What went so wrong for India in dealing with its second wave of Covid-19?
Saturday, April 24, 2021, 8:05pm, Heritage City. A wail broke the tense stillness of our home. Husband and wife shot from their room, fearing the worst had come to pass. And so it had. King Corona had claimed its latest victim.
Shanti Gupta, dark and rotund, just a few feet of height to her name, a live-in help of the last seven years, had received confirmation of the dreaded news she had carried in her bones over the week gone by, the weight of which had pressed her features into a taut mask as the fateful day progressed -- the younger brother, the child of the family, all of five years old when his sister had been given in marriage, had succumbed to the virus on the fifth day of his struggle.
Admitted to the general ward of a hospital in Lucknow, the teeming capital of the state of Uttar Pradesh, his steady deterioration compelled the intervention of a good Samaritan in the shape and form of a gentleman he had chauffeured around their town for the better part of 20 years, who expedited his transfer to the intensive care unit of the hospital.
As we know now, it was too little too late. Maybe if the bereft family had alerted the benefactor four days earlier, the outcome would have been otherwise. Perhaps, if, perhaps, if, if.
A drastic change
Was it just a few short weeks ago, in the halcyon days of March, when life was so rosy and sunny and sweet? The general consensus at the time, fuelled by images of smiling figures of authority and upbeat bulletins, was that we had bested the parabola and were now poised on the edge of an exhilarating downhill roller-coaster ride.
Testing was underway in droves, positive cases were but a fraction of the count of 12 months ago, the multitude was being inoculated by a variety of vaccines, immunity was on the ascendant, and the virus was at bay. With the infection of phase 1 peaking in September 2020, India enjoyed a straight 30-week period of a disease in apparent retreat.
In February, the government had even proclaimed a victory of sorts. We were the stars of the international community, as the government continued to occupy a premier seat at the high table of nations, remaining associated with the vanguard in the war against the virus, riding the crest of the crisis, and crafting a spectacular diplomatic blitz by shipping vaccines in bulk to almost 100 countries across the world.
India could do no wrong and we, as citizens of the saviour of the world, counted the days when the mass exodus from home to office and school would commence and we could snatch our life of normalcy back from the pernicious clutches of the Deadly Scourge.
Confidence is gone
A few short weeks later, on the cusp of March and April, and the environment of optimistic confidence had evaporated in the heat of the summer sun. In the days that followed, King Corona has razed the delicate fabric of a society, now dazed and terrorized. Covid-positive cases accumulate in the hundreds of thousands every single day, with fatalities counted in their thousands. The rising numbers reported from mid-February had failed to alarm, as we continued with our merry and blinkered way.
A renowned data scientist and statistician informed us that the mathematical modelling constructed on the basis of available data had forecast as many as 500,000 positive cases and upward of 3,000 deaths a day by the beginning of May. The peak in the number of infections, again the outcome of a reading of several statistical models, could arrive in the middle of the month, and as May ends, deaths could be a horrific 4,500 per day.
Where precisely are we to place blame? Easily answered with the benefit of hindsight -- in believing that a resurgence of Covid-19 was improbable. Most countries have suffered a second wave. We have been in inexplicable denial about the possibility in our own fair country.
This isn’t Sunday school
Friday, April 23, 2021, 8:30pm, Republic of India. Mr Modi addressed the nation. Elegant and articulate he was, but uncharacteristically brief and to the point. A seasoned leader who carries the worry and responsibility of a vast nation with the ease of the natural administrator, he appeared visibly worried and weary. Every sentence was heavy with the disappointment of a PM who saw the success of the past 12 months dissipate in the likelihood of the potentially millions of positive cases that the country now desperately seeks to thwart.
We waited with bated breath for the directive of another total lockdown, and were left astonished when the PM spoke instead about fostering awareness at the micro-level of the apartment complex and every hamlet of the nation and the overriding need to enthuse the young to form self-help groups and spread the good word of the (now double) mask, social distancing, and personal hygiene.
What does one make of this Sunday school-like message? Have we capitulated in the face of the leviathan emerging from the depths of the darkest book of the Holy Bible?
Meanwhile, the number of detected cases raced to a daily average of 350,000. But the frightening implication of this statistic is that the undetected cases could number from anything between 20 to 30 times that of proven cases. On average, the “underreporting factor” could be at a minimum of 15 times for the country, although Delhi, the seat of power and privilege and, as it turns out, the capital of the cavalier and callous, is estimated to be in the region of a gigantic 20 to 25 times.
The evidence of virologists would suggest that the original strain of King Corona has mutated, the malignant forms of which now includes the N440K variant of Covid-19, and appears to be wreaking the havoc of today. Cluster infection, caused by the virus hopping amongst families and communities of individuals living in close proximity, and of people being scythed down en masse, is the hallmark of this phase.
To add to our woes, there are sinister murmurings of a “Bengal Variant” which has not yet manifested in its full fury. On April 30, India became the first country in the world to record over 400,000 cases. There were also 3,464 reported deaths on that day.
What caused this catastrophe?
As with any crisis, we look to a combination of reasons. In February and March, the program of inoculation underway on an admittedly industrial level should have been further ratcheted up on a war footing, whereas what we have been privy to are unsubstantiated whispers of a government squabbling with vaccine manufacturers in order to beat them down to a minimum price.
In typical fashion, the energies of the machinery of state are squandered in the perennial human foolishness of saving the penny and spending the pound. And in spite of all reports through media and social media making it amply clear that Covid-positive cases were aggressively on the rise, we ignored the data from February and the evidence of our eyes, instead choosing to bury our collective heads in the sand in a massive act of “data denial.”
A recent shocker has it that a panel of scientists from Reuters warned the central government in March about the impending catastrophe. And while the hapless state of Maharashtra has been reeling for months, where the infection appeared to have been localized, the data now demonstrates that the densely populated states of Uttar Pradesh, Bihar, and West Bengal could be the primary petri dish of the second phase of the catastrophe.
Sunday, May 2, 2021, the counting of votes in India. A few hours into the day, the non-stop election commentary and graphics revealed that the fate of the Bharatiya Janata Party had been conclusively sealed in the all-important state of West Bengal.
The ruling national party registered higher returns in the unlikely state of Tamil Nadu and retained power in Assam. However, MK Stalin secured a well-deserved victory, ending the decades-long political drought of the Dravida Munnetra Kazhagam in Tamil Nadu, and the state of Kerala rewarded communist Chief Minister P Vijayan with a second term for the stellar performance of his administration in containing first the great deluge and then the menace of King Corona.
Was it overweening confidence caused by patently flawed reporting on the ground which permitted the electoral juggernaut to be activated in West Bengal, Assam, Tamil Nadu, Puducherry, and Kerala during a global pandemic? Was it raw ego which, when powered by the mechanics of a foolish momentum, pushed the centre to pull out all the stops in a final determined bid to unseat the Iron Lady of the Bengali nation?
An unprecedented galaxy of political heavyweights descended upon the state to do battle with one slight and sari-clad figure, the sole individual whose name carries any weight out of the legions that comprise the All India Trinamool Congress.
However, a combination of an excessive reliance on Hindutva, the mockery of a combative woman who dared to defy the seemingly insurmountable odds, and unlimited resources and access to all the instrumentalities of state which, many declare, also included a compliant Election Commission of India, failed to unseat the incumbent government which, under the leadership of Mamata Banerjee, romped home to a third term, even wresting the 50 assembly constituents corresponding to the Lok Sabha seats that had been lost in 2019 to the juggernaut of the BJP.
According to the experts, a groundswell in favor of Ms Banerjee assumed such proportions as to activate what was quaintly referred to as a “psephological bump” and the momentum of a phenomenon that has the sound of a dance step from the Swinging Sixties generated the velocity to crash through the psychological ring that a compliant national media and the inane non-opinions of the chattering class had attempted to corral the Bengali nation with.
Total lockdown was imposed in March 2020 with barely a whimper, a total blanket of administrative arbitrariness that made the Emergency of 1975 seem like a walk in the park. In the age of calamity that we live, where the mesh of civil liberties attached to a life of normalcy are happily forsaken, where was the need to adhere to the motions and notions of electoral law and politics in what can now be viewed only as a highly selective exercise of adherence to the principles of democracy which went disastrously wrong for the BJP?
Mamata Didi is now the undisputed giant killer, magnified to several times her stature as chief minister of a state tucked into the corner and, most importantly, the critical core around which a viable opposition can be built.
The silver lining is that the beating that the central government has taken at the hustings in the latest round of electoral politics would have jerked it out of its complacent lethargy and made the war against King Corona its one-point mission, if not obsession. If Mission Novel Virus demonstrates results, the government still stands to reap huge political dividends. Three years is a long time in Indian politics to refurbish an image eroded by actions that smack of triumphalist politicking and misplaced nationalism.
Thursday, January 14, 2021 to Tuesday, April 27, 2021, India. For the better part of four months, the town of Haridwar played host to a ceaseless stream of devotees eager to participate in the essentially modern Indian phenomenon of the Kumbh Mela, a gigantic logistical enterprise that plays itself out in an approximately 12-year cycle by turn on the banks of four river-bank pilgrimage sites of Allahabad, Haridwar, Nashik, and Ujjain.
The Kumbh is the largest manifestation of a mass folk-based Hinduism complete with festivity and fete and highlighted by the ritual dip in the river and the excitement of religious orders jockeying for pole position for the now-legendary sprint into the water.
Statistics would have it that over 9 million pilgrims took the holy dip in the Ganga. At least 6 million people, the overwhelming majority, collected in the month of April to coincide with the almost-vertical rise in the number of Covid-positive cases in the country. It would be a foolish person who nursed the fond hope that some modicum of Covid protocols was upheld for all those months in the dense and clustered life in Haridwar.
Yet another depressing example of the irresponsibility of the human collective was reported on April 27 when a huge crowd gathered for the funeral of Congress leader and Rajasthan Minister Saleh Mohammad’s father Maulana Gazi Fakir. The maulana was a figure of influence for half a century in Jaisalmer and, no doubt, the crowds that thronged his final send-off were a tribute to his stature in the community.
But this is just one more tale out of a thousand incidents across the length and breadth of the country where significant numbers of people gather for convocations, conferences, and ceremonies with no heed to the thunderstorm raging around us against which there is scant protection, if any.
The above provides glimpses of collective folly on a monumental level. And here in the permanent darkness of individual experience, the tale of mayhem is peeled back, layer by layer, to reveal the full extent of its horror.
In the restricted universe of our home, we know of only that rare family which remains unscathed by wave II of the infection. For the past four weeks, every avenue of social media has been saturated with information and images of death and suffering.
The plight of the National Capital Region has been underpinned by a humanitarian crisis built on an epic scarcity of oxygen. Life’s precious ether appears to have dissipated into the atmosphere as patients battle collapsed lungs and struggle to draw breath of their own accord.
Loved ones watch agonized and helpless, telephoning and messaging every known source and contact in the chimerical hope that the elusive cylinder will materialize, as if by magic. I can narrate a litany of tragedies of citizens whose relatives breathed their last in the ambulance while being transported the short distance to the hospital; of patient after patient caught in their dying gasp in the mere seconds as the oxygen cylinder was being changed, too exhausted to hang on for those few moments.
None are spared
What about the unfortunate who, as a member of over 40 WhatsApp groups, is forced to bear mute and disbelieving witness to the roll call of death and illness to afflict each and every group that she is a member of? What about the driver of a close friend, always immaculately turned out, who contracted King Corona, who by all accounts was healthy, but nevertheless succumbed to the dread virus?
But he was a young man, damn it! What about my colleague, many years younger than me, who lost his cousin in Mumbai, many years younger than him? To date, he cannot confirm whether the last rites were performed by his young cousin’s wife and son. My college mate ran from pillar to post looking for a canister of oxygen to bolster his wife’s damaged breathing, husband and wife teetering on the edge as friends and their spouses hopped from one WhatsApp group to the other and forwarded any of a hundred messages stuffed with details of names and numbers of merchants of injections and oxygen.
While most of these leads are turning out to be dead ends, a cylinder was requisitioned and breathing returned to normalcy, but his exhausted voice informed us that as veterans of the medical system in India, they had never been more afraid for their lives than they had been during the hell endured of the past week.
What about the tragically bizarre incident of the young woman upstairs, who succumbed to the virus in spite of being completely negative? Her psyche had been taken over by the ubiquitous presence of King Corona in a classic case of mind having gotten the better of the body. Today, one cannot have a conversation with colleagues without discovering that either they or their best friend have just lost a loved one or close relative.
Testing has now increased exponentially. Every pathology lab is swamped with more requests than it is equipped to handle. Accuracy is at a new low, and any number of reports which declare the patient to be virus-negative mask the grim reality when they are discovered gasping for air just days after being declared healthy.
Desperate circumstances call for desperate measures, and a medical protocol based on the assumption that the sufferer has contracted the virus now prevails if the all-too-familiar symptoms of high fever, sore throat, cough and runny nose, zero taste and smell, and a bout of diarrhea are complained of. The pharmacies are reeling under the commercial success of orders increased in their multiples combined with a chronic lack of staff whose ranks are decimated by the disease.
In an absurd tale of how skewed our priorities could possibly become, our friendly contact at the liquor shop informed in a harassed tone that it would be impossible to deliver the tipple for the weekend because he and his staff were besieged by 500 customers stocking up for an impending lockdown. I can’t think of a more effective way of boosting the sale of whiskey than to let loose the rumor of indefinite curfew. Pathetic!
And as if Shanti has not suffered enough. Hardly had she laid her brother to rest than the family was buffeted with the news that her husband’s aunt had passed away. And so it goes that the personal universes of a million households eventually overlap to throw a patchwork quilt of suffering and death over the sprawling expanse of the Republic.
Where are the bare essentials?
What accounts for the shortage of the bare essentials to combat King Corona? Apart from the shortage in oxygen, where are the hospital beds? What have we been doing for the last 12 months? Resting on our laurels, by all accounts!
Could a basic minimum program of constructing a full-service hospital in every district of the country not have been put in place? In response to the surge in infection, emergency Covid centres housing beds in multiples of a hundred are now mushrooming across the country.
The first year of disease was underpinned by breathlessness. Therefore, in anticipation of this primary symptom, oxygen facilities should have been commissioned in their hundreds rather than finding oneself in the avoidable situation where an administration is sheepishly forced to admit to the lacuna by promising to underwrite the creation of one thousand such centres from the prime minister’s emergency fund.
In the meantime, whole floors of hotels are requisitioned while hospitals convert wards into super-specialized centres of treatment. The gallant armed forces are lending their property and logistical experience to the national endeavour. Another aspect of the terrible tale was revealed by the plight of the venerable Batra Hospital in Delhi, where 12 patients had lost their lives because the oxygen ran out.
A similar story played out in Sitaram Bhartia Hospital, Madhukar Rainbow Hospital for Children, and Sama Hospital, to whose plight we had a macabre ringside seat as their fate hung in the balance and the slow and inexorable march to their death sentence was broadcast live on national television.
The last several weeks have also been witness to the wickedness of humanity. Horrific videos have circulated, in which the screaming bouts and bloody gashes featured in the images appear to tell a story of a harvesting of organs while the body of the recently deceased Covid patient is still warm enough to gouge out what body parts can be easily salvaged before the grieving family storms the ward to claim the body of the victim.
These are not time-stamped and do not carry any distinguishing feature and, therefore, are of questionable authenticity. However, can we put it past human nature to make hay while the sun shines? While the grisly industry of illegal organ harvesting and implants is not as prevalent, or has not been as widely reported in our country, the fact that a kingpin operating in North India was brought to justice a few years ago establishes the existence of this particular form of evil.
To give credit where it is due, the present dispensation has the ability to think not just big, but on a colossal scale. Come May 1, 2021, and vaccination was thrown open to all citizens of 18 years and above. Was it a day of reckoning? The census informs us that we possess 595 million people between the ages of 18 and 44. The present production capacity of the Republic is at 2.4 million vaccines a day, a decent number, but not nearly enough to cater to the deluge.
News filters through that Sputnik V of the Russian Federation is landing in bulk. My mother, and all 81 years of her, has so far fought inoculation tooth and nail. I don’t believe there is any particular reason for the stubbornness other than the pig-headed vagaries of age.
But as if this wasn’t enough, she claims that her personal doctor who supervises and navigates her through the labyrinth of tests which have become de rigueur today has declared that he will never take the jab. Very helpful, as you can see!
All told, India needs at least 2 billion vaccines to make this phase of the war against corona viable, coupled with a program that will induce even the reluctant and suspicious in their millions to make that crucial appointment with the dispensary, hospital, personal physician, or camp in their apartment complex.
The new generation
The scourge of the virus manifests itself in different ways. For my grand-nephew, comfortably ensconced in Lucknow, child of both parents who have recently passed through the fatigue and fever of King Corona, it is the wailing undulations of the ambulance siren which prevails as he scampers through the house mimicking its tones.
Finally, his mother, exasperated beyond endurance, snaps: “All right, all right! We hear you! The ambulance must have arrived. Why don’t you treat the patient now?” To which Amay Mandhyan, MD, pushing three, noble calling inspired by the chronicles of Peppa Pig, opens a doctor’s suitcase straight from the cartoons, and dutifully falls to administering to the needs of the sick and needy.
Of course, till another wail of an approaching ambulance causes him to leave the tools of his trade strewn on the floor for someone else to pick up and sends him, once again, careening through the house.
We are on the subject of the generation of tomorrow, who appear to be affected by King Corona in numbers not witnessed before. And, dear reader, I must confess to having been labouring under a severe and dangerous delusion, namely, that children below a certain age do not get affected by the virus.
I believe this can be attributed to some chance scrap of information picked up from a line of social media at the beginning of last year to the effect that children below a certain age were less susceptible because certain glands and organs, the maturity of which to a great extent determined the probability of infection, were less formed in them.
Not to say that this crass ignorance caused us to be reckless or cavalier with the basic precautions taken by our daughter during every waking moment, but a dangerous notion nevertheless borne of some corner of my optimistic self.
In the meantime, school holidays have been advanced by two weeks. My first reaction was to ask myself of the need for this directive, only to recall that our cadre of teachers, harassed by a lost year of unruly and apathetic pupils dulled by the monotony of the Zoom class, and burdened with the added responsibility of tending to their families, with the likelihood of being affected by infection, should be the first to enjoy a reprieve from the rigours of the academic year.
As we speak, news reports would have it that Bharat Biotech, Rokote Laboratories Finland Ltd, Avalon GloboCare Corp, Altimmune, and a handful of boutique outfits, in various stages of conceptualization, development, and clinical trials, are hurtling towards the market with various types of nasally administered sprays.
If these should work, and it would appear that the probability created by the determined efforts of modern medical technology lies in favour of these trailblazers, then we are on the verge of completely transforming the protocols of vaccination, which has implications far beyond the crisis that we are currently in the throes of.
Thus, the reality is that every person is susceptible to King Corona, and the herculean efforts of the last 15 months have failed to develop, or not focused on the development of, a vaccine for the juvenile, whose number today stands at 2 billion. That a protocol needs to have been put in place as of yesterday, to my mind, should be the priority of the Comity of Nations. All else pales into insignificance.
So, therefore, arrogance, hubris, complacency, exasperation with the life of the 12 months past, a refusal to acknowledge that the worst was on the horizon, these have been the contributing factors to the war that we are fighting. Can we only blame those in power? Absolutely not!
Each inhabitant of this frightened Republic had a role to play in the collective negligence which unfolded before us. The consequences of our criminally cavalier behaviour are writ in the smoke curling from the dense gridiron of burning pyres, where cremation grounds open around the clock are unable to cope and sidewalks are commandeered for the final farewell, while families bent with sorrow wait their turn in to the late hours to consign a son, aunty, or father on a night turned orange by constantly burning fire, and wondering, dazed and disbelieving, how it has come to pass. Perhaps, if, perhaps, if, if.
The resilience of humanity
As I write, we are also witness to the resilience of humanity and all that is good in the human endeavour. Social media, news media, the national channels, and the archives of recorded history shall demonstrate how people, at the sound of the faintest cry for help, left no stone unturned in ferreting out that elusive oxygen cylinder or having that hospital bed released from what was ostensibly a full roster.
It is the collective spirit, borne of the frightened determination to survive and the simple desire to make a difference and do good in the lives around us that is contributing, step by step, to the gradual turnaround to the cataclysm.
It is but natural to highlight only the negative, but one set of statistics would have it that India has, as of May 23, 26,530,132 positive cases, 299,296 unfortunate deaths and a staggering 23,425,467 persons who have recovered. This speaks volumes for the collective endeavour.
You would recall the early days of the disease when King Corona was spoken of in furtive tones and the identities of those affected were concealed in careful layers of hierarchy lest those around them got to know and, inexplicably, shunned them in a replay of the primitive notions of plague and leprosy.
Today, the stigma attached to the sufferer has lifted in the wake of every third person seemingly having had their personal brush with the virus. Our attitude is matter of fact, we consider the affliction more in the nature of an extreme version of the common cold, and those who recover are, rightly, feted and treated as the conquering heroes of the modern era who bear their suffering with pride and a badge of honour. How heartening! We indeed appear to have evolved!
The legion of “frontline workers” has, in the first 15 months of the invisible war, been constituted of all members of the medical fraternity in the collective consciousness. Spare a thought, however, for every single member of the apartment complex who diligently labours to ensure that the flower beds remain tended, the roads are swept clean, and that the plant remains functioning for the comfort of its citizenry.
Think of the units of policemen escorting health workers with their precious cargo of oxygen from the warehouse to a hospital repeatedly beseeching the chief minister over Twitter for essential supplies, and ensuring that the cylinders are delivered as planned; spare a thought for the staff in every bank branch, on premises because of complex compliance which prohibits them from logging in from home, receiving scores of requests and entertaining the power of attorney holder of the account holder, himself too terrified to step out of his home. Surely, these are also examples of the frontline warriors who need to be felicitated.
And, dear reader, if you have somehow, somewhere, contributed to the collective enterprise of helping a person in need, any person, if you were motivated to activate all your contacts because of that desperate voice on the phone which reminded you of a higher purpose that we are able to achieve, then you are also a frontline warrior.
“Do not be afraid of what you are about to suffer. I tell you, the devil will put some of you in prison to test you, and you will suffer persecution for ten days. Be faithful, even to the point of death, and I will give you life as your victor's crown.
“Since you have kept my command to endure patiently, I will also keep you from the hour of trial that is going to come on the whole world to test those who live on the earth.”
Perhaps those precious rays of light from the Revelation will provide hope and the guidance to where we will eventually arrive in this journey fraught with trauma and danger.
Sumit Basu is a corporate lawyer based in India, and is a freelance contributor.