The global death toll from the coronavirus pandemic has topped 3.34 million and over 160.8 million cases of the infection have been detected, according to Baltimore, Maryland’s Johns Hopkins University (JHU).

The U.S., India and Brazil are the top three countries in terms of the number of registered coronavirus infections, while the largest number of COVID-19-related deaths has been observed in the U.S., Brazil, India and Mexico, according to JHU.

Number of Cases in India Rises by 343,144

India has confirmed 343,144 new cases of the coronavirus over the past 24 hours, with the total number of those infected having reached 24,046,809, the country’s Ministry of Health and Family Welfare said on Friday.

The death toll from the disease has reached 262,317 people, with 4,000 new fatalities being recorded over the past day.

More than 20.07 million people have recovered in India since the start of the outbreak.

A day earlier, the country confirmed 362,727 new coronavirus cases, with 4,120 fatalities.

As many as 533 of India’s 700-plus administrative districts are now reporting a test positivity rate of more than 10 per cent, government officials said during a weekly briefing.

The situation is particularly bad in rural areas of Uttar Pradesh, India’s most populous state with a population of over 240 million. Television pictures have shown families weeping over the dead in rural hospitals or camping in wards to tend the sick.

Bodies have washed up in the Ganges, the river that flows through the state, as crematoriums are overwhelmed and wood for funeral pyres is in short supply.

India is the world’s largest vaccine producer but has run low on stocks in the face of the huge demand. As of Thursday, it had fully vaccinated just over 38.2 million people, or about 2.8% of a population of about 1.35 billion, government data shows.

More than 2 billion doses of coronavirus vaccines will likely be available in India between August to December this year, top government adviser V.K. Paul told reporters amid criticism that the government had mishandled the vaccine plan.

Those doses would include 750 million of AstraZeneca’s vaccine, as well as 550 million doses of Covaxin, made by Bharat Biotech.

Global tenders

Several state governments including Maharashtra, Delhi and Uttarakhand are considering floating global tenders to acquire COVID-19 vaccines.

West Bengal chief minister Mamata Banerjee urged Prime Minister Narendra Modi to push for import of vaccines and encourage manufacturers to set up franchise operations in India.

Two vaccines are currently being used in India: the AstraZeneca-Oxford University shot manufactured by the Serum Institute of India under the name Covishield as well as Covaxin, which has been developed jointly by Indian pharmaceutical company Bharat Biotech and the state-supported Indian Council of Medical Research.

The two firms have been unable to meet the demand for vaccines after the government opened eligibility to all Indians above the age of 18 from May 1.

Both Serum Institute and Bharat Biotech were expanding their capacities with financial assistance from the government.

And with Russia’s Sputnik V vaccine also expected soon the vaccine crunch should ease in a few weeks, Covid Task Force member Randeep Guleria said on CNN-News18 television channel.

The government is considering requests for the Covaxin formula be shared with other manufacturers.

India has so far administered 175.2 million doses of the vaccine, with about 39 million being given both doses.

India’s latest surge has been linked to a variant of the virus – B.1.617 – which has been found in 44 countries according to the World Health Organisation and has been labelled it a variant of concern.

The country accounts for half of COVID-19 cases and 30 per cent of deaths worldwide, the WHO said.

Indian, South African Coronavirus Variants found in Americas

The four most worrying coronavirus variants have been detected in virtually all countries and territories of the Americas, but although they are more transmissible there is no evidence they are more lethal, a World Health Organization (WHO) expert said on Thursday.

The vaccines that are being administered in the region do provide more protection against the variants, Jairo Mendez, a WHO infectious diseases expert said in a webinar by the Pan American Health Organization (PAHO).

“What we still do not know is whether fully vaccinated people who do not become ill can still spread the virus to others. We have a lot to learn,” Mendez said.

The newest variant, the Indian B.1.617 variant, has been detected in cases in eight countries of the Americas, including Canada and the U.S., he said.

One case is under investigation, and others with the variants were travelers in Panama and Argentina who had arrived from India or Europe. In the Caribbean, cases of the Indian variant have been detected in Aruba, Dutch St Maarten and the French department of Guadeloupe.

The B.117 prevalent in the UK has been found in cases reported in 34 countries or territories in the Americas, while the South African variant B.1.351 has been reported in 17.

Brazil’s so-called Manaus variant P.1 has so far been detected in 21 countries, the WHO expert said.

“These variants have a greater capacity for transmission, but so far we have not found any collateral consequences,” Mendez said. “The only worry is that they spread faster.”

The mutant strain has also been detected in Singapore.

China Supports WTO Proposal

China has voiced support for a World Trade Organisation (WTO) proposal to waive intellectual property protection for coronavirus vaccines.

India’s COVID-19 Disaster May Be Turning Into an Even Bigger Global Crisis

The coronavirus outbreak reflects a broader one across Nepal, which shares a long, porous border with India. Daily confirmed cases in the Himalayan nation increased thirtyfold from April 11 to May 11, when 9,300 infections were recorded. It is a grim omen of how India’s devastating COVID-19 crisis may be turning into an even bigger global emergency.

As countries around the world airlift oxygen, vaccines and medical supplies to India, they are also closing their borders to the world’s second most populous country. It may already be too late. The B.1.617 variant of the virus, first detected in India, has now been found in 44 countries on every continent except Antarctica — including Nepal, the U.S. and much of Europe.

Scientists say it could be more infectious and better at avoiding humans’ immune systems. On May 10, the World Health Organization declared it a variant of “global concern.” And because only around 0.1% of positive samples in India are being genetically sequenced, “there may well be others that have emerged,” says Amita Gupta, deputy director of the Johns Hopkins University Center for Clinical Global Health Education.

The true scale of the COVID-19 outbreak in India is impossible to accurately quantify. Officially, confirmed daily cases are plateauing just under 400,000 but remain higher than any other country has seen during the pandemic. Experts warn that the real numbers are far bigger, and may still be rising fast as the virus rips through rural India, where two-thirds of the population lives and where testing infrastructure is frail.

The University of Washington’s Institute for Health Metrics and Evaluation (IHME) estimates the true number of new daily infections is around 8 million — the equivalent of the entire population of New York City being infected every day.

Official reports say 254,000 people have died in India since the start of the pandemic, but the IHME estimates the true toll is more than 750,000 — a number researchers predict will double by the end of August.

Experts say that the crisis was entirely predictable, and that rich countries could have done more to prevent it. “The pandemic has once again highlighted the extreme international inequality in access to lifesaving vaccines and drugs,” says Bina Agarwal, professor of development economics and environment at the University of Manchester. The Indian government failed to order enough vaccines for its population — or ramp up its vaccination program fast enough. But, for months, the U.S. also blocked exports of crucial raw materials India needed to manufacture vaccines, and stockpiled 20 million Astra-Zeneca shots even though the FDA had not authorized their use. Although President Biden has now changed course, sending much-needed vaccine raw materials to India and pledging to export the Astra-Zeneca shots, it will take a long time for the country to catch up: only 2.8% of the population was fully vaccinated as of May 12.

Now, India’s brutal second COVID-19 wave is sparking worries that the worst is still ahead. Especially concerning are densely populated African countries, many of which have yet to experience large outbreaks. Versions of the B.1.617 variant have already been reported in Angola, Rwanda and Morocco. Many of the vaccines that could curb outbreaks in such countries were meant to come from factories in India — which has now ordered that most of its vaccine production be used to meet domestic needs.

Hunt for $1,000 Machines

On May 13, 2021, a Bloomberg report said:

Oxymed, oxygen concentrators, is a little known machine that separates Oxygen, the critical gas, from air and assists patients with low blood-oxygen levels.

Calls from India are overwhelming the supplier. “They are desperate,” the supplier said, referring to the callers he’s been speaking to lately. “They tell me about relatives dying on the streets, that there is no space in the hospitals and that the few oxygen concentrators that are still available are being sold for up to 10 times the normal price.”

After a new coronavirus variant unleashed a brutal wave of infections in India, demand has shot up for the device. When health-care facilities are running short of oxygen tanks and beds, the portable machine is increasingly becoming a line of defense for those seeking to avert breathing difficulties while recuperating at home.

Just as some countries needed ventilators in large quantities last year, India is now desperately seeking oxygen supplies and concentrators.

The latest outbreak has seen oxygen requirements at Indian hospitals rise 10-fold, according to Abhinav Mathur, founder of the Million Sparks Foundation, which is part of efforts around Delhi to import the devices and donate them to healthcare facilities. A small part of this surge is being met by the concentrators, he said.

To be sure, oxygen concentrators are useful only to those who do not require intensive care. The machines deliver about five to 10 liters of the gas per minute, typically at about 93% purity, whereas those fighting Covid in hospitals may need as much as 60 liters per minute, which can be met only by liquid-oxygen tanks.

Data tracked by the Indian Council of Medical Research between August 2020 and April 2021 show shortness of breath was reported by almost 48% of patients hospitalized this year, compared with about 42% last year. Oxygen utilization jumped to 55% in the second wave, from 41% during the first.

The report said:

India needs as many as 200,000 oxygen concentrators to meet the current demand, or five times pre-pandemic levels, Mathur said. Prime Minister Narendra Modi’s government on May 10 said it distributed 6,738 of them from the pool of foreign aid it received in recent weeks, underscoring the inadequacy of supplies and donations trickling in from countries ranging from the U.S. to China and Switzerland.

Distraught families are looking to source the gadget – which could set some back by as much as $1,000, or about half of India’s per capita gross domestic product – from wherever they can. The cost is an additional burden for some Indians who face shrinking incomes after losing businesses and jobs to lockdowns. A study by Pew Research Center showed an estimated 75 million people slipped into poverty in India since the outbreak began.

Some of the biggest manufacturers including Royal Philips NV are stepping in to help. The company has “significantly increased its global production and is making these products available in India to help save more lives,” Philips said in an emailed statement, declining to elaborate.

Enough Capacity

Chinese maker Jiangsu Yuyue Medical Equipment & Supply Co. said in an investor call in April that “orders from India continue to grow.” The Nanjing-based company said its daily production capacity of 4,000 units is sufficient to deliver orders amounting to 18,000 pieces. Shares of the company have jumped 18% in the past month in Shenzhen, compared with the 3% gain in the Shenzhen Stock Exchange Composite Index.

Koch’s Oxymed website lists several oxygen concentrators. The EverFlo by Philips, for example, costs 1,550 Swiss francs ($1,715). Other devices have price tags ranging from 1,250 francs to 4,850 francs.

Models imported from China may be more affordable at 25,000 rupees ($340), but because of high demand and price gouging, some in Delhi are paying 80,000 rupees for any available piece. Indian budget airline SpiceJet Ltd. said it has airlifted more than 27,000 oxygen concentrators from the U.S., Hong Kong, mainland China and Singapore.

Until recently, India’s federal government used to levy an import duty of as much as 20.4% on the oxygenates, but the levies were scrapped temporarily in the first week of May after the red tape prevented life-saving equipment and medicines from reaching the needy.

A relief fund set up by the Indian Prime Minister last year is set to order 150,000 units of an oxygen supply system developed by India’s Defence Research & Development Organisation, the government said Wednesday.

Demand for oxygen concentrators are only likely to surge further, said Million Sparks Foundation’s Mathur. Home care, government-run facilities adding more beds and hotels getting converted into Covid care centers will fuel the demand, he said.

India’s Semi-urban and Rural Areas

“The next big worry is that the pandemic is clearly seen moving to semi-urban and rural areas,” he said. “The government should start to plan for improving the availability of oxygen in these areas to be ready to respond.”

A Tiny Village near Zurich

In a tiny village about 20 miles east of Zurich, Dino Vivarelli runs MediCur AG, a specialist retailer of all things oxygen, ranging from therapies to air purifiers. He has never done business outside of Switzerland.

But after the Indian embassy contacted him about two weeks ago to source large quantities of liquid oxygen, Vivarelli said he’s been getting inquiries from charities and the Indian diaspora in Switzerland and Germany. Until recently, he said he used to be able to order oxygen concentrators by the dozen by email and receive them the next day.

How India’s Vaccine Drive Went Horribly Wrong

On May 14, 2021, a BBC report said:

All 18-44 year-olds in India have to register on the government’s CoWin platform to get vaccinated. With demand for jabs far outstripping supply, tech-savvy Indians are even writing code to corner elusive appointments.

Millions of Indians are on the right side of the country’s digital divide – unlike hundreds of millions of others who do not have access to smartphones or the internet, currently the only route to a jab.

Prime Minister Narendra Modi’s federal government has opened up vaccinations for some 960 million eligible Indians without having anything close to the required supply – more than 1.8 billion doses.

Worse, the severe shortage comes amid a deadly second Covid wave and warnings of an impending third wave.

A cocktail of blunders – poor planning, piecemeal procuring and unregulated pricing – by Mr Modi’s government has turned India’s vaccine drive into a deeply unfair competition, public health experts told the BBC.

How did the world’s largest vaccine manufacturer, often dubbed “pharmacy of the world” for generic drugs, end up with such few vaccines for itself?

The BBC report said:

“India waited till January to place orders for its vaccines when it could have pre-ordered them much earlier. And it procured such paltry amounts,” says Achal Prabhala, a co-ordinator with AccessIBSA, which campaigns for access to medicines in India, Brazil and South Africa.

Between January and May 2021, India bought roughly 350 million doses of the two approved vaccines – the Oxford-AstraZeneca jab, manufactured as Covishield by the Serum Institute of India (SII), and Covaxin by Indian firm Bharat Biotech. At $2 per dose, they were among the cheapest in the world, but not nearly enough to inoculate even 20% of the country’s population.

Declaring that India had defeated Covid, Mr Modi even took to “vaccine diplomacy,” exporting more jabs than were administered in India by March.

Contrast that with the U.S. or EU, who pre-ordered more doses than they required nearly a year before the vaccines became available for immunisation.

Some 100 million Indians over the age of 45 are still waiting for their second jab

“This guaranteed vaccine manufacturers a market, gave them certainty to forecast supply and sales, and ensured that some of these governments got large quantities as quickly as possible, once the vaccines were ready,” Mr Prabhala says.

Unlike the U.S. and the UK, India also waited until April 20 – well into the second wave – to extend a $610m financing line to SII and Bharat Biotech to boost production.

Another failure, according to Malini Aisola, co-convener of the All India Drug Action Network, was the decision not to enlist the vast swathe of India’s manufacturing capabilities – biologics factories, for instance, that could have been repurposed into vaccine production lines.

Again, four firms, including three government-owned ones, have only recently been given rights to make Covaxin, which is partially publicly-funded.

On the other hand, by early April, Russian developers of Sputnik V, had inked manufacturing deals with a host of Indian pharma companies, which are set to produce the vaccine.

The report added:

As the sole buyer initially, the federal government could have held far greater leverage over pricing, Ms Aisola says.

“Centralised bulk procurement would have allowed the price to come down from $2. Instead it has gone up,” she adds.

This is because since 1 May, it has been up to individual states and private hospitals to broker their own deals with manufacturers.

Opposition parties have called it a “scam,” saying the federal government had abdicated its responsibility, opening up “debilitating competition among states.”

States have to pay double – $4 – the federal government’s rate for a dose of Covishield and four times as much for Covaxin – $8. This was after the two companies lowered prices for states as a “philanthropic gesture”. States are also competing for scarce stocks alongside private hospitals, which can pass on the costs to customers.

The result: a veritable free market for vaccines that have been developed and manufactured with both public and private funding. At private hospitals, a single dose can now cost up to 1,500 rupees ($20; £14).

Sputnik V has been approved, but it is still unclear when the vaccines will be rolled out.

The report said:

Some have accused SII and Bharat Biotech of “profiteering” during a pandemic, especially after receiving public funding.

But others say they took substantial risks and that the fault lies with the government. India is the only country where the federal government is not the sole buyer, and one of the few where vaccinations are not free.

But public health experts agree that SII and Bharat Biotech need to be more transparent about their manufacturing costs and their commercial contracts.

Ms Aisola says SII needs to disclose how it spent the $300m it received from the international Covax scheme and the Gates Foundation, funding which was meant to finance vaccines for low-income countries. SII has failed to do so, partly because India banned exports. The company is also fielding a legal notice from AstraZeneca for defaulting on its promise to send 50% of its supply to low-income countries.

Public health experts are also calling for scrutiny of the Indian government’s contract with Bharat Biotech, especially since the Indian Council of Medical Research has said it “shares” intellectual property (IP) for Covaxin, which it developed along with the company. But the jab costs more – often double – than Covishield.

“They say they share IP but what sort of an agreement did they sign? Does it give them [the government] the right to override any clauses in case of an emergency?” asks Dr Anant Bhan, a public health expert.

While India has supported waiving the patents on foreign-made vaccines, it has made no move to suspend it for Covaxin.

Contrary to its international position, it has opposed suggestions from opposition leaders to invoke compulsory licensing and allow other pharma companies to manufacture the approved vaccines, saying these measures would prove “counterproductive.”

Dr Bhan agrees that at this stage, it would take time to transfer technology and build capacity in other pharma companies – but he also says it’s unclear why none of this was attempted earlier.

Vaccinating even 70% of India’s 1.4 billion people was always going to be a long exercise in planning and patience. But given the country’s strong record on immunisation, it was not an impossible task, Dr Bhan says.

However, why the government chose to rely on just two companies who can now control supply and dictate prices is a question that few have answers to.

Misinformation surges amid India’s COVID-19 calamity

On May 14, 2021, an AP report said:

“The man in the WhatsApp video says he has seen it work himself: A few drops of lemon juice in the nose will cure COVID-19.

“‘If you practice what I am about to say with faith, you will be free of corona in five seconds,’ says the man, dressed in traditional religious clothing. ‘This one lemon will protect you from the virus like a vaccine.’”

The report said:

False cures. Terrifying stories of vaccine side effects. Baseless claims that Muslims spread the virus. Fueled by anguish, desperation and distrust of the government, rumors and hoaxes are spreading by word of mouth and on social media in India, compounding the country’s humanitarian crisis.

“Widespread panic has led to a plethora of misinformation,” said Rahul Namboori, co-founder of Fact Crescendo, an independent fact-checking organization in India.

While treatments such as lemon juice may sound innocuous, such claims can have deadly consequences if they lead people to skip vaccinations or ignore other guidelines.

In January, Prime Minister Narendra Modi declared that India had “saved humanity from a big disaster by containing corona effectively.” Life began to resume, and so did attendance at cricket matches, religious pilgrimages and political rallies for Modi’s Hindu nationalist party.

Four months later, cases and deaths have exploded, the country’s vaccine rollout has faltered and public anger and mistrust have grown.

“All of the propaganda, misinformation and conspiracy theories that I’ve seen in the past few weeks has been very, very political,” said Sumitra Badrinathan, a University of Pennsylvania political scientist who studies misinformation in India. “Some people are using it to criticize the government, while others are using it to support it.”

It said:

Distrust of Western vaccines and health care is also driving misinformation about sham treatments as well as claims about traditional remedies.

Satyanarayan Prasad saw the video about lemon juice and believed it. The 51-year-old resident of the state of Uttar Pradesh distrusts modern medicine and has a theory as to why his country’s health experts are urging vaccines.

“If the government approves lemon drops as a remedy, the … rupees that they have spent on vaccines will be wasted,” Prasad said.

Vijay Sankeshwar, a prominent businessman and former politician, repeated the claim about lemon juice, saying two drops in the nostrils will increase oxygen levels in the body.

While Vitamin C is essential to human health and immunity, there is no evidence that consuming lemons will fight off the coronavirus.

The claim is spreading through the Indian diaspora, too.

“They have this thing that if you drink lemon water every day that you are not going to be affected by the virus,” said Emma Sachdev, a Clinton, New Jersey, resident whose extended family lives in India.

Sachdev said several relatives have been infected, yet continue to flout social distancing rules, thinking a visit to the temple will keep them safe.

The report added:

India has also experienced the same types of misinformation about vaccines and vaccine side effects seen around the world.

Last month, the popular Tamil actor Vivek died two days after receiving his COVID-19 vaccination. The hospital where he died said Vivek had advanced heart disease, but his death has been seized on by vaccine opponents as evidence that the government is hiding side effects.

Much of the misinformation travels on WhatsApp, which has more than 400 million users in India. Unlike more open sites like Facebook or Twitter, WhatsApp — which is owned by Facebook — is an encrypted platform that allows users to exchange messages privately.

The bad information online “may have come from an unsuspecting neighbor who is not trying to cause harm,” said Badrinathan, the University of Pennsylvania researcher. “New internet users may not even realize that the information is false. The whole concept of misinformation is new to them.”

It said:

Hoaxes spread online had deadly results in 2018, when at least 20 people were killed by mobs inflamed by posts about supposed gangs of child kidnappers.

WhatsApp said in a statement that it works hard to limit misleading or dangerous content by working with public health bodies like the World Health Organization and fact-checking organizations. The platform has also added safeguards restricting the spread of chain messages and directing users to accurate online information.

The service is also making it easier for users in India and other nations to use its service to find information about vaccinations.

“False claims can discourage people from getting vaccines, seeking the doctor’s help, or taking the virus seriously,” Fact Crescendo’s Namboori said. “The stakes have never been so high.”


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One Comment

  1. P. S. Sahni says:

    Only a Nuremberg-type trial of those responsible for mismanagement would reveal the truth.