The snaking queue outside Maasaheb Meenatai Thackeray Hospital terrified Mariselvan Thevar. More than 200 people were in line, sagging in the heat as they coughed and wheezed. Some had come hoping to find a dose of coronavirus vaccine, which remains a scarce commodity in India. Others were trying to get their hands on medication, a bed, oxygen—anything.
A 21-year-old engineering student with a tall, lean frame and a patchy beard, Thevar thought he had little choice but to join the growing crowd outside the hospital, a small public facility in suburban Mumbai. His father, Kannan, had been ill for days. At 49, Kannan was far younger than the people who, for most of the pandemic, have experienced the worst outcomes from Covid-19. Yet Thevar grew increasingly anxious as they waited to be seen; his father was running a high fever, and even slight exertions left him breathless.
With just two overwhelmed doctors working, the hospital was allowing only a trickle of patients to enter its doors. After 10 hours in the baking sun, Thevar and his father were turned away. “The doctors were insisting patients go home, citing a shortage of beds, on the assurance that they will call them,” Thevar said. “They never call back.”
As the virus burns through India, this sense of futility and fear has become commonplace. The country is reporting nearly 400,000 confirmed infections and 4,000 deaths every day, tallies that are certain to be drastic undercounts. In Delhi, public parks have been requisitioned as makeshift crematoriums, with rows of funeral pyres burning where kids once played cricket. Hospital beds and oxygen cylinders are in short supply, as are doctors and nurses. Some researchers predict that the total number of fatalities—currently at 250,000—could top 400,000 by mid-June and then keep climbing.
The crisis in India is horrific on its own terms, generating misery and loss at an enormous scale. It also has worrisome implications for the rest of the globe. Home to the world’s largest vaccine industry and, until remarkably recently, recording only a modest number of coronavirus cases, India was central to international plans to inoculate developing countries by churning out low-cost doses. Instead its exports have largely ceased, with available vials prioritized for domestic use, and there’s no timeline for when they might resume. Meanwhile, an unchecked outbreak in a nation of over a billion citizens creates ideal conditions for new variants to take hold. It’s hard to imagine a more effective way to come up with mutations that might resist current vaccines.
But for Indians, huge numbers of whom are now sick or caring for ailing loved ones, those concerns are secondary to the immediate catastrophe. After being sent away from the hospital, Thevar’s father deteriorated further, struggling through the night to breathe. The student made frantic calls to friends and relatives, trying to find anyone who could help get Kannan a hospital bed. None could. He called about 20 clinics, all of which gave him a version of the same answer: They had no space to spare. Next, Thevar raided his family’s savings, spending 8,000 rupees ($109) to have a private ambulance shuttle his dad around Mumbai, searching fruitlessly for oxygen.
Eventually, Thevar’s luck turned. He managed to get a local politician on the phone, and persuaded him to pull some strings and have his father admitted to a hospital run by a charity. The staff there took Thevar’s number, promising to update him twice a day. Exhausted, he returned home, finally able to rest. Two days after Kannan was admitted, his doctors contacted Thevar with some bad news. The older man had stopped responding to remdesivir injections and had to be put onto a ventilator. A few days later, early in the morning, they called Thevar again. His father was dead.
A few weeks into 2021, the Reserve Bank of India issued a curiously optimistic press release. Straying from monetary policy into epidemiology, the central bank declared that India had beaten Covid, and that, better yet, “soon the winter of our discontent will be a glorious summer.” Of the virus’s curve, the RBI said, India had managed to “bend it like Beckham.” Although he used less florid language, Prime Minister Narendra Modi was similarly bullish. At a digital-only meeting of the World Economic Forum in January, he boasted that he and his compatriots had “saved humanity from a big disaster by containing corona effectively.”
Such statements may seem delusional in retrospect, but the viral numbers did look good at the time. After a surge last September that pushed daily case numbers to almost 100,000, by January new infections had slumped to less than a tenth of that level—a per-capita rate comparable to South Korea’s, which is among the lowest in the industrialized world. Even in Dharavi, a Mumbai slum home to perhaps a million people, an aggressive public-health campaign had kept the virus largely under control. With social distancing restrictions mostly lifted, crowds returned to markets and restaurants, and well-heeled families booked holidays at beach resorts.
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