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Complacency and Government Failures Fueled India's COVID-19 Disaster

Der Spiegel, May 3, 2021

By Laura Höflinger and Adnan Bhat in Delhi

Cremation of corpses in a Delhi parking lot, April 30, 2021

 

Complacency and Government Failures Fueled India’s COVID Disaster

India’s health care system and hospitals are on the verge of collapse and crematoriums are overloaded. The country got through the first wave of the coronavirus relatively unscathed, but the second has been a catastrophe, the product of inconceivable mistakes by the government.

In a parking lot in Delhi, dozens of shrouded corpses lay in rest in the open. Workers have piled wood into pyres, and relatives in white protective suits stand next to the dead. They wait until they are allowed to light the wood for their deceased, a Hindu ritual to free the soul from the perishable body. Sometimes, the silence is interrupted by a sob or a scream. Otherwise, the only thing you hear is the crackling of the fires and the sirens of ambulances.

Lalan Kumar, a 52-year-old with strong hands and tired eyes, stands off to the side. He has driven an ambulance for 10 years, but he says he has never seen as many dead people as he has in the past few days. "I took 22 bodies to the crematorium today,” he says. "But there are at least a dozen more waiting at the hospital where I came from.”

He pours disinfectant over his hands, shirt and pants. He wears flip-flops, but doesn’t own any protective gear. Kumar says he was called to a house yesterday where he found a lone dead man. All of the man’s family members had fled. He’s getting panicked calls from families looking for oxygen tanks. He says he feels helpless. If he doesn’t get the job done, though, "the bodies pile up in the street.”

Helpless Families Rush from Hospital to Hospital

As darkness falls, a cloud of smoke and ash billows over the cremation ground, as if winter has descended on the city in the middle of April. In a few hours, the city administration in Delhi will announce the new COVID death toll for the day: It will be 357 people on this Saturday, more than on any previous day. But the official numbers are a gross understatement. At the Seemapuri cremation ground alone, where Kumar waits with his ambulance, more than 125 people are cremated by the evening.

The cremation ground, run by a volunteer organization, is so overloaded that workers have torn down a wall to make room. Many of the dead are now cremated in the parking lot – so many that the firewood runs out on some days. Even last summer, when the first wave swept across the country, it wasn’t half as bad, Kumar says.

And it’s not only in Delhi that pyres are burning and lines are forming outside the cemeteries. Hospitals and crematoriums are overloaded in many parts of the country. A second wave of the coronavirus is ravaging India, and it is harsher and deadlier than what much of the world has seen since the pandemic began. Helpless families are rushing from hospital to hospital in search of beds for loved ones. Desperate people are asking for oxygen tanks on social media.

At its peak, the number of new infections could be close to a million a day

Dozens have died because hospitals have run out of oxygen. And it is unlikely things are going to get any better before mid-May. By then the number of daily deaths could rise officially to more than 5,500, but unofficially, it is likely to be considerably more. At its peak, the number of new infections could be close to a million a day – assuming the country manages to get that many tests done. That's not much given India's vast population, but experts already believe that the real figures in India could be up to 30 times higher. In Delhi right now, one in three tests for the coronavirus comes back positive. On Monday night, the city’s coronavirus app indicated there were only 12 intensive care COVID beds left in the metropolis – to serve a population of 20 million.

A mixture of hubris, recklessness and incompetence has driven the country to disaster. As recently as January, Prime Minister Narendra Modi had boasted that India had the pandemic under control. His political party, BJP, celebrated him as a "visionary” who had defeated COVID-19.

Although the number of infections was already rising in mid-February, large-scale events were not only allowed, but in some cases downright encouraged: Modi’s BJP staged campaign rallies, people held weddings. "If we imagine that the virus needs people to spread, then India was like a superhighway for the virus,” says Srinath Reddy of the Public Health Foundation of India. That makes India a warning to the world, too: What is happening here could happen wherever large parts of the population aren’t vaccinated – and if new mutants emerge that are resistant to the vaccines, it could happen in countries where vaccination campaigns have been a success. "Do not celebrate prematurely,” Reddy warns, because that was the mistake his country made.

Just a few weeks ago, the mood in India was relaxed. The virus had hit rich nations hard, but India had been a kind of success story – and an improbable one. It's home to nearly 1.4 billion people, there are enormous gaps between rich and poor and its sprawling cities are among the most densely populated in the world. Many had predicted bad things for the country, but it escaped the first wave of the coronavirus relatively unscathed.

"The overall situation is under control."

Harsh Vardhan, India's health minister, at the end of March

Since mid-September, the numbers had fallen steadily to just over 11,000 new infections a day. There were many explanations for the drop in the number of infections. There had been talk of possible herd immunity in the cities and of Indians supposedly being immune because they had previously overcome several other diseases. "Politicians wanted to revive the economy, the public wanted to get on with their lives, the industry wanted trade to pick up again,” says Reddy. "Everyone heard what they wanted to hear.” Meanwhile, the government gave them what they wanted.

At the beginning of March, for example, the health minister saw the "end game” approaching. By the end of the month, he announced: "The overall situation is under control.” Today, barely a month later, Prime Minister Modi is saying the coronavirus has now swept over the country like a "toofaan,” a perfect storm. And it has – only, it was man-made. Instead of moving to contain the catastrophe when the country still could have done so, the public and politicians did everything they could for weeks to fuel it.

In January, the government kicked off a Hindu festival, the Kumbh Mela, which goes on for months and is one of the world’s largest gatherings. Millions of pilgrims journeyed from all parts of the country to bathe in the Ganges River. They crowded shoulder to shoulder, and few wore masks.

March was also an intense month of electioneering in five Indian states. The most important is West Bengal, with its capital city Kolkata. Modi’s party wanted to win there at all costs. As late as April 17, when intensive care beds in the capital were already filling up, the prime minister was still holding election rallies with thousands of participants. "I’ve never seen such a large crowd,” Modi shouted at one event, not wearing a mask.

People saw the lack of concern as a good sign – that there was nothing they needed to be afraid of. Meanwhile, the cricket stadiums began filling up. People became more casual about removing their masks.

But even at that point, the government already suspected something was out of control. Only a short time before, it moved to stop exports of vaccines. By then, the country had already shipped out more vaccines to the rest of the world than it had provided for its own people. In doing so, India also did something that many richer countries refused to do: It shared its vaccines with weaker countries – to the benefit of developing countries that otherwise would have been left empty-handed. Vaccine doses even went to Britain. India prided itself on being the world’s biggest vaccine manufacturer.

India wanted to save the world with its vaccines, now it needs saving

But the government failed to ramp up production capacities to their fullest. It bought too little vaccine, and foreign companies like Pfizer were long denied market access. All the while, Modi frequently used his slogan of economic "atmanirbhar,” or self-reliance. The message being that India is strong and doesn’t need outside help.

The goverment also moved to dismantle provisional emergency hospitals it had erected to handle the first wave of the pandemic. It did move ahead with plans to build oxygen factories and begin sequencing to detect new virus variants, but the money for that reached the responsible authorities only partially or too late. As a result, it still isn’t clear what role virus variants are playing in the outbreak and whether, for example, it is primarily being driven by the British mutant, the South African mutant or a new Indian mutant: B.1.617, a variant that appears to spread more rapidly and may even outsmart the immune system.

By the time the politicians recognized the danger, it was too late to respond with countermeasures. By mid-April, the wave had turned into a tsunami, with numbers rising rapidly almost everywhere. The Indian air force had to fly oxygen to the capital. Germany, Britain, Singapore and the United States are sending relief aid, and even rivals like China and Pakistan are offering help. India, which had wanted to save the world with its vaccines, now needs saving itself.

And Indians, who do not rely much on the state, anyway, are suddenly completely on their own. People are hoarding medicines and oxygen tanks out of panic. In many places, a brutal battle for survival is breaking out. And nowhere is it being waged harder than in Delhi, a city-state with no oxygen factories of its own.

Covid-19 patients on the sidewalk gasping for breath

It's Sunday, and a half a dozen men and women can be seen sitting here on a sidewalk in front of LNJP Hospital, gasping for breath. Their families beg the guard to let them through the gate. But the guard waves them away and points to the sign at the entrance: All COVID-19 beds are occupied. "We’ve been to all the hospitals. Everywhere we go, we are told the same thing. Where else can we go?” pleads a young woman on the verge of tears.

Rahul Seth has been luckier than them, but he is also afraid. The lawyer was able to secure a bed for his sick mother at the LNJP Hospital last week. But only after his uncle, who knows "influential politicians,” intervened on the family’s behalf. However, the day before, he received a call from the hospital saying that they were running out of oxygen and that he needed to pick up his mother. "How am I going to find a hospital for her now?” the 28-year-old asks. "I know the doctors are trying their best. They can't just leave us out to die.”

1,300 euros for a tank of oxygen

In the meantime, his aunt has also been infected. The hospital where she is staying had a bed, but the family had to bring their own oxygen tank. They paid 120,000 rupees, more than 1,300 euros ($1,600), to get one on the black market. Seth shows the receipt on his mobile phone. "How is the average person supposed to pay such extortionate prices?”

Seth feels let down, and like so many, his anger is directed at an entire class of politicians and bureaucrats who love grand gestures but have proven incapable of long-term planning. Above all Narendra Modi.

Unlike other populists, the Indian prime minister has never denied the danger of the coronavirus. To the contrary: Last year, he imposed a draconian lockdown when the numbers were still low. Modi knew how threatening the virus could become for India. But he is also driven by his belief in exceptionalism – his own and that of his country.

Prime Minister Modi has built a cult of personality around himself

Modi has built a cult of personality around himself, and that hasn’t made crisis management any easier. He has become a kind of father of the nation, a man who unimpeachably towers above things. He has grown his beard long and his hair curls at the nape of his neck. These days, he looks more like a religious leader than the reformer he once set out to be. There aren’t many people left in the country who counter him publicly – either in the media or in his party.

It was also, to a significant extent, Modi’s complacency that caused India’s COVID catastrophe. Warnings were ignored, if they existed at all. One doctor says he had been warned, only slightly indirectly, that if he kept talking to the media, his behavior would have consequences, for him and for his staff as well. Even now, Modi’s party seems to care less about the disaster and more about their own image.

On May 2, it will become clear whether millions of Indians continue to believe the legend of the prime minister and of his party’s infallibility. That’s when the results of the election in West Bengal and the other states will be declared. At least to some extent, it will then be seen whether people continue to believe that Modi and his party can change their lives for the better. Or whether people like lawyer Rahul Seth will instead long remember that they were left to fend for themselves at their moment of greatest need.

"I have never felt so helpless in my whole life."

Rahul Seth

On Sunday, the 28-year-old is standing outside the hospital where his mother is being treated. She can’t go to the bathroom by herself and there’s was no one to help her. She kept calling her son over and over again. "I cried all night,” he says. "I have never felt so helpless in my whole life.”

Seth hands a nurse a bedpan he bought. Then he calls his mother since he isn’t allowed to enter the building. Her voice can be heard through his mobile phone. She says they have turned her on her stomach because she is having difficulty breathing. Seth asks if she is doing OK. Her response is barely audible. "I think so.” He then asks if her oxygen levels are stable. "I don't know,” she answers. "I’m so terribly tired.” After a few moments, she asks: "Will I see your face again before I die?”

A Country in Flames: Complacency and Government Failures Fueled India’s COVID Disaster - DER SPIEGEL

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