COVID-19 in India: an ongoing humanitarian crisis
There have been many predictions about how many people have had COVID-19 and whether or not a particular country has achieved collective immunity. We have already seen this in Manaus, Brazil, and in India. Optimism is unfortunately always misplaced and sometimes used irresponsibly.
We have seen naturally-acquired herd immunity approaches as high-level ideas for public policy in Great Britain and internationally, such as Grand Barrington Declaration. These proposals were largely decried by health experts, including in the Memorandum from John Snow. the World Health Organization described the idea as “scientifically problematic and unethical”.
There is no doubt that a humanitarian emergency is currently unfolding in India. India is a catastrophic example of a population that has certainly not achieved collective immunity against COVID-19. The stories of a failing healthcare system abound, with reports lack of oxygen for hospitalized patients and body burning on pyres in the streets.
India has manufactured vaccines locally, which are being rolled out, including the AstraZeneca vaccine. But the proportion of the vaccinated population is still very low and, alas, there are more than enough susceptible people for the virus to continue to spread.
The figures are also striking. The Financial Times reunited a sobering review data, with unwanted new world records set for new confirmed cases in one day. One of the most worrying aspects is the level of under-counting that will occur.
The test positivity rate (the proportion of people tested for COVID who return a positive test) in India is high – around 18%. This is well above the WHO threshold of 10%, suggesting that many positive cases are missed due to a lack of capacity for timely screening and notification.
Indeed, one of the main concerns is the lack of high quality real-time data to give an informed picture of the scenarios unfolding in India. The death toll is starting to rise on a steep path, and that graph will surely increase further over the next few weeks.
When there was speculation that herd immunity could be compromised, India was relatively cash-strapped with much lower levels of COVID-19, vaccines becoming available and a pandemic that appeared to be under control in Southeast Asia. South East.
So what changed all that? Emphasis was placed on Variant B1617, which was first detected in India. Much remains to be learned about this variant, for example whether it is more transmissible and thus contributes to increased community transmission. This is a plausible theory, but still unknown.
But it is the mixing of susceptible populations that ultimately leads to the transmission of infectious respiratory diseases. There have been bold statements from senior politicians, with Health Minister Harsh Vardhan declaring in early March that India was “the pandemic end game“.
Since then, there have been mass rallies in India. In March and April, there were state-level elections in several Indian states, with a campaign and population mix associated with it. Fans attended the international cricket matches between India and England, with full stadiums and few masks. And there have been several major religious festivals, such as the Kumbh Mela, an event that takes place once every 12 years and is attended by millions of people.
There are recent examples in China, Saudi Arabia and Israel where main events of the religious calendar have been canceled or reduced, to reduce the mix of infectious and susceptible people during the pandemic. This includes Hajj and Chinese New Year.
India may have reduced its celebrations a bit, but millions of people have gathered for Kumbh Mela at different venues, and thousands of new cases of coronavirus are already confirmed among revelers.
The Serum Institute of India is currently one of the most important buildings in the world. It produces the AstraZeneca vaccine in large numbers and is a key supplier to many countries, including the Covax Initiative. however, exports from India have fallen in recent weeks and it would not be surprising to see the Indian government act to keep even more valuable vaccines in India.
This will affect the supply for other low income countries. The humanitarian crisis in India will have a significant ripple effect that will fuel the pandemic even longer. It shows how vulnerable the use of a few manufacturing sites for these vital products is to lethal consequences.
This underscores the importance of global readiness. When the fire department is summoned to the burning building, they have already purchased and installed the pipe beforehand. Public health firefighting during the pandemic is nearly impossible when the primary tool for extinguishing fires (vaccines) is unavailable for the first 12 months and in short supply thereafter.
The world needs all the vaccines they can get, so factors like distribution equity and public confidence must be strengthened to ensure that AstraZeneca and other vaccines are available everywhere and not just in rich countries.
For as countries around the world watch, we could easily have “the next India” just around the corner. How many excessive deaths must we see before global cooperation overcomes the “me first” approaches of richer countries?