The Narendra Modi government has a foolproof way of ensuring that a public health crisis is not repeated in the years to come. It simply has to look at the grave mistakes of 2021, especially now that the threat of the omicron variant looms.
A brutal second wave of covid-19, extreme shortage of vaccines, and irresponsibly large social gathering while thousands of Indians perished, together offer a blueprint for how not to handle a pandemic.
Though evidence suggests that omicron is highly contagious, its spread at the moment is limited in India to about 600 cases. The number of new covid-19 infections in the country has stayed below 10,000 for several weeks despite there being no restrictions on social gatherings and domestic travel.
And yet, it brings back memories of early 2021 when the low caseload led prime minister Modi to declare victory over the pandemic at the World Economic Forum meeting at Davos.
Members of Modi’s cabinet, including the health minister, were convinced that Indians had beaten the virus.
On March 7, speaking at a Delhi Medical Association event, health minister Harsh Vardhan said that India was “in the end game of the pandemic.” Vardhan made that comment in the backdrop of the fact that after a peak of nearly 100,000 cases a day in September 2020, the country was registering close to 20,000 cases at the time.
India had also just begun vaccinating its elderly and vulnerable, including healthcare and frontline workers. Vardhan claimed then that, unlike other countries, India had no shortage of vaccines.
Most of these claims fell flat within a couple of months. The premature triumphalism cost India dearly when, in April, a tsunami of new infections swept the country.
Right around (after?) the Hindu festival of Holi on March 29, new cases exploded.
Delhi, which had around 3,000 cases per day at the beginning of April, saw the number rise by 900% to over 25,000 by April 20. Mumbai, by April 4, was registering 11,000 cases, which, data suggested, had a doubling rate of 42 days.
The surge in Delhi was so sudden and unexpected that it overwhelmed the city’s healthcare system. While Mumbai had a covid-19 war room, patients in Delhi were left to their own devices to find hospital beds, medicines, and oxygen cylinders. Social media feeds were inundated with SOS calls for everything from RT-PCR tests to drugs like remdesivir.
For those who lost loved ones, the trauma of having to wait in long queues at crematoria, which were functioning round-the-clock by then, only aggravated this suffering.
Helplines were dysfunctional and desperate hospitals, too, turned to social media to catch the government’s attention when they ran out of oxygen. At Ganga Ram Hospital, one of Delhi’s largest private hospitals, 25 people allegedly died as oxygen supplies depleted. This, despite ongoing—and almost overnight—hearings in the Delhi high court to solve the problem of oxygen shortage in the city. The Modi government has said in parliament that there were no deaths because of oxygen shortage.
Desperate scenes played out from cities like Ahmedabad and Vadodara in the state of Gujarat, too. Emergency wards aside, even parking lots at hospitals were teeming with hapless patients and their families. Ambulances stood in a queue outside hospitals, sometimes for as long as 15 hours.
And while death, disease, and despair became an everyday reality for common Indians, Modi’s Bharatiya Janata Party was leading a full-scale election campaign in the eastern state of West Bengal, complete with massive rallies and roadshows. Similar election rallies were held in other states like Kerala, Assam, and Tamil Nadu, too.
In Uttar Pradesh, also ruled by the BJP, schoolteachers were forced to appear for duty during village-level elections. The teachers’ association said that over 1,600 of them had died of covid-19 in the line of duty—the government’s official figure was only three.
In neighbouring Uttarakhand, a massive gathering of Hindu seers and millions of devotees was held despite widespread criticism. The Kumbh Mela was organised on the banks of the Ganga river between April 1 and 17, at a time when India was recording upwards of 200,000 cases a day. It was yet to reach its peak of 400,000.
The religious fair was cut short following the death of a seer due to covid-19, reports of fake RT-PCR tests, and photographic evidence of covid-19 protocol being completely abandoned.
All this coincided with an unforeseen and acute shortage of vaccines.
On April 19, the Modi government announced that from May 1 it would open up vaccinations for all adults aged over 18.
This was a welcome and much-needed decision, except that states like Maharashtra, Rajasthan, and Chhattisgarh were shutting down vaccination centres due to an acute shortage.
India had then approved only two vaccines, the homegrown Covaxin and Serum Institute of India’s (SII) Covishield, for use, with the latter accounting for a majority of the doses.
SII, however, also had international commitments to fulfil, including the orders from the global vaccine sharing initiative Covax. These shipments were halted to prioritise domestic needs, and the World Health Organization warned member countries of delayed supplies.
The Modi government also said it would vaccinate only those above 45 years for free. It left it to the states to directly buy vaccines from manufacturers, and decide if they would vaccinate their respective populations for free.
The policy also allowed manufacturers to reserve 25% of their supply for private hospitals, where vaccines would cost citizens upwards of Rs750 ($10).
Manufacturers like SII were suddenly under fire from all quarters. They were to negotiate different prices with different state governments, instead of a single national vaccine body. Amid such pressure, SII CEO Adar Poonawalla shifted to the UK, citing threats to his life from those who wanted vaccines before the others.
Even when vaccinations opened up for a larger demographic on May 1, there were no appointment slots. Indians in urban centres had to resort to tech hacks like Telegram groups to be alerted when a slot opened up, or drive several miles to faraway villages to get inoculated.
Following a backlash from the civil society, and a rap on the knuckles from the supreme court, which called the official approach “arbitrary and irrational,” the government changed its policy: It would now give free vaccines to all over the age of 18, coordinate all supplies for the states, leaving direct procurement to only private hospitals.
Through it all, the government also had different estimates for vaccine production. On a single day, it provided three different figures pertaining to domestic vaccine production. On July 20, the health ministry stated that Covaxin-maker Bharat Biotech was producing 10 million doses a month, and will be increased to 100 million in the coming months.
“Firstly, India’s vaccine production capacity is not rising as is regularly claimed by the government of India. Secondly, the government’s projections for vaccine availability are consistently inflated and unrealistic,” R Ramakumar, professor at the Tata Institute of Social Sciences in Mumbai, wrote in The Indian Express newspaper.
Data transparency remained a grave concern throughout 2021, more seriously in the way deaths were counted.
Epidemiologists rang the alarm on poor quality data in India early on in the pandemic but were horrified by how much the government worsened it during the second wave.
“It’s a complete massacre of data,” Bhramar Mukherjee, an epidemiologist at the University of Michigan, told the New York Times. It was up to statisticians to compare excess deaths with those expected according to the civil registration system to arrive at the actual toll of covid-19.
According to this analysis, for every death that was counted, six were missed. The Modi government denied this in parliament. The official count showed nearly 480,000 Indians dead due to covid-19. But pictures of mass funeral pyres, dead bodies washing ashore along river Ganga, and evidence from regional media organisations stood in stark contrast.
At one crematorium in Gujarat, the metal frame melted and collapsed after being used continuously for days.
Despite such evidence, besides regional media reports on cremations, the number of covid-19 deaths published by the Gujarat government was only a minuscule fraction of what was there in plain sight.
The government also said in parliament that it had no data on how many doctors died because of covid-19. According to the IMA, nearly 800 doctors died during the second wave alone.
The Indian Medical Association, the country’s top voluntary medical body, has consistently criticised the Modi government for not maintaining this data. But it went further and called Modi a “super-spreader” of the pandemic for hosting mega election rallies and allowing the pandemic to spread unchecked.
With crucial elections scheduled in states like Uttar Pradesh and Punjab early next year, a repetition of this year’s affairs isn’t all that difficult to imagine.
How the next wave of the pandemic plays out will now depend on whether the government remains in denial or learns from the devastation of 2021.