India has recorded more than 20 million Covid infections, but the government says cases are “slowing down”.
The country added more than 355,000 cases on Tuesday, up from more than 400,000 daily cases on April 30.
But testing numbers have also dropped, raising concerns that the actual workload in India is much higher.
However, the number of cases has steadily declined in Maharashtra state, which had resulted in the second wave since early April.
Meanwhile, an oxygen shortage has shown no signs of abating and residents of several hotspot cities, including the capital Delhi, are struggling to seek treatment.
India’s second wave, fueled by lax security protocols and massive public festivals and election rallies, also overwhelmed its hospitals. Delays in testing, diagnosis and treatment, along with a shortage of intensive care beds and essential medicines, have also led to an increase in the number of deaths.
The country has so far reported more than 222,000 deaths from the virus. But experts say India’s Covid death toll is vastly underestimated, as official counts don’t seem to match what people are seeing on the ground – long queues at crematoriums, funeral pyres en masse and cities running out of space to bury or cremate the dead.
Many states have introduced restrictions, ranging from full lockdowns to nighttime curfews. The northern state of Bihar, which has added around 13,000 daily cases in recent days, is the latest to announce a full lockdown – only essential services, such as government offices, grocery stores and hospitals, will be open.
Are infections really slowing down?
Although India’s daily workload appears to have decreased, it is too early to tell if infections are slowing down.
Given the delays in testing and keeping official records, experts typically look at weekly averages rather than daily cases to get a more accurate picture. And on average, cases in India increased over the past week – but at a slower pace than the week before.
But it’s also true that daily cases have dropped, on average, in Delhi, Uttar Pradesh and Maharashtra, all of the hotspot states.
However, erratic testing makes it difficult to assess the significance of these numbers. While Maharashtra’s test numbers have been consistent, Delhi’s have fallen in recent weeks.
The other problem, experts say, is insufficient testing. While Uttar Pradesh, one of the worst-affected states, has not seen any drop in testing numbers, it tests far fewer than other states.
It is India’s most populous state, with over 220 million people, and performs around 184,000 tests per million people. Compare that to Tamil Nadu, which has around 75 million people and performs over 300,000 tests per million people.
Health officials said there was “cautious hope” of a second wave respite. But Lav Agarwal, deputy secretary of the health ministry, said the “gains” were very early and had to be backed up by “containment measures at district and state levels.”
Experts also say other hot spots are likely to emerge in the coming weeks as the pandemic spreads across the country.
A fight for oxygen
The Delhi government has said it wants the military to run Covid care facilities and intensive care units.
Delhi Chief Minister Arvind Kejriwal has repeatedly said the city is not getting enough oxygen from the federal government, which allocates oxygen quotas to states.
But federal officials deny there are any shortages, saying the challenge comes from transportation.
India produces thousands of tons of oxygen per day, but some experts say the shortage of supply stems from a lack of investment in distribution networks.
Delhi hospitals have resorted to sending SOS messages on social media to secure supplies. For residents, the hours spent waiting in line to recharge portable canisters have become a part of everyday life.
Officials have also been urged to find more sites for cremations as the city’s morgues and crematoriums are overwhelmed with masses of Covid dead.
Is India’s Vaccination Campaign Helping?
A slow vaccination campaign worsened the crisis.
Since January, India has administered more than 157 million doses of the vaccine to date – it ranks third in the world, after China and the United States. But just over 10% of India’s 1.4 billion people received one dose and only around 2% received both doses.
Despite being the world’s largest producer of vaccines, India faces a shortage of supplies. And vaccination rates are dropping from 3.7 million doses per day about a month ago to just 1.7 million per day.
The chief executive of the Indian Serum Institute, the world’s largest vaccine maker, has warned that the shortages will last for months. It is expected to deliver 220 million doses over the next few months, which would still only cover 8% of India’s population.
The Indian government is reportedly in talks with Pfizer, which is seeking a “fast-track approval path” for its Covid-19 vaccine.