NEW DELHI (AP) – The Indian city of Pune is running out of fans as gasping coronavirus patients crowd the hospitals. Social media is rife with people looking for beds, while family members crowd pharmacies looking for antiviral drugs that hospitals stopped using long ago.
The increase, seen across India, is particularly worrying as the country is a major vaccine producer and a critical supplier of the UN-backed COVAX initiative. That program aims to shoot some of the poorest countries in the world. Increase in cases has forced India to focus on meeting domestic demand – and delay supply to COVAX and elsewhere, including the United Kingdom and Canada.
India’s decision “means that there is very little or nothing left for COVAX and everyone else,” said Brook Baker, a vaccine expert at Northeastern University.
Pune is India’s hardest hit city, but other major metropolises are in crisis as well, as daily new infections hit record levels and experts say missteps stemming from the belief that the pandemic was ‘over’ continue to haunt the country.
When infections started to plummet in India in September, many concluded that the worst was over. Masks and social distancing were abandoned, while the government gave mixed signals about the level of risk. As the number of cases started to pick up again in February, authorities continued to struggle.
“No one had a long-term view of the pandemic,” said Dr. Vineeta Bal, who studies the immune system at the city’s Indian Institute of Science Education and Research. For example, she noted that instead of strengthening existing hospitals, temporary locations were created. In Pune, authorities are reviving one of those makeshift facilities, which was crucial to the city’s fight against the virus last year.
India is not alone. Many countries in Europe that saw a decline in the number of cases are experiencing new peaks, and the number of infections has increased in every region of the world, partly driven by new virus variants.
For the past week, India had an average of more than 130,000 cases per day. It has now reported 13.5 million virus cases since the start of the pandemic – pushing its toll beyond Brazil and placing it in second place to the United States, although both countries have a much smaller population. Deaths are also on the rise, crossing the 170,000 mark. Even those numbers, experts say, are likely to be under-graded
Nearly all states are showing an increase in infections, and Pune – home to 4 million people – now has just 28 unused ventilators Monday night for the more than 110,000 COVID-19 patients.
The country now faces the daunting challenge of vaccinating millions of people, while also tracking the tens of thousands who become infected every day and preventing the health system from collapsing.
Dilnaz Boga has been in and out of hospitals for the past few months to visit a sick relative and witnessed the shift firsthand as the cases started to rise. Beds were suddenly unavailable. Nurses warned visitors to use caution. There were posters everywhere advising the correct wearing of a mask.
And then, earlier this month, Boga and her 80-year-old mother tested positive. Doctors suggested that her mother be hospitalized, but beds were not initially available. Both she and her mother are now recovering.
Additional concern about the increasing number of cases is the fact that the country’s vaccination urge could also end in trouble: several Indian states have reported shortages of doses, although the federal government has insisted on adequate supplies.
After a slow start, India has recently overtaken the United States in the number of shots it gives every day and now averages 3.6 million. But at more than four times the number of people and starting later, it has given at least one dose to about only 7% of its population.
India’s western state of Maharashtra, home to Pune and the financial capital of Mumbai, has registered nearly half of the country’s new infections in the past week. Some vaccination centers in the state have turned people away due to shortages.
At least half a dozen Indian states report similarly low supplies, but Health Minister Harsh Vardhan calls these concerns “regrettable attempts by some state governments to divert attention from their failures.”
Concerns about the supply of vaccines have led to criticism of Prime Minister Narendra Modi’s government, which has exported 64.5 million doses to other countries. Rahul Gandhi, the face of the main opposition party in Congress, asked Modi in a letter whether the government’s export strategy was “an attempt to garner publicity at the expense of our own citizens.”
Now India has changed course. Last month, COVAX said shipments of up to 90 million doses of AstraZeneca vaccines were delayed because the Serum Institute of India decided to prioritize domestic needs.
The institute, which is based in Pune and is the world’s largest vaccine producer, told The Associated Press earlier this month that it could resume exports of the vaccine by June. – if new coronavirus infections decrease. But a sustained rise could lead to more delays.
And experts warn that India may be looking into that.
They suspect that the most likely cause of the widespread wave is the presence of more contagious variants. Health officials confirmed last month that 80% of infections in the northern state of Punjab were due to the version of the virus first discovered in the UK. There is also growing concern about another new and potentially troublesome variant first discovered in India itself.
India needs to speed up vaccinations and take steps to stop the virus from spreading, said Krishna Udayakumar, founder and director of the Duke Global Health Innovation Center at Duke University. “The coming months in India are extremely dangerous,” he said.
Still, some say the government’s confused reporting has failed to communicate the risk.
Modi has noted that people have to wear masks because of the “alarming” increase in infections. But in recent weeks, he has been addressing tens of thousands of mask-free supporters during his campaign.
The federal government has also allowed large gatherings during Hindu festivals like the Kumbh Mela, or the pitcher festival celebrated in the Himalayan city of Haridwar, where millions of devotees take a holy dip in the Ganges River every day. Responding to concerns that it could become a ‘superspreader’ event, the state’s prime minister, Tirath Singh Rawat, said that ‘belief in God will overcome fear of the virus’.
“Optics are so important, and we’re making a complete mess of it,” says Dr. Shahid Jameel, who studies viruses at Ashoka University in India.
Dozens of cities and towns have imposed partial restrictions and curfews to try to curb infections, but Modi has ruled out the possibility of another nationwide lockdown. He also rejected calls from states to offer vaccinations to younger people.
Experts, meanwhile, say the current limit on vaccine delivery to people over 45 should be relaxed and shots should be aimed in areas with power surges.
“The burden of COVID-19 is being felt unequally,” said Udayakumar. “And the response must be tailored to local needs.”
Journalists Rafiq Maqbool of the Associated Press in Mumbai and Maria Cheng in London contributed to this report.
The Associated Press Department of Health and Science is supported by the Science Education Department of the Howard Hughes Medical Institute. The AP is solely responsible for all content.