Why India Failed | MIT Technology Review


But rumors like his have been drowned out by federal government messages, suggesting that India had somehow overcome the virus. The public was so loud that even some medical professionals bought into it. A professor at Harvard Medical School told the financial daily Mint that “the pandemic has behaved in a very unique way in India.”

“The real damage in the subsoil is that people will take the pandemic lightly,” Arun says. “If supposedly few people die because of the covid, the public will think they’re not killing them, and they won’t change their behavior.” In fact, by mid-December India had reached another sad step: it recorded its 10 thousandth infection. It was only the second country to do so, after the United States.

The government had not used the first lockdown with caution, but December was their chance to fix things, says Gagandeep Kang, a professor of microbiology at Christian Medical College in Vellore, Tamil Nadu. She says a series of tactics – increasing sequencing, studying public behavior, collecting more data, refusing permission for superspreader events, and initiating vaccine launches before the project – would have saved many lives during the second. inevitable wave.

Instead, she says, the government has continued its “top-down approach,” in which bureaucrats rather than scientists and health professionals make decisions.

“We live in a very unequal society,” she says. “So we need to engage people and build partnerships at a granular level if we are to effectively provide information and resources.”

In December the Goa government released the entire guard. The state is heavily dependent on tourism, which makes up almost 17% of its revenues. Most tourists show up in December to celebrate Christmas and New Year’s Eve on the sandy beaches with radishes and fireworks.

Vivek Menezes, a Goan journalist, says the state’s reputation as “the place to be” did not fade during the pandemic. “It’s the place for the rich of India and for Bollywood, and that’s why it’s the place for India,” says Menezes. The pandemic had prevented foreign tourists from visiting, but domestic holidays were reversed. Some states, such as Maharashtra, had placed restrictions on their borders; others, such as Kerala, had a strict policy of tracking contacts. In Goa, visitors don’t even need to show a negative covid test. And the state’s masking policy extends only to health workers, visitors to health facilities, and people who show symptoms. “Goa has been left to the dogs,” Menezes says.

The largest superspreader in the world

India started 2021 after registering almost 150,000 deaths. Just then, in January, the government placed its first vaccination order, and it was for a shockingly low amount – only 11 million doses of Covishield, the Indian version of the AstraZeneca vaccine. He also ordered 5.5 million doses of Covaxin, a locally developed vaccine that has not yet released efficacy data. Those orders were far from what the country actually needed. Subhash Salunke, senior advisor to the Independent Foundation for Public Health of India, estimates that 1.4 billion doses would have been needed to completely vaccinate all eligible adults.

On January 28, at an address at the World Economic Forum in Davos, Modi stated that India had “saved humanity from a great disaster by containing the crown effectively.” Later, his government took the trip to Kumbh Mela, a Hindu festival that attracts overwhelming crowds of millions of people in the holy city of Haridwar in northern Uttarakhand, which is famous for its temples and sites. of pilgrimage. When the former chief minister of the state suggested that the festival be “symbolic” this year given the circumstances, he was fired.

A former politician in the Bharatiya Janata Party of the Prime Minister he said the Indian magazine The Caravan that the federal government had its eye on the upcoming state elections and did not want to lose the support of religious leaders. As it turned out, the Kumbh wasn’t just a superspreader event — with a reported 9.1 million people in attendance, it was the world. bigger superspreader event. “Anyone with a basic manual on public health would have told you it wasn’t the time,” Kang says.

The Indian government issued its first vaccination order in January 2021 alone, after registering nearly 150,000 deaths. Even then, it was for a shockingly low amount — 11 million doses of Covishield and 5.5 million doses of Covaxin for a country of 1.3 billion.

In February Salunke, the public health expert, was working in an agricultural district in the western state of Maharashtra when he noticed that the virus was transmitting “much faster” than before. It was touching whole families.

“I feel like we were dealing with an agent who was changed or who seemed to be changing,” he says. “I started investigating.” Salunke, it turns out now, had found a mutation in a variant that had been detected in India the previous October. He suspected that the variant, now known as delta, was on the verge of escaping. He did. It is now in more than 90 countries.

“I went to all those who are responsible and those who count – both district-level officers and bureaucrats at the central level, the call. Everyone who knew me immediately shared this information with him,” he says.

Salunke’s discovery does not appear to have influenced the official response. Although the second wave accelerated and after the WHO designated the new mutation “a variant of interest” on April 4, Modi maintained his frantic schedule ahead of state elections in West Bengal, appearing personally in numerous public events.

At one point he did gloated about the size of the crowd he had attracted: “In all directions I see huge crowds of people … I have never seen such crowds in a rally.”

“The demonstrations were a direct message from the leadership that the virus was gone,” says Laxminarayan of the Center for Disease Dynamics, Economics and Politics.

The second wave filled hospitals, which soon ran out of beds, oxygen and medication, forcing patients to anxiously wait – and then die – at home, in parking spaces, and even sidewalk. Crematoriums had to build makeshift piers to keep up with demand, and they were there report that the ash development had gone so far that it stained the clothes a mile away. Many poor people could not even afford to pay for the funeral rites and immersed the bodies of their loved ones directly in the Ganges River, which led to hundreds of corpses being washed on the banks in many states. Alongside these apocalyptic scenes came the news that lethal fungal infections were overwhelmingly covetous patients, probably as a result of lower infectious control and an over-reliance on steroids to treat the virus.

The chaos continues; Delta spreads

And all the while, there was Modi. The prime minister had been the face of India’s fight against the pandemic – literally: his headache appeared primarily on the certificate given to people taking his vaccine. But after the second wave, his premature triumphalism was mocked and his lack of preparation was largely derided. Since then, it has largely disappeared from the public eye, leaving it to colleagues to blame elsewhere, in particular – and inaccurately – the government’s political opposition. As a result, Indians were left to face alone the biggest national crisis of their lives.

This abandonment created a sense of camaraderie among some groups of Indians, with many use social networks and WhatsApp to help each other sharing information on hospital beds and oxygen cylinders. They also organized them on the ground, distributing the meals to those in need.

«U [BJP] the demonstrations were a direct message from the direction the virus was going. ”

Ramanan Laxminarayan, Center for Disease Dynamics, Economics and Politics

But the leadership vacuum has also produced a huge market for profiteers and scammers at the highest levels. In May, opposition politicians accused a BJP party leader, Tejaswi Surya, of participating in a vaccine commission scam. And Goa’s health minister, Vishwajit Rane, has been forced to deny claims that he played a role in a scam involving the purchase of fans. Even the prime minister’s first secret, Prime Minister Cares, came under fire after spending 2.25 billion rupees (more than $ 300 million) on 60,000 fans that doctors complained later were defective and “Too risky to use.” The fund, which has attracted at least $ 423 million in donations, has also raised concerns about corruption and lack of transparency.

A successful vaccination agenda might have helped erase the memory of the chain of wrong steps, but under Modi it was just one technocratic mistake after another. In late May, with far fewer vaccines on hand than it needs, the government announced plans to begin mixing doses of different types of vaccines. And at the height of the second wave, it introduced Co-WIN, an online booking system that was mandatory for anyone under the age of 45 looking to get vaccinated. In the system, which had been under scrutiny for months, was disastrous: not only did it automatically exclude those who don’t use computers and smartphones, but it was also hit by bugs and overrun by desperate people for protection.


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