testing? Comparing testing numbers across countries is tricky because some count how many people they test, while others count how many tests they do. India does the latter and this number is slightly exaggerated because most people get tested more than once.

So instead, scientists prefer to calculate how many tests it takes to find a single confirmed case. The more tests it takes, the wider you are casting your net. Here, India fares poorly compared to countries that have managed to control the spread of the virus.

The data suggests that those in India who have been diagnosed with the virus are recovering from it faster than they are dying from it. This is crucial, Dr Jameel said, because it determines the strain on the health system. Currently, deaths are rising more slowly than confirmed cases or recoveries– but if that rate quickens, it would increase the pressure on hospitals, possibly driving up deaths.

The caveat is that low testing rates means fewer new cases are recorded, and at a slower pace. That will quicken the recovery rate in comparison to that of confirmed cases.

Each Indian state tells a different story. Since India is a large land mass, and is composed of various states, like the USA or the European Union, the handling differs, so the coronavirus statistics vary widely across India’s states. Three states– Delhi, Maharashtra, and Tamil Nadu– account currently for about 60 percent of the country’s caseload. However, India’s response to the virus has so far been centralized, and that necessitates revisiting. India would have to be “broken down into districts” to implement a successful strategy against coronavirus, “because another national lockdown could be even less effective than the last one.” Covid-19 is a global pandemic but the disaster in India is homegrown.

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