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May 10, 2021

SOS calls grow as corona cases surge in India

PUNE, India: Dire SOS pleas from doctors, patients and their loved ones in need of hospital beds, oxygen and medication have flooded social media platforms, foreign media reported.

In Pune, one of the worst-hit cities in India, the wailing sirens of ambulances have become a macabre feature of the city’s soundscape. In many parts of the country, family members are shedding tears of despair outside of hospitals as they beg for medical attention for their dying kin.

“We don’t have enough ward beds, we don’t have enough ICU beds, and we’re running out of ventilators,” said Sumit Ray, a critical care specialist at Holy Family Hospital in India’s capital city of New Delhi. “People are coming into the ER requiring huge amounts of oxygen support, and we were on the edge of running out.”

COVID-19 cases and deaths have been hitting records every two or three days. Deaths rose by more than 3,748, while 366,499 new cases were reported.

Like many others in India, Ray is somewhat baffled by the seemingly sudden COVID-19 surge. In an unprecedented move, hundreds of scientists sent a plea on April 30 to Prime Minister Narendra Modi asking to ramp up data collection and allow access to already collected COVID-19 data. These scientists say more data are needed to understand how the coronavirus is spreading, manage the outbreak and predict what’s to come.

During the first wave of the pandemic in 2020, India reported over 90,000 daily new COVID-19 cases at its peak, with the highest single-day record at 97,894 on September 16. Daily case numbers then gradually declined to nearly 10,000 in early February.

In December, India recorded its first six cases of the highly infectious B.1.1.7 variant, which was first identified in the United Kingdom. Between February and March, genetic testing showed that the variant became dominant in India’s northern state of Punjab, appearing in 326 of 401 sequenced viral samples. In New Delhi, B.1.1.7 was present in half the samples sequenced toward the end of March compared with 28 percent two weeks earlier.

India’s own B.1.617 variant first identified in October in Maharashtra is now present in up to 60 percent of samples from some parts of this hard-hit state, according to Shahid Jameel, a virologist at Ashoka University in Sonipat, India. This variant is also spreading in Delhi, he said, in addition to other parts of India and the world.

While B.1.1.7 is thought to be highly transmissible and potentially more lethal than other known variants, it’s still unclear how contagious B.1.617 is and if it induces severe disease. This makes it challenging to assess its role in India’s increasingly grim situation. One glimmer of hope is that Covaxin, a COVID-19 vaccine administered in India, appears to be effective against the variant, according to a recent paper posted online April 23 at the preprint server bioRxiv.org.

An array of mathematical models predict that India’s surge will peak sometime between early and mid-May. Daily case numbers could rise to anywhere between 800,000 and 1 million, and single-day deaths may hit around 5,500 toward the end of the month, said Bhramar Mukherjee, a biostatistician at the University of Michigan in Ann Arbor who has been modeling India’s COVID-19 outbreak since March 2020. “That’s really troubling,” she said.

But these may be overestimates; Mukerjee’s model doesn’t account for the current lockdowns and restrictions that are in place in some states, cities and villages.

To quell case numbers, some public health experts in India say it’s time for a nationwide lockdown, but one that’s more coordinated and humane than the last lockdown. But the unfolding COVID-19 crisis is not just India’s problem; it’s the world’s problem. Rising numbers of infections can provide the virus with greater opportunities to mutate and evolve and thus form new variants. In a globally connected world, short of draconian lockdowns, it’s hard to contain the spread of infections and new strains. India’s outbreak has already spilled over into neighboring Nepal; other countries, including the United States, are now limiting travelers from India, but it may be too late. B.1.617 has already shown up in and at least 20 other countries.

Meanwhile, The Indian defense ministry said on Sunday that the country will recruit hundreds of former army medics to support its overwhelmed healthcare system.

Some 400 medical officers are expected to serve on contract for a maximum of 11 months, the ministry said in a press release, adding that other defense doctors had also been contacted for online consultations.

Many Indian states have imposed strict lockdowns over the past month while others have announced restrictions on public movement and shut down cinemas, restaurants, pubs and shopping malls.

But pressure is mounting on Prime Minister Narendra Modi to announce a nationwide lockdown as it did during the first wave last year.

The Indian Medical Association (IMA) called for a "complete, well-planned, pre-announced" lockdown instead of sporadic night curfews and restrictions imposed by states for a few days at a time.

"IMA is astonished to see the extreme lethargy and inappropriate actions from the ministry of health in combating the agonizing crisis born out of the devastating second wave of the COVID-19 pandemic," it said in a statement on Saturday.

Dr. Anthony Fauci, a top White House coronavirus adviser, said on Sunday he has advised Indian authorities they need to shut down.

"You’ve got to shut down. I believe several of the Indian states have already done that, but you need to break the chain of transmission. And one of the ways to do that is to shut down," Fauci said on ABC's "This Week" television program.

India on Saturday reported its highest ever single-day COVID-19 death toll of 4,187. The Institute for Health Metrics and Evaluation estimates that India will see 1 million COVID-19 deaths by August.

With an acute shortage of oxygen and beds in many hospitals and with morgues and crematoriums overflowing, experts have said the actual numbers for COVID-19 cases and fatalities could be far higher than reported.

The world's largest vaccine-producing nation has fully vaccinated just over 34.3 million, or only 2.5 per cent, of its 1.35 billion population as of Sunday, according to data from the government's Co-WIN portal.

The pace of administering the shots has dropped with states saying they only have limited stock to give out.