EDITOR-IN-CHIEF
The darkest tale of a victory declared prematurely comes from Greek mythology. At the end of the Trojan War, the attacking Greeks abandoned a 10-year-long siege of the city-state of Troy and sailed away, leaving behind a giant wooden horse. The relieved defenders, falsely believing they had won, carted the horse inside the city. As the Trojans slept, Greek warriors slipped out of their hideout within the horse and opened the city’s gates to its destruction.
It could well be a metaphor for where India was at the beginning of this year. As the first wave receded in February, we believed Covid had left for good and resumed our daily life, shedding masks and the social distancing protocols doctors and scientists had mandated, oblivious to the prospect of a second wave darkening the horizon. In January this year, the government all but declared victory. Our vaccination programme went awry with the government’s misplaced priorities.
Then, without any warning, the second wave hit. Its defining feature has been its speed, ferocity and new mutant strains that we have yet to understand fully. What we do know, however, is that, like the mythical Trojans, we let our guard down. And we are paying a heavy price for it. India has been setting new records of daily Covid cases every day of the past fortnight—on April 26, it recorded a stupendous 350,000 new cases. Our peak in the first wave last year was 97,894 new cases on September 16.
With over 200,000 people dead, India is now the world’s second most affected country after the United States. The new wave may be raging in 12 states, including the National Capital Region, Uttar Pradesh and Maharashtra, but is fast radiating outwards. Tragically, Delhi, the national capital, is the epicentre of this second wave, recording 24,149 new cases and 381 deaths on April 27, with heartrending visuals of despair and bereavement all around. Mumbai has registered a dip in daily cases, though we cannot be sure if this results from a drop in testing. Clearly, our healthcare system is overwhelmed.
The new strains of the virus in the second wave have attacked our lungs with greater speed and ferocity. As our experience in the first wave taught us, oxygen was the key to saving lives. Tragically, however, these lessons were quickly forgotten by the state and central governments. When the first wave subsided, they declared victory. Many states that had created spare capacity undid their efforts, folding up temporary hospitals and dismantling beds with oxygen supply, infrastructure crucial to managing the second wave. The new surge promises to rapidly overwhelm the country’s Covid capacity of 1.5 million isolation beds, 230,000 oxygen beds and 63,758 ICU beds as of September 2020.
There were also coordination issues between the Centre and the states. Both allowed things to drift. This Centrestate mismatch was starkest in New Delhi, where the oxygen distribution system collapsed and patients died in their critical care beds. The state government did not set up a monitoring mechanism or a control room to track the movement of oxygen tankers.
While the central government had an inkling of the need for medical oxygen at least since last year, it failed to anticipate the surge in demand. The Centre and the states were unable to enhance capacity. As hospitals ran out of oxygen in late April, there was a shortage of cryogenic tankers and oxygen trucks to supply liquid oxygen, cylinders for last-mile delivery and even on-site oxygen-generation plants—approved but not built— that could have reduced the reliance on tanker shipments.
Among the handful of government officials who forecast the arrival of the second wave and indeed prepared for it was the collector in a remote district of eastern Maharashtra. Last September, he set up a liquid oxygen plant to provide medical oxygen, several isolation wards and made prepartions for launching the Covid vaccination drive. If only the Centre and the states had learned from him.
The crux of the problem was the gap in demand and supply. The demand for medical oxygen registered a near 10-fold spike—from 700 metric tonnes per day (MTD) earlier this year to a projected 6,593 MTD in the 12 most affected states alone by April 30. Even large states like Maharashtra, with oxygen-producing plants, faced shortages. People began hoarding oxygen cylinders and Remdesivir injections, the surest sign that they had lost faith in the state’s ability to deliver. The sustained neglect of medical infrastructure in some states exploded in our faces in the second wave. The global standard is 10-45 hospital beds per 10,000 people. India, on average, has just 5 beds for 10,000 people.
We now have a four-fold task on our hands— boost our oxygen supply, bend the curve of infections and reduce transmission, ramp up our vaccination capacity and rapidly create additional hospital infrastructure such as oxygen beds with attendants and doctors. This is because the second wave could seep into parts of India where the health system is abysmal.
Our cover story package, ‘Breathless’, looks at the impact of the second wave across the country. Executive Editor Sandeep Unnithan tracks the oxygen crisis. Executive Editor M.G. Arun and Associate Editor Anilesh S. Mahajan gauge its effect on India’s 63.4 million MSMEs. At the same time, Senior Deputy Editor Amarnath K. Menon weighs in on the challenges in our vaccination campaign. Our state bureaus trace the spread of the virus into rural India.
The virus is a force of nature, but the tragedy we are living through is a man-made one. It results from criminal ineptitude, a lack of foresight among the rulers, gross mismanagement, bureaucratic sloth, over-regulation, weak implementation and, above all, political hubris. I cannot imagine a worse sight than our fellow citizens gasping for breath. India deserves better. Much better.