As the cumulative number of
infections crosses 27 million by
the end of the third week of May
and the cumulative death toll
passes 300,000, hospitals are running
out of the medical supplies, beds are
overflowing to corridors and waiting areas,
oxygen supplies dwindled, and patients are
running from one medical center to other
begging for beds or oxygen supply for their
loved ones.
India was touted internationally for
successfully controlling the first wave
of COVID-19 last year, but the second
wave has been causing havoc as the
country is experiencing the world’s worst
outbreak, with new cases surging past
400,000 per day and breaking the record
for the highest single day figure globally
reached on May 7, which was 414,000.
This uncontrolled resurgence can in part
be attributed to the loosening restrictions
of public outings, as well as new strains
of the virus that have been identified. Due
to the first wave of the coronavirus being
controlled, people began to resume life
as before by going to big events, such
as political rallies, parties, and religious
12 DALLAS MEDICAL JOURNAL • June 2021
celebrations. As the public felt more
comfortable congregating in big crowds
and maskless, new strains began to
emerge and spread rapidly, contaminating
millions of people. One such strain is
the B.1.617 variant, which has genetic
mutations found in two other variants of
the coronavirus: increased transmissibility
and an ability to evade immune protection.
This variant was first identified in October
2020 in the state of Maharashtra and is
now found to be present in up to 60% of
the samples from the state. B.1.617 is
particularly insidious as its effects are still
unknown.
Variant of Concern: The World Health Organization
has classified COVID-19 variant
B.1.617 as a variant of concern, saying
on May 10 that it shows a possibility of
increased transmissibility.
To assess the amount of variant activity
occurring in a country, experts believe
that between 5% and 10% of all COVID-19
test samples need to be genetically
sequenced. India has sequenced less
than 1% of cases, according to Dr. Ashish
Jha, dean of the Brown University School
of Public Health – meaning until we have
more data available, it’s too soon to say
what role the variant is playing.
Uncounted Deaths: COVID-19 and its
subsequent variants have resulted in over
27 million cases in the country and over
300,000 deaths according to the World
Health Organization (WHO) (India, 2021).
However, many sources and physicians on
the ground state that estimated COVID-19
deaths could be five times that number.
These hyperbolic under-calculations of
reported deaths could be explained as the
majority of deaths occurred at people’s
homes or smaller hospitals and without
them having had the COVID-19 tests done,
hence they are not counted in the total
deaths.
Shortcomings of India’s
Health Care System
For several decades, health systems in
India have not received the respect and
resources they deserve. Public financing of
health stagnated around 1% of GDP. said
K. Srinath Reddy, president of the Public
Health Foundation of India. Compared to
India, the U.S. spent nearly 17% of its
gross domestic product on public health
care in 2018, while France and Germany
spent more than 11% of GDP that year.
“With 8.5 hospital beds per 10,000
population and 8 physicians per 10,000,
the country’s healthcare sector is not
equipped for such a crisis. Moreover, the
significant inefficiency, dysfunction, and
acute shortage of the health care delivery
systems in the public sector do not match
up with the growing needs of the population,”
the report added.
India makes vaccines for the world, but
few Indians have been inoculated. India is
one of the world’s leading vaccine manu-
By Anil Tibrewal, MD, MS,
FRCS, FACS
Barely 3% of the India’s
1.4 billion people have
been fully vaccinated, the
lowest rate among the 10
countries with the most
COVID-19 cases, leaving
India and its ill-equipped
healthcare system
vulnerable to a potential
third wave, experts say.
GLOBAL HEALTH
COVID-19
Crisis in India India is going through a devastating situation
fighting COVID-19 in the midst of a health system
on the brink of collapse in certain areas.