For most of this month, India has consistently been contributing the most number of daily confirmed COVID-19 infections to the world. This week, it reported 78,508 infections on a single day — a record single day spike — that has pushed the infection tally to over 3.6 million. In March, when the epidemic was yet to take hold in the country, there was the belief that it could be vanquished. In those days, projections based on epidemiological modelling which indicated that millions would be infected were met with denial by the government as well as disbelief by many, especially because of how it had pulverised medical health systems in Europe and the United States. The dominant note in the government’s narrative on how it has handled the pandemic is that it has kept India’s death rate low. India’s confirmed case fatality rate (CFR) is below 2% — totalling to over 64,500 deaths. The U.S. and Brazil, the only two countries with more cases than India, have a CFR of around 3% and a good number of countries that lead the COVID-19 tally have their confirmed deaths in that region. Were India too to have a similar death rate, that would work out to 103,000 deaths. Whether the nearly 40,000 averted deaths are so far evidence of a dodged bullet, or in part due to an undercount that results from States not reporting ‘suspected or probable deaths’ (as required by ICMR guidelines) and not medically certifying all deaths can only be known by more data being made available in the future for analysis.
That the virus has managed to infect some of India’s most secluded tribes in the Andaman and Nicobar Islands is a pointer that it has now set deep roots within the country along with several other bacteria and viruses that thrive in India’s tropical climate. Its invincibility has contributed to the widespread adoption of face covers and masks and the vital role of maintaining hygiene and avoiding crowds. These are welcome behavioural changes that will serve well in the future when India will continue to grapple with seasonal outbreaks and epidemics of influenza, dengue as well as its old scourge of TB. The health-care system being pushed to its breaking point has also underlined the country’s historical neglect of widespread affordable health care as well as the paucity of qualified personnel to treat the poor. In spite of the availability of sophisticated labs and expert scientists and doctors, India continues to struggle to develop indigenous testing kits as well as conduct well-designed trials to check for the efficacy of drugs that might help with the infection. There must be deep reckoning to fix gaps in the manufacturing and product delivery chain to put in place new habits and erect a stronger line of defence against future blights.