Why the second coronavirus wave is devastating

Rajeshwari Devi, 58, died on Sunday at Covid-19 Hospital after waiting two days to get uninterrupted oxygen, an ambulance, and a bed.

She kept waiting and gasping, but it was too late for help to arrive. She was taken to the hospital’s emergency room on April 16 after her oxygen saturation had dropped. Her CT scan showed that she had developed chronic pneumonia.

But without her Covid’s report, the hospital refused to admit her. She spent about 36 hours in the emergency room for oxygen support in Robertsganj’s North Indian region. Staff there told her family that they had run out of oxygen and she needed to be transferred to a larger hospital, but there were no ambulances or bed appointments.

The desperate family drove her to a hospital where beds became available after politician intervention. She had no oxygen support in the car-she died a few minutes before she could be admitted to the hospital.

Her son, Ashish Agrahari, said his mother “would have had a chance to survive if the treatment was done in time.”

Such a tragic story comes from all over India, as the second Covid wave is causing havoc. Although India’s viral mortality rate is still relatively low, data suggest that the wave has proven to be more infectious and more deadly in some states.

But the county’s healthcare system is collapsing in the midst of a surge in incidents-doctors say it’s hard for them to do “Look at the light at the end of the tunnel this time.”..

Rapid increase in cases

The increase in the number of cases is exponential in the second wave.

On June 18, last year, India recorded 11,000 cases, with an average of 35,000 new cases added daily over the next 60 days.

On February 10, at the start of the second wave, India confirmed 11,000 cases, with an average daily average of about 22,000 cases over the next 50 days. However, over the next 10 days, the number of cases increased sharply, reaching an average of 89,800 per day.

Graph showing examples of the first and second waves

Graph showing examples of the first and second waves

According to experts, this rapid increase indicates that the second wave is spreading much faster across the country. Dr. A Fatahudeen, part of the Covid Task Force in Kerala, thinks India has relaxed alerts when daily infections in January dropped from a peak of over 90,000 in September to less than 20,000. Said the rise was not entirely unexpected.

Large religious rallies, reopening of most public places, crowded election rallies It is blamed for the rise. Dr. Fathahudeen said there were signs of warning in February, but “we couldn’t put together an action.”

“In February, Covid said he didn’t go anywhere and the tsunami would hit us if no urgent action was taken. Sadly, the tsunami did hit us now,” he said. Added.

“A false sense of normality creeped in and everyone, including people and officials, did not take steps to stop the second wave.”

Lack of beds

Many Indian cities report a chronic shortage of beds. It’s also evident in the desperate cry for help on social media platforms. Disturbing reports of people who died without timely treatment I’m from all over the country.

Some state governments say they are building new facilities, but experts say it will be difficult to keep up with the pace of increase in infections.

India has consistently reported more than 150,000 cases over the past few days. 273,810 cases were reported on Monday. This is the largest daily surge since the pandemic began.

In high-impact cities such as Delhi, Mumbai and Ahmedabad, most hospital beds are scarce.

Graph showing bed data

Graph showing bed data

The situation is not so different in other cities such as Lucknow, Bhopal, Kolkata, Prayagraj and Surat. Public health expert Anant Bhan said authorities did not use the lean period to reinforce the facility.

“I didn’t learn any lessons from the first wave. There were reports that some cities were short of beds in the first wave, which should have been a good reason to prepare for the second wave.” He said.

He adds that there appears to be a lack of coordination between the state and the federal government regarding the supply of oxygen and essential medicines. “We need an integrated response and resources should be shared between states.”

When it comes to ICU beds, the situation is much worse. Dozens of ICU beds remain in some cities and are now desperate to build additional capacity in hotels and stadiums.

Graph showing bed data

Graph showing bed data

However, getting the ICU bed up and running quickly is not easy. Dr. Fathahudeen says adding more beds is not enough. “We need to make sure that most of these beds have oxygen facilities. We need more doctors and nurses to manage the additional ICU beds,” he adds.

He states that it would be a “difficult task” for the government to operate such facilities and ensure quality care in a short period of time.

Unreported death

In the second wave, the daily death toll is skyrocketing. India reported 1,761 deaths on Monday, with more than 180,000 casualties since the pandemic began.

Crematoriums operate day and night in some cities, and people have to wait hours to cremate or bury the deceased.

According to experts, this indicates that the actual number of deaths can be much higher.

Graph showing mortality

Graph showing mortality

Photojournalist Sanjeev Gupta, based in the city of Bhopal in central India, arrived at one of the city’s crematoriums last week because he thought it was his usual job.

Bhopal reported only four Covid-related deaths that day. But Mr. Gupta was surprised to see dozens of funeral firewood burning. In addition, several bodies were lined up for cremation in an electric furnace.

Gupta says he was impressed when a young man asked him to take a picture of the smoke coming out of the chimney of an electric crematorium.

“He said the smoke represents his mother. That’s the most tragic thing I’ve ever heard.”

Another photojournalist in Lucknow, the capital of Uttar Pradesh, told the BBC on April 14 that he had counted nearly 100 crematoriums burning at one of the city’s crematoriums. The official state-wide mortality data for the day was 85.

“The sky turned orange near the crematorium. I still feel chills thinking about it. We definitely don’t have the correct death data from the government,” he said.

Photo showing the crematorium

This is a picture taken by Mr. Gupta after the request of a young man

Another photojournalist spoken by the BBC in Varanasi, Uttar Pradesh, also talked about a similar contradiction in how deaths were reported.

Experts say there are several reasons for this. One of them is that many people have died at home because they haven’t got a hospital bed or can’t get a Covid test. As a result, it is not possible to find a location as a Covid patient in databases maintained by various states.

“Inspections are still poor, even in small towns and some cities, and we may have missed many Covid-related deaths in these areas,” Van said.

He added that there seems to be a problem recording Covid’s death in some states. There is also a report on management supervision However, authorities have denied the claim.

“We need to increase the transparency of the numbers to help manage the situation and clearly show how serious the situation is,” Bhan adds.

Variant in play

India announced on March 25 that a new “double mutation” variant of the coronavirus was detected in samples collected from various states.

“Double mutations in important areas of the virus’s peplomer may increase the infectivity of the virus and allow it to escape the immune system,” said virologist Shahid Jamesel.

He says that viral changes are the only “logical explanation” behind the surge. UK health authorities are currently investigating Whether the double mutant spreads more easily and avoids the vaccine.

Dr. Jameel added that India began seeing mutations “quite late.” “By December, India had sequenced only 5,000 samples. It was not an intensive effort.”

In January, India put together a group of labs to speed up the sequence, and these labs went live in February. “But unfortunately, the second wave started and the vision of sequencing about 5% of all samples didn’t come true.”

Sequences are important in pandemics because they allow scientists to monitor changes in the virus. “If we can detect more infectious variants early in an area, we can immediately take public health measures to prevent it from spreading to the community,” he explains.

But “it’s never too late” to take action. “We need to strengthen our safety protocols and immunize people quickly. We also need to pay attention to mutations. Doing all this can significantly reduce numbers. . “

Read more stories by Vikas Pandy