Why India has seen such a dramatic spike in coronavirus cases and deaths over the past month

With more than 2,000 people dying daily, here are some reasons for the vicious new wave and the overwhelming healthcare system.

‘Herd immunity

While the pandemic raged elsewhere at the start of 2021, in India, daily infections slid to under 9,000, with fewer than 80 deaths.

Despite having some of the planet’s most densely populated cities, this raised hopes that India had somehow escaped the worst.

Blood surveys suggested that a hefty proportion of the population might have antibodies and that India might have achieved “herd immunity”.

Other possible factors cited were India’s young population and greater exposure to different pathogens increased resistance to the virus.

But possibly because of a new variant, cases took off again in March. This month alone, India has recorded more than four million new infections.

Cricket and Kumbh

As cases started falling in October and November, the Hindu nationalist central government and state authorities allowed the most activity to return to near-normal levels.

Bollywood productions resumed, lavish weddings returned, and spectators watched India thrash England at cricket in Chennai at the vast new Narendra Modi stadium.

Tens of thousands of farmers participated in demonstrations against new agriculture laws, and people thronged religious festivals such as Durga Puja and Dussehra.

The biggest was the Kumbh Mela in Haridwar, attended by upwards of 25 million Hindu pilgrims between January and this week.

Masks and social distancing were largely forgotten, as they were at election rallies in several states. One in Kolkata saw Prime Minister Narendra Modi address an estimated 800,000 people.

‘No demand’

But authorities also failed to use the time to beef up India’s chronically underfunded healthcare system and hospitals’ medicines and oxygen facilities stocks.

In early 2021 production of remdesivir was “negligible or nil” after firms were left with unwanted stockpiles, some of which expired and were destroyed, the Indian Express daily reported.

“Government had asked us to reduce manufacturing because COVID-19 cases were reducing and there was no demand,” DJ Zawar, managing director of Kamla Life Science, told the paper.

“One solution to this crisis was to create a stockpile of antiviral drugs when cases were low, but that did not happen,” said Raman Gaikwad, an infectious diseases specialist at Sahyadri Hospital in Pune.

Experts have long warned that India, like many poor countries, severely lacks medical oxygen, which is vital for treating serious COVID-19 cases.

According to the news website Scroll, it took until October for the government to float tenders to build oxygen units on-site at 150 district hospitals. Most still aren’t up and running.

The Tribune Daily reported that 290 new ventilators are lying in a warehouse in Punjab. Hospitals have not ordered them because the staff wasn’t trained to operate them.

Vaccine diplomacy

At the same time, in a show of generosity and “vaccine diplomacy”, India was exporting tens of millions of AstraZeneca shots made domestically by the Serum Institute.

But once cases started surging, New Delhi froze exports of the Covax inoculation initiative for poorer countries to prioritize India.

So far, India has administered some 130 million shots, and from 1 May, all adults will be eligible even though stocks have been running low in some areas.

Serum, meanwhile, is warning that production will be badly affected unless the United States lifts export controls on raw materials needed to make the vaccines.

“I think a premature declaration of victory lulled the population into a false sense of complacency,” Ramanan Laxminarayan from the Center for Disease Dynamics, Economic, and Policy told AFP.