India must not relax as it combats second wave of coronavirus infections

The second coronavirus wave in India is actually a tsunami of cases. More than 270,000 were reported on Sunday alone. The government has responded by expanding its vaccine drive. From May 1, every Indian aged 18 and above will be eligible for a vaccine.

But herd immunity is still a distant dream.

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The number of infections has to fall sometime. But there's no guarantee as to when. On April 12, India was at 161,000 cases. Six days later, we are at 273,000. This translates to a surge of 70 per cent in just a week.

There's no telling when the number will hit the peak and then slide down. Right now, all we have is an uphill drive.

Nonetheless, some models have made bold claims. Most of them think 2021 will be the peak. But India has consistently bucked the statisticians. In the first wave, they made doomsday predictions. We know that those never materialised.

This year they said February would mark a decline in cases. The opposite happened. By the end of February cases started going up.

The fact is, models work under perfect conditions. They do not account for super-spreader campaign rallies or massive religious gatherings. These are externalities, aberrations that make projections impossible.

India did not plan for the second wave. So it is now reacting to crises as they come. Even the courts are having to step in. The Allahabad High Court has ordered mini-lockdowns in five cities in Uttar Pradesh.

The courts normally don't assume such a role but the situation is that bad. The judges are being forced to step in thanks to the administration's inaction. The most pressing challenge right now is Oxygen.

Supply of Oxygen is not looking good. Maharashtra has already reached full capacity. Madhya Pradesh does not have Oxygen plants of its own. And states that do have excess Oxygen have no means to transport it. In a matter of days, the demand for Oxygen has shot up.

The Wuhan virus attacks your lungs. Supplemental Oxygen is critical to treating it. A shortage of cylinders can be devastating.

So what is the government's plan?

There are three specific measures that are being implemented.

1. Importing Oxygen.The government is looking to buy 50,000 tonnes of medical Oxygen.

2. A ban on supply to industries .From April 22nd, Indian industries will not have access to Oxygen. This stock will be diverted to hospitals.

3. Oxygen express.This is a railways initiative. Special trains will transport Oxygen cylinders across the country. This could be a game-changer for rural India.

A similar story is unfolding in case of hospital beds. We are getting reports of patients being turned away from hospitals. The problem is acute in New Delhi. Banquet halls and hotels are being turned into makeshift hospitals. The chief minister says only 100 beds are left.

So India is still treating patients, while the rest of the world is immunising them.

But how did we end up here? To understand this we need to compare the two waves.

What are the similarities and differences?

For instance, does the second wave infect young people more? The data doesn't say so. In both waves, 70 per cent of patients were aged 40 plus.

So the elderly are still the most vulnerable group.

What about younger patients? In the first wave they made up 5.8 per cent of the cases. Now 4.2 per cent.

And this isn't a medical trend. It's just that we have opened up schools and public activities. So kids who stayed at home last year were out playing on the streets.

That accounts for a lot of the younger cases.

What about symptoms?

Let's look at the most common one: shortness of breath. In the first wave, 41 per cent of patients complained of breathlessness. In the second wave, the number is 47.5 per cent and this trend has extended to the use of supplemental Oxygen.

41 per cent patients in the first wave needed Oxygen. This time around 54.5 per cent patients need it. So more than half the admitted patients are using Oxygen cylinders. This is why the shortage is unsettling.

But it's not all bad news. India's fatality rate is under control. In fact, it is lower than the first wave. Another feature of this second surge has been false negatives.

You take a test, It comes out negative. But you may actually be infected. Some reports blame RT-PCR tests.

Virus mutations may mislead tests, giving you a negative result. But the Indian government has dismissed this report. They say the RT-PCR can catch all mutations. If that's the case why are so many false negatives popping up?

One possible reason is shoddy testing. Clinics are swamped with people right now. And collecting swabs is a delicate task. Not everyone has got the perfect training.

So what's the big takeaway here? India relaxed at the wrong moment. The masks and social distancing disappeared when the vaccines arrived.

In contrast, that was the time to put our heads down. India missed a golden chance to crush the pandemic. We are seeing a success story slowly unravel thanks to a lack of foresight.