Why India Shatters Global Infection Records

NEW DELHI (AP) – The world’s fastest spread of infections and the highest daily increase in coronavirus cases are driving India further into a deeper and deadly healthcare crisis.

India is huge – it is the second most populous country in the world with nearly 1.4 billion people – and its size poses extraordinary challenges in the fight against COVID-19.

About 2.7 million doses of vaccine are administered daily, but that is still less than 10% of people who receive their first injection. Generally India confirmed 15.9 million cases of infection, the second highest after the United States, and killed 184,657.

The latest wave has pushed India’s fragile health systems to breaking point: Understaffed hospitals are overflowing with patients. Medical oxygen is scarce. Intensive care units are full. Almost all fans are in use and the dead pile up near crematoriums and cemeteries.

HOW DID WE GET HERE?

Authorities were lulled into believing the worst was behind them when cases began to recede in September.

The number of cases fell for 30 consecutive weeks before starting to rise in mid-February, and experts say the country has not taken the opportunity to expand its healthcare infrastructure and vaccinate aggressively.

“We were so close to success,” said Bhramar Mukherjee, a biostatistician at the University of Michigan who has tracked the pandemic in India.

Despite warnings and advice that precautions were needed, authorities were unprepared for the magnitude of the wave, said K Srinath Reddy, president of the Public Health Foundation of India.

Critics have pointed out that the government has decided not to interrupt Hindu religious festivals or elections, and experts say these may have exacerbated the wave.

“Authorities across India without exception have put public health priorities on the back burner,” said Reddy.

As a result, the 7-day moving average of confirmed daily new cases in India has increased over the past two weeks from 6.75 new cases per 100,000 people on April 6 to 18.04 new cases per 100,000 people on April 20, possibly caused by new variants of the virus, including one that was first discovered in India, experts say.

India’s top health official Rajesh Bhushan did not want to speculate on Wednesday why the authorities could have been better prepared, saying: “Today is not the time to go into why we missed, or missed, we prepared ? “

WHY IS INDIA HEALTH SYSTEM COLLAPSE?

India spends only a fraction of its gross domestic product on its health system, less than most major economies.

When the virus arrived last year, India imposed a harsh, nationwide lockdown for months to prevent hospitals from becoming overburdened. This brought terrible hardships millions, but also bought time to take steps to close critical gaps, such as hiring additional health workers on short-term contracts, setting up field hospitals, and installing hospital beds in banquet halls.

But authorities did not have a long-term view of the pandemic, said Dr. Vineeta Bal, who studies immune systems at the Indian Institute of Science Education and Research in the city of Pune.

Suggestions for permanent improvements, such as adding capacity to existing hospitals or hiring more epidemiologists to detect the virus, were widely ignored, she said. Now authorities are trying to resuscitate many emergency measures that were halted when the numbers dropped.

A year ago, India was able to avoid the medical oxygen shortages that plagued Latin America and Africa after it converted industrial oxygen production systems into a medical-grade network.

But many facilities continued to supply oxygen to industries and now several Indian states are facing such shortages that the Ministry of Health has urged hospitals to implement rationing.

The government started building new factories to produce medical oxygen in October, but now, about six months later, it remains unclear whether or not some have come online, with the Health Ministry saying they were “under close scrutiny. on early completion ”.

Oxygen tanks are being transported to hot spots across the country to meet the demand, and several state governments have claimed that many of them have been intercepted by other states on their way to be used to meet local needs.

WHAT IS NEXT?

India faces the daunting challenge of trying to prevent its health care from further collapsing until enough people can be vaccinated to significantly reduce the flow of patients.

The good news is that India is a major vaccine producer, but even after stopping large exports of vaccines in March to make them for domestic use, there are still questions about whether manufacturers can produce fast enough.

“Vaccination is one way to slow the spread – but it really depends on the speed and availability of the injections,” said Reddy of the Public Health Foundation.

Several states have already said they are vaccine shortages – although the federal government denies this.

India said last week that it would allow the use of all COVID-19 recordings made green by the World Health Organization or regulators in the United States, Europe, Great Britain or Japan.

On Monday, it said it would soon expand its vaccination program from people over 45 to all adults, about 900 million people – more than the entire population of the entire European Union and the United States combined.

Meanwhile, Reddy said some states needed to implement new lockdowns, but in the long run, it was also up to individuals to do their part.

“As a society, it is critical that we enforce public health measures such as masking, taking physical distance and avoiding crowds,” he said.

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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.

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