In Numbers: How India Prepared For A Second Wave But Got Overwhelmed By A Tsunami

The Covid-19 pandemic has ravaged almost every country around the world. The second wave of the pandemic seems to be especially lethal in India. It rose suddenly in early April and has left big scars in the last four weeks.

Life in India had gone to normal in March. On 27 March, the Filmfare awards functions were held in Goregaon Film City in Mumbai. We saw pictures of the ENBA awards ceremony, shared by almost every media house, on 3 April , where large teams came together in closely huddled groups for smiling and cheering that evening. The usage of masks was already forgotten.

6 April saw the culmination of the election process in four locations – Assam, Kerala, Puducherry and Tamil Nadu.

Until then, no one really had called for suspension of election campaigns, let alone the elections. The Covid-19 cases were rising, but they seemed under control across the country except a few states. Certainly, there was no urgency in the poll-bound states.

And then the worse happened. The exponential jump of cases caught everyone off-guard. From governments to healthcare professionals, from the manufacturers of medical devices to pharmaceutical companies, from hospitals to volunteer groups – the ferocious nature of the second wave threw everyone off-guard. There were shortages of oxygen, medicines and hospital beds. Some of these shortages were demand supply mismatches, some a hard supply constraint and some an outcome of immoral profiteering by those who had the supplies in stock.

Every death is an inconsolable tragedy for the affected families. The pictures have been grim and filled with pathos. It is clear that the country’s healthcare infrastructure has not been able to react to the challenge. But it is equally true that perhaps no country’s healthcare infrastructure would have reacted to a challenge of this magnitude.

We have all read the stories from Italy last year, where doctors had to explicitly decide to save younger patients as opposed to the older ones because there weren’t enough ventilators and beds.

In January this year, dead bodies were piling in Los Angeles, a city home to the richest people in show business. The city had to use refrigerated trucks to store the bodies. In the same month, New York was alleged to have underreported the death count in nursing homes.

All of this happened at a much lower case count – a fraction of the caseload that India is witnessing. It is normal to assume that India did not prepare for a second wave. The reality however is that despite preparing for a second wave, we got overwhelmed by the replication speed of the virus.

Starting with a single National Institute of Virology in Pune handholding 75 government labs in March 2020, India today has 1,231 government and 1,227 private labs testing for the virus. In fact, more than 100 of these labs were added in 2021, despite the virus receding in the early part of the year.

Since March 2020, the availability of PPE kits has gone up 46 times and that of N95 masks has gone up 43 times. An Economic Times report described how India achieved this feat. In fact, India became the second largest global producer of PPE kits in this period despite starting with a very low base.

India had 10,180 isolation beds and mere 2,168 ICU beds for managing the pandemic before the virus hit us. Today the country has 1.5 million isolation beds and more than 80 thousand ICU beds to manage Covid-19 patients. The force of the second wave has been such that this increase of 40 times in the ICU beds has also not been able to absorb the shock.

Government hospitals in India had about 17 thousand ventilators before the pandemic. Since then, almost 35 thousand new ventilators have been delivered to states.

In fact, most of them were ‘Made In India’ ventilators.

Last month, before the second wave became a tsunami, The Tribune had published a story how 250 out of the 290 ventilators sent by the central government to Punjab were not even unpacked. Based on the demand raised by the states, these ventilators are being allocated and delivered to various states.

Even in the case of oxygen, the peak demand in the country, which before the pandemic used to be 10 per cent of the total installed capacity – industrial and medical – shot up to 50 per cent of the installed capacity on 12 April – just a couple of weeks after the rapid case load surge began.

With the additional constraint of the production being in a few states and transportation not being easy, it was virtually impossible to meet the peak.

However, the government did react fast in diverting almost all of the country’s installed capacity for medical purposes as was practically possible. This order was passed on 7 April at the first sign of a jump in oxygen consumption. The private sector jumped in to supply oxygen.

Currently, 162 pressure swing absorption technology-based oxygen plants are being installed. Most of them will be commissioned by May end. These were allocated to the states a few months ago, but very few states actually acted on the building of these plants. Additionally, DRDO is also going to work on 500 oxygen plants to be funded from PM-CARES fund.

There is no doubt that this wave of Covid-19 has scarred the country. But at a policy level, the impact has to be assessed in terms of an aggregate response and within the limitations of our federal operating structure. Not only this pandemic teaches us the lesson to invest more in healthcare but also revisit how Centre and States coordinate with each other.

The battle continues and it must be dealt with empathy and hard data and with optimisation of the underlying processes. The need of the hour is for the country to stand together and fight not just the viral pandemic but also the pandemic of self-hate, self-loathing and delirious public commentary.

Like everything else in the past, we shall overcome this and we will emerge much stronger.