By Dr. Sameeksha Dhillan & Dr. Divya Singh

COVID

From an average of over 93,000 new cases per day in September last year to roughly 10,000 new COVID cases per day in February 2021, India has made great strides. This significant and consistent decline led to the withdrawal of lockdown with a partial relaxation in various sectors. Social or religious activities along with the cinemas were permitted up to 50 percent of the hall capacity. There shall be no restrictions on the interstate and the intra-state movement of the persons and the goods. Gradually, life was coming back to normal for India.

Just after two months in April 2021, India saw an alarming rise in Covid cases and the daily new cases reached approximately 1,50,000. This resulted in immediate imposing of state-wise curfews, shutting of cinema halls. Once again, people were trapped in their houses and glued to their laptops & TV screens. This marked the beginning of the horrific second wave of COVID-19 pandemic for India.

The World Health Organization (WHO) and Indian  medical fraternity anticipated the second wave long before it actually hit India. However, the Indian authorities did not address their concerns. What caused this ignorance? Could this be avoided or at least mitigated? For the sake of historical accuracy in our collective memory, this article provides the possible reasons which led to the devastating second wave of COVID-19.

Let’s recap the first wave for a little bit. The first wave of the pandemic concluded with the constant decline in the number of COVID cases. However, the subsequent  ease in restrictions combined with the diminished awareness campaigns resulted in the violation of COVID appropriate behavior by the people. The recklessness could be seen in the widespread video footage and pictures shared on social media depicting people being part of social events and gatherings.

One of the events that turned out to be the super-spreader was the Kumbh Mela that was held on April 12th, 2021 in Uttrakhand, where millions of devotees gathered on the shores of the Ganges without masks and proper social distancing. This incident led India to become the second-worst hit country with 169,000 plus new COVID-19 cases. However, the exact count of fresh cases would never be known due to inconsistency in data collection. In addition, thousands of pilgrims returned home without being screened or quarantined. This portrayed that faith and religion took priority, while preventive measures and life of the people were pushed to the back of the line.

Amidst continuous hike in COVID cases, when centre and states should have concentrated  on guaranteeing the safety of the citizens, they were solely focused on the election rallies and voting activities in West Bengal followed by Assam and Kerala. Thousands of people attended rallies where COVID restrictions were often flouted with no social distance and little mask-wearing.

The aforementioned two events emerged as super spreaders, as evident from daily cases increasing by about 6,000 percent between 1 March and 22 April in poll-bound Bengal, and by more than 450 percent between 1 April, when the Kumbh Mela began, and 17 April, when the religious assemblage was called off. Because of these events, India reached a point where it was reporting a global record of over 415,000 new cases each day, with approximately 4,000 fatalities on a daily basis. This catastrophic rise in cases has pushed India’s already overstretched, overworked, and on the point of collapsing public health system even farther. It demonstrated the absence of resources, facilities and infrastructure in the health system. This finally led to congestion in hospitals, shortages of ICUs and general wards. Moreover, the diagnostic laboratories struggled to process increasing caseload of COVID-19 tests. The poor and delayed action by authorities, pushed individuals to wait for hours to buy life-saving drugs, oxygen cylinders. Lag in the implementation of essential commodities acts against the selling of vital medications, oxygen, and even unreasonably high prices by ambulance services for short-distance travel with patients or corpses.

In January 2021, India began the largest immunisation campaign in the world against Covid-19 with first priority being healthcare and frontline workers, the elderly, and those with comorbidities. Just over three months later, the government’s plans went haywire as they could manage to immunise even fewer than 2% of its overall population. The herculean task was not only the logistics to distribute the vaccination to the vast population, but also to acknowledge the misinformation and distrust that continue to cause the widespread hesitation, especially in rural regions where two thirds of the country’s inhabitants dwell. Lack of trust and confidence towards vaccination arise when authorities fail to justify the deaths after vaccination. Moreover, lack of transparency in the aftermath of immunisation led to the anxiety of educated people and rise of imaginary hypotheses to fill the void left by the lack of reliable facts. As a result, vaccination reluctance has increased not only in rural areas, but even in urban areas where people are more open minded. This further led to an increase in severe COVID infections, which burdened the hospitals.

India is still struggling and facing the dreadful impact of COVID-19. This second wave is most likely the result of a mix of societal behaviour, health system flaws, and governmental decisions in India. The second wave, in which the daily average count of COVID cases reached about 3,00,000, has thrown the entire healthcare system into disarray. People have endured not only economic loss, but also the loss of loved ones. There were numerous issues and gaps that could have been avoided or addressed, depending on how the government handled the situation. We can not change what has already happened but we sure can improve our future by mending our actions. India still has a long way to go when it comes to its Public Health system as well as the  healthcare system. However, the urgent need of the hour is to win over the pandemic. So, along with the COVID appropriate behaviour, vaccination is critical to slowing and then ultimately stopping the spread.

  • Dr. Sameeksha Dhillan – I am a dentist who is currently pursuing a master’s degree in Public Health from Manipal University. sameekshadhillan27@gmail.com
  • Dr. Divya Singh – I am a dentist who is currently pursuing a master’s degree in Public Health from Manipal University. divyasingh425@gmail.com 

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