Health workers attend to a coronavirus patient inside the ICU in India Photograph:( AFP )
We need to mask up and prepare. We also need to introspect, draw the right lessons from the past, fix the lapses
This may sound alarmist. But a third wave is coming in India. The principal scientific advisor to the prime minister says it's inevitable. But the exact time of its arrival cannot be predicted.
What we do know is that this wave could go beyond cities. Travel to towns and villages. It could also cross age groups, putting children at the same risk as adults.
We need to mask up and prepare. We also need to introspect. Draw the right lessons from the past. Fix the lapses not the narrative.
When india was on the path to normalcy, we saw the lowest new cases in eight months. The lowest death count in almost a year. Vaccinations had begun. Hospitalisations had fallen. It appeared as if the worst was behind us, that it was time to open up.
But the virus was evolving and mutating. The warnings were there. In February, reports say several experts voiced fears of an impending second wave, of a 'Covid tsunami'. The message didn't reach the top brass.
Then in March, a forum of scientific advisers set up by the Government of India issued warnings that a new and more contagious variant was spreading. But no significant containment measures were taken.
Instead, it was declared that we were in the 'end game' of the pandemic and should trust the science behind vaccines. The real task of preparing for this wave was lost in the din.
The result was this: On March 15th, India reported 24,000 new cases. This figure increased to 53,000 on March 30th.
100,000 by April 4th. Nearly 200,000 by April 14th.
And despite this colossal spike in cases. Two mass public events went as per plan. Five states and union territories went to polls.
Pretty much every political leader, from union ministers to opposition leaders, from chief ministers to the prime minister, all of them drew thousands of people at their rallies.
The Kumbh Mela in Haridwar was attended by more than 4.8 million devotees. There were no masks or social distancing. Both these events, the dip and the ballot, ended up being super-spreaders. The figures tell you the story.
Between April 10th and 14th, nearly 2,000 devotees tested positive at the Kumbh. When the congregation began. Daily cases in Uttarakhand stood at 500.
By the time it was finally called off on April 17th. The daily cases had grown to 2,700 plus.
In Madhya Pradesh, 99 per cent of the Kumbh returnees tested positive. And atleast 22 couldn't be traced.
The elections had a similar outcome. In West Bengal, each phase of election saw a spike in daily cases.
They went from 812 on March 27th. To 16,403 by April 27th.
In Tamil Nadu, the daily cases went from 474 on March 1st to nearly 8,500 on April 16th.
In Kerala, the cases went from 2,500 on April 2nd to 10,000 on April 16th.
And in Assam, they went from 92 on April 6th to over 1600 on April 21st.
It was said at the time that election rallies didn't contribute to the spike in cases. We have a lot to say.
On March 1st, the growth rate of daily number of new cases in non-election states was 6.09 per cent. In states witnessing elections, it was 6.13 per cent.
By 15th April, this figure had come down to 3.01% in non-election states and risen to 7.99% in states that were holding rallies.
Yes, this is partly due to the unpredictability of the virus. But it is equal parts complacency and politics.
It didn't have to be this way. This situation could have been avoided.
The heart-breaking scenes outside hospitals, the desperate run for oxygen. The SOS calls for medical aid, the waiting list for last rites. The sight of burning pyres, of overwhelmed burial grounds.
All of this could have been contained.
India was always the perfect place for a virus like this to run wild. We are a vast country, We have 1.3 billion people, high rates of diseases and an under-developed health infrastructure.
India's healthcare spending, in both public and private sector, has been 3.6 per cent of the GDP for the past six years.
This is among the lowest in both the developed and the developing world. The US spends 16.9 per cent of its GDP on healthcare.
Germany spends 11.2 per cent, Brazil 9.2 per cent, South Africa spends 8.1 per cent while Russia and Thailand spend 5.3 and 3.79 per cent respectively.
India is called the land of engineers and doctors. But we have fewer than 10 doctors per 10,000 people. In some states the figure is less than five.
It's true that this cannot be changed overnight. But we had several months to make arrangements to fix the shortcomings.
One year ago, When the first wave had just arrived, the empowered group of officers set by the centre for an effective pandemic response, had red-flagged oxygen shortage in the months to come.
The group said we needed to produce more. Or cut down supply to industries. But very few warning bells rang.
Then in November 2020. A parliamentary standing committee on health had flagged the same concerns. That there was an inadequate supply of oxygen. Yet, it was only on April 22nd this year.
That the supply of oxygen to industries was prohibited. By this time. The demand for medical oxygen had reached about 60 per cent of the total daily oxygen production.
Today, the oxygen shortage is proving to be deadly.
The only saving grace has been India's diplomatic record. India provided the world with vaccines. Now the world is returning the favour. Several countries have pledged critical aid to New Delhi.
India has been getting planeloads of oxygen, ventilators, testing kits, masks, anti-viral drugs.
But are the people getting it? This is the second issue we've got to address.
We are also facing logistical nightmare. We are getting oxygen from abroad, yet struggling to transport it within the country.
Last month, a lot of foreign consignments had to sit at airport hangars for several hours as hospitals across india gasped for breath.
Because until now we didn't really have a mechanism in place to distribute these supplies. The work began only on April 26th. And it was on the 2nd of May, after one long week, that the health ministry issued a 'Standard Operating Procedure'.
SOP guidelines! For the distribution of foreign aid. Do you know how many Indians died in these seven days?
And even with these guidelines in place, the distribution remains complex. It keep getting delayed.
Because it has to go through unnecessary bureaucracy, time-consuming protocols and paperwork.
Right now for many, vaccination has become the last hope.
But where are the vaccines? India, the world's largest vaccine producer, is running short of vaccines.
Critics say it's because we shared vaccines with the world.
We provided 60 million doses to 70 countries. But we must remember that Vaccine Maitri is the reason we are seeing the kind of global support that we are.
Vaccine Maitri is not india's problem right now.
Government negligence, unclear messaging, corporate profiteering, opaque contracting, differential pricing, patchy record-keeping and inequities in the global pharma market.
These are India's problems.
Who should take the blame for these problems? We're told that health is a state subject. That the primary responsibility for healthcare lies on state governments.
But disaster is a federal subject!
The second wave is the biggest disaster that we've ever faced. The centre cannot escape the blame. If credit is taken for every positive outcome, blame too should be shouldered.
It's another matter that a blame game won't save lives. But we need to rethink how we organise our politics.
Elections cannot be given more priority than economic, security and health policy. We cannot have a system, where the centre and the state don't even see eye to eye. We are suffering due to bureaucracy and protocols. We're also suffering due to lack of political coordination.
So we've put together some challenges. The centre and states must address immediately. And preferably together!
Proper estimation and communication of vaccine procurement...
Long queues outside vaccine centres are not helping anyone. They're only making things worse.
A crisis management team.
We don't have one. We need a team of public health and management experts. A task force that can be replicated at state and district levels. How long will we depend on social media for supplies?
Challenge number three
Breaking the transmission chain. We need regional, local and phased lockdowns. A complete ban on any religious and political gathering.
Black-marketing and hoarding of medicines. We need stricter punishment for both of them. Or perhaps a state-level committee. The govt of odisha has formed one. Other states can do the same.
The fifth challenge
We need to mask up. And keep it on.
The sixth and last challenge...
End the city-centric approach!
We don't even know what's happening in rural India. A large part of the suffering in small towns is going unchronicled. We've all been overwhelmed by this pandemic. We have to be more cautious than we've been.
As a community, as a society and as a government. We've got be to be more tough. It can't be business as usual. We need to take lessons from our past. India has always been a country with a strong sense of community. And it reflects in today's digital world. We have come together as a community on social media.
Individuals across political ideologies, religious belief, class barriers are rallying their network and resources to help those in need
Only if this sense of community could reflect in our political system.