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April 27, 2021 – India is facing a humanitarian catastrophe, unprepared, and unable to confront a deadly new surge of COVID-19. What is happening in India? How and why is it happening? And what must be done to stop this tragedy?  A webinar yesterday sponsored by Brown University’s School of Public Health, Watson Institute and Center for Contemporary South Asia explored these issues with Dean Ashish K. Jha, and Barkha Dutt, an award-winning Indian journalist and Washington Post columnist.

What is happening in India?

“If you ask me how many people are actually getting infected in India every day, I would say it’s a least one million.”
–Dr. Ashish K. Jha, Dean, Brown School of Public Health

The number of daily new COVID infections in India has exploded, from about 10,000/day on February 11th, to about 18,000/day February 26th – doubling the number of infections in just two weeks. Infections continued to grow in March, alarming public health observers, but little action was taken by the Indian government. Today, there are about 350,000 infections per day in India, with a test positivity about 20 to 23% nationally, which indicates the true number of infections may be three times that.

 “In my living memory, I have never seen India gripped by this level of despair.”
–Barkha Dutt, Indian Journalist, Washington Post Columnist

Reporting from the front lines of this crisis, Ms. Dutt has documented the grim realities of India’s second wave. Overwhelmed and overcrowded hospitals lack critical, life-saving supplies like oxygen. Those fortunate to be admitted to hospital are asked to sign forms releasing the hospital from liability if death results from the hospital’s inability to provide treatment due to stockouts or other problems.

“It is not the fault of doctors and it is not the fault of hospitals, but peoples’ pain is turning to fury. Their helplessness is turning to rage.”
–Barkha Dutt, Indian Journalist, Washington Post Columnist

The sick can’t get care, the dead aren’t being accurately counted for fear the numbers will be too alarming. Officially, about 2,000 people are dying (of COVID) every day in India, but most experts estimate that the true number is 5 to 10 times that. Data is skewed, underreported, manipulated.

“If you do not go to these burial grounds and cremation sites, you do not find the gap between the official data and what’s actually happening on the ground.”
–Barkha Dutt, Indian Journalist, Washington Post Columnist

 
How did India get to catastrophe?

“…as a country and as a state, we declared victory too soon, we were complacent, we were callous, we were ignorant, and we were casual.”
–Barkha Dutt, Indian Journalist, Washington Post Columnist

Lessons learned early in the pandemic about how to limit infections have been forgotten, with crowds packing cricket stadiums, political rallies, movie halls, and other places and creating potential superspreader events. Testing is spotty and inadequate. Temporary field hospitals have been dismantled, removing now-critical beds. Vaccines thought to be in excess supply were sold to other countries, failing to anticipate the overwhelming need for vaccines now.

“India is doing a very inadequate job of genomic surveillance [that] lets you figure out where are things spreading, which variants are spreading where, and gives you a lot of insights into where things will go next.”
–Dr. Ashish K. Jha, Dean, Brown School of Public Health

Ideally, India should be genomic sequencing 5 to 10 percent of all infections, but it is doing well less than 1 percent. That is making it hard to predict which virus strain is spreading where, amidst concerns – still unproven — about variants undermining existing vaccines.

The time to act is now.

“We have the tools in our power to turn this around. But they are not easy ones to wield. And there’s a lot of complexity.”
–Dr. Ashish K. Jha, Dean, Brown School of Public Health

The lessons of COVID are simple: Wear a mask; stop indoor gatherings and avoid large outdoor gatherings; test, test, test, with genomic sequencing; effectively and equitably distribute vaccines and get them into arms; advance and share accurate, true information and data.