Death and dereliction

Over just the last two days, around 45 people have taken their last breath in the National Capital alone, despite being lucky enough to be admitted to hospitals. Distastefully enough, they were still left gasping and heaving for breath as even the best hospitals had no oxygen supplies to support even those in dire, desperate need.

Now, the social media is flooded with cries for help not just from patients and doctors, but from everyone; except for the few who are too tied up with addressing election rallies.

Till just a month back, we as a nation were convinced that we had beaten back the devil. No. It has pounced right back, even more destructive now. The scary part is that the worst is yet to come. The next few months shall be telling. And it is paradoxical since this will happen at a time when countries like Israel, Australia, New Zealand etc. are showing the importance of precise planning in pushing the Coronavirus back.

And what have we learnt from our prime time speeches so far? You are not an Aatmanirbar-being if you don't manage to arrange your own oxygen and hospital beds!

The second wave has taken us aback but should it have been so? Haven't we seen countries go through the deadly experience of the repeated onslaught of the virus? The fact that we've been caught completely off guard is a matter of shame and retrospection.

Whatever be the reason, we were in an advantageous position with the buffer time we had from last year's peak in September — the time we misappropriately used for activities that we ought to have refrained from.

The new mutant of the SARS-Cov-2 tends to dethrone India from its assumed role of 'vaccine guru'. It has exposed our crumbling health infrastructure and inaction regarding the preparation against the second wave. India's testing capacity and its much talked about 'vaccination drive' also stand severely challenged. The most imminent danger, however, is the steep graph of raging Covid numbers and death. To add insult to the injury, experts across the country are flagging concerns against under-reporting of Covid cases. Is this just the tip of an iceberg?

The different second wave

The first difference is in terms of causal factors. The second wave is not as unprecedented as the first wave. It is largely a result of organizational failure. The number of single-day rise in cases during the peak of the first wave in September was 97,894; it has increased nearly threefold to 3,46,786 on April 23, 2021. The other differences are in terms of the behaviour of the new strain. It has found its new target amongst the younger population. The virus spreads faster and attacks people in clusters. The cases peaked during the first phase from around 8,000 towards the end of May to 97,894 in September in over a hundred days. For the second wave, the peak hasn't come yet. Cases are breaking daily records each passing day at almost double the rate.

The second wave has a higher positivity rate — more people are being diagnosed with Covid for the same numbers of testing — and also a higher mortality rate. During the first phase of the pandemic, the number of deaths rose from 200 on June 1, 2020, to 1,247 on September 18. For roughly the same increase in daily death numbers, the second wave took just a month. The number of deaths is surging four times faster in the second wave.

How have we reached here?

As the cases started declining after the September peak, our complacency, ignorance and defiance took an upward graph. Our road to the second wave has indeed been very notorious. We let our guards down and gathered massively at religious events hoping the supreme will take care of all! As things turned out, it became evident that religion has little interference to make in the way of science, otherwise, results could be disastrous. The crowd also didn't fail to make its appearance in the recently concluded India-England cricket matches.

The government must have intervened and at least asked its citizens to avoid complacency and ignorance. This task would have been a bit too obvious for the otherwise offbeat government. It rather joined the party mood to lure voters to election rallies. Though the government's decision was certainly odd, the result is obvious — what we are seeing today.

All the political parties owe an explanation, if there exists one, for their deadly acts. I wonder if people will give air to this extremely crucial question or they will accept fate as by default explainer. If votes are to them, are not hospital beds and oxygen to you?

What should we do now?

Covid-appropriate behaviour! The guidelines are laid out, they are pronounced so many times through word-of-mouth publicity, mass media, social media and many other platforms. The most important thing is to stick to these guidelines.

The second step should be the equitable distribution of vaccines globally and within the country. The stated global capacity for vaccines including all participants is 14 billion doses. It means that we can twice vaccinate the entire global population if the capacity is utilized. While strong nations have apportioned the lion's share of the vaccines, often double or triple the order they genuinely require, poorer countries like Argentina, Ukraine etc are reeling under the burden of Covid with a shortage of vaccines. There is just one plain and simple fact — vaccines are meant for the safety of life, and diplomacy and assertion of dominance must take second place if the world seriously wants to beat the virus.

On the vaccine side, the first thing that India could do is evolve its vaccine production to suit the new emerging variants. There is a growing need to carry out genome sequencing so that new variants are successfully tracked and countered. Next, India needs to ramp up its vaccine supplies, but since capacity is limited, the government has no other alternative than to open up the market for emergency use of other vaccines such as Pfizer, Sputnik, Zydus etc. Government should strike a balance on the supply side by moderating or increasing demand through advertising of vaccines and mobilizing people.

Best way forward

As the cases began to rise, states have started resorting to curfews and lockdowns. But, lockdown may not be the best option. While it is deployed as a tool to save lives, it serves the contrary purpose by hitting out livelihood prospects of the people, many of whom survive on daily wages. Even the Prime Minister has assured in his recent address that lockdowns should be used as the last resort. Last year, the lockdown was required as we needed to buy time for preparing for the situation. This time we already had time for preparedness. So if it is not a lockdown, what should be the best way forward?

Experts have come out with the epidemiological triad of factors — the agent, the host, and the environment. Transmission of the virus can be checked at all three stages. The agent refers to the virus itself which is evolving itself into new forms. The new strains not only increase the newer types of risks among the population but also calls for a shift in vaccine production and repurposing. India ought to have carried out genome sequencing at the time when caseloads had declined and experiences of other countries had warned of a dangerous retreat of the virus. Pushing for genome sequencing at the later stage might not be as effective because new strains have already spread their wings. What is more worrying is the government's initial attempts to hide the emergence of new strains in Maharashtra's Vidarbha.

The second stage consists of the hosts i.e. humans. The human body can be made safe by timely administration of Jab. India has so far administered over 130 million doses. In the process, a large amount of vaccines has been wasted. India cannot afford to continue such a situation, especially as it has opened vaccination for all adults from May 1.

Last month, the government came up with the data where a significant amount of vaccine was wasted by many states including Telangana (17.6 per cent), UP (9.4 per cent) and Andhra Pradesh (11.6 per cent). Also, the administration of jabs will be effective only after there is robust testing across all the states and the union territories. India has ramped up testing figures after the resurgence of Covid cases. The increased testing number is only slightly up from the September last year peak.

Once we start focusing on the first two links of the triad, we notice that our efforts are limited by the third link — the environment. The agent's ability to negatively affect the host increases manifold if the environment becomes conducive to the virus. It will not be difficult for the government to channelize the prevailing fear among the masses positively to push them to caution without creating panic. But for that, the government will itself have to be a role model and exemplify covid-appropriate behaviour. It is difficult to imagine people following necessary restrictions when the government itself is going all out for electioneering and political gains. A question that everyone should ask is if parties involved in dangerous election rallies can bring back the lost lives? If not, then what gave them the green signal for putting aside all the norms and the protocols? The question may be abstract but cannot be left unanswered.

Data and coordination

A crisis of such scale can be fought only through the coordination among all stakeholders including the Central and the state governments. The situation is far from satisfactory on this front too. The loud noise a few weeks before over the shortage of vaccines lays bare the level of coordination between the Centre and the states.

This situation becomes even more pronounced in states like West Bengal and Maharashtra and UTs like Delhi where ruling regional leaders are in confrontation with the Centre. While political competition is a healthy thing, it becomes gloomy when something as big as human life is put at stake in the game of politics.

A holistic strategy to fight the covid is possible only through coordinated decision-making. The Centre has the requisite infrastructure and resources to fight against the pandemic and states have better knowledge of the prevailing needs and regional situations. An effective decision is not possible if these two are not linked together.

Several experts and photojournalists who have been reporting from the affected areas have shown their dissatisfaction with the death figures in particular. They have found a significant difference between the number of bodies at crematoriums and the reported deaths across the country. This is not just a matter of accountability but can potentially ruin the entire battle against the pandemic.

Is any large-scale public policy conceivable without reliable data? Certainly not. One possible explanation could be that many people were unable to go to hospitals before their death. These numbers remain unreported. The other reason could be a discrepancy in the data collection by concerned authorities. In any case, it is a serious problem, and a mockery of the lost lives, and one of the greatest hurdles in our fight.

Conclusion

The initial comfort that the second wave is less deadly than the first wave has faded as daily deaths have almost doubled. Moreover, the target group is larger this time. This means the containment plan will have to be more extensive. With the graph of cases approaching the vertical, experts see no light at the end of the tunnel. Indian Medical Association has predicted that settling the situation will possibly require at least three months.

Though the experts are divided on the issue of lockdown, the possibility of wider lockdowns cannot be ruled out as the cases will increase. Maharashtra and Delhi have already resorted to the measure. It is high time that we give away complacency and make a coordinated effort to break the transmission chain. The battle against the second wave has to be guided by transparent and comprehensive data which can be gathered only through proper communication among various stakeholders. All the parties should come together to fight against the threat that is equal to all. Stay safe!

Views expressed are personal