COVID-19 is going to kill more people in 2021 than it did last year. If you want to see why, look at what’s happening in India.

Cases have been surging in the country of 1.37 billion people. Case counts are rising quickly, too. Average infection numbers over the past seven days have run at nearly three times the level two weeks ago, a pace of growth that the US last saw in the early days of the outbreak a year ago.

The real numbers may be yet higher. The city of Bhopal used COVID-19 protocols to cremate or bury 84 people April 13, according to the Hindustan Times, while declaring only five COVID deaths. The B.1.617 variant, which isn’t well understood yet, has features associated with higher infection rates and lower antibody resistance. It’s turning up in more than half of viral samples taken in India.

As caseloads push medical facilities toward capacity, the health system itself is starting to crack. Vaccine stocks, hospital beds and even oxygen supplies are running short, leading to bitter arguments between the states and the federal government. In some places, the dead are being transported by truck because cities have run out of hearses. Elsewhere, crematoria have started to break down because of the sheer number of bodies being burned. The government promised to open up vaccines to all people over the age of 18.

If things don’t change soon, the country will be facing 3,000 deaths a day -- twice its current level, and 10 times what was being seen through most of this year -- Bhramar Mukherjee, a biostatistician at the University of Michigan, wrote.

As my colleague Mihir Sharma has written, arrogance, hypernationalism and incompetence helped foster a fatal sense of complacency amid India’s apparent success against the outbreak earlier this year. Until a few weeks ago, lockdown restrictions had been progressively loosening for months. Cinemas were allowed to open to full capacity Feb. 1. Health Minister Harsh Vardhan declared the country “in the endgame of the COVID-19 pandemic” in early March, at almost precisely the point that cases started to surge again.

Worryingly, the clear signs of a second wave haven’t prompted much course correction since. With elections underway in the states of Assam and West Bengal, the Twitter feed of Prime Minister Narendra Modi has been interspersing updates about the virus with Trump-style footage of him, unmasked, addressing mass rallies.

The other side isn’t necessarily doing much better, either. West Bengal’s chief minister, an opponent of Modi’s BJP, only got around to canceling her campaign rallies Sunday.

Worse may be to come. The Kumbh Mela, a Hindu pilgrimage festival that’s normally the largest mass gathering on earth, is now underway on the banks of the Ganges, attended by an estimated 3.5 million people. That’s well down on the numbers in a normal year, and even Modi, far too late, urged that the event be purely “symbolic” rather than physical. Still, it’s far above the mere thousands allowed to other mass events like last year’s Hajj in Saudi Arabia and Arbaeen pilgrimage in Iraq.

Even held outdoors, such events carry a profound risk of spreading the most infectious variants to every corner of the country. Close to 10 percent of people returning to Gujarat’s largest city, Ahmedabad, from the festival tested positive for the coronavirus, the Press Trust of India reported Monday. Hitherto, the coronavirus has mostly hit the relatively affluent, urbanized parts of the country that are best able to cope with it, such as the southern states of Kerala and Karnataka, the capital Delhi, and Maharashtra, home to Mumbai. If the Kumbh Mela seeds it in rural districts, where the majority of India’s population lives, the death toll could be higher still.

There’s a lesson in this for the world. The 1.2 million people who’ve died from COVID-19 so far this year already represent about two-thirds of the 1.8 million fatalities in 2020. Yet people are behaving as if it’s already over. That’s removing the sense of unified urgency that led many nations to make such strides in turning around the pandemic last year.

Vaccine supplies for the richest (and, thanks to global initiatives, poorest) countries are relatively ample. Yet those for middle-income nations, where the majority of the planet’s population lives, are grossly inadequate, blocked by restrictive patent rules. India, with one of the world’s largest pharmaceutical industries, is far better placed than most midsize economies to cope, but even it is crumbling under the strain.

The more people infected in emerging countries while the rest of the world looks away, the more opportunities COVID-19 will have to develop into fresh strains and prolong this death and misery. We must do better. The globe is still under attack, but our defenses are in disarray.


David Fickling
David Fickling is a Bloomberg Opinion columnist. -- Ed.

(Bloomberg)