What went wrong in India's battle against Covid-19?

A recent surge in Covid-19 cases has brought India's healthcare system to a breaking point, with countries including France, Britain, Germany, and the United States pledging to send urgent medical aid to help battle the crisis.

On Monday, the southeastern country set a new global record with 352, 991 daily coronavirus infections, while virus-related fatalities also jumped by 2,812, an all-time high, in the last 24 hours. This marked the fifth consecutive day that the country reported the highest daily data on Covid-19 since the pandemic began in December 2019.

In the country of 1.3 billion, the tally of infections has reached 17 million and overcrowded hospitals have begun to turn away patients after running out of oxygen supplies and beds nationwide.

Heart-rending images coming from the capital New Delhi showed people forming long queues outside hospitals, desperately searching for oxygen tanks. The city's crematoriums also filled up. 

Earlier this year, the South Asian country ruled by the Bharatiya Janata Party's Narendra Modi declared it had the virus under total control and normal life was just around the corner. Control measures were eased and authorities allowed religious gatherings all around the country. 

But in a two-month period, all previous efforts have gone down the drain and the country is confronting an unprecedented surge in infections.

We take a look at the possible reasons for the latest surge and what is going wrong in India's battle with the coronavirus pandemic.

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Mutated variants

All viruses mutate over time as they spread from person to person to acquire genetic changes to adapt to their hosts.

Some mutations can make viruses less infectious, some may cause them to be deadlier or spread faster and others can go discounted without causing any significant differences. 

India's high population and density created the perfect environment for viruses to mutate and experiment with new ways of infections.

The B.1.617 variant of the SARS-CoV-2 virus, which causes the Covid-19 disease, was first detected in Maharashtra state in October. The variant has quickly spread not only in India but also in at least 21 other countries so far.

While there are many other variants in circulation globally, what makes the Indian variant a matter of concern is that the B.1.617 consists of two different mutations of significance, giving it the infamous "double mutant" name. 

Another strain, the B.1.618, has been found in India, is also characterised by at least one of the mutations found in the "double mutant" strain. Some in the media have dubbed the new strain a "triple variant", but experts warn against the simplistic labels.

What makes both strains more worrisome are the L452R and E484K variants. These are known immune escape variants, they can evade immune system responses.

Experts warn that people who recovered from another Covid-19 infection or those who have been vaccinated could be at risk of re-infection with the variant because they are not resilient against this new version. 

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Premature relaxation of measures

As cases declined through mid-February 2021, the Indian government, led by Modi, placed the possibility of a second wave aside and announced reopening. 

In the middle of March, a few weeks before the skyrocketing numbers were recorded, India's largest Hindu festival, the Kumbh Mela, kicked off despite worrying reports about surging infections. 

Nearly 3.5 million Indian devotees gathered in Uttarakhand to take an annual holy dip in the Ganges to mark the colourful event, ignoring any coronavirus threat.

The festival that lasted almost a month unsurprisingly turned into a super-spreader event; the aftermath has become more visible in recent following weeks. 

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Millions of Indians also gathered to vote in the legislative assembly elections in four states West Bengal, Assam, Kerala, and Tamil Nadu. Between March and April, parties held extensive rallies and crowded political campaigns. 

Voting has started at the end of March and carried on in April.

Amid the voting, daily coronavirus numbers in West Bengal surged to over 20,000 and Modi called off the rallies, responding late to growing concern.

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Exporting oxygen

In addition to reopening, India increased its oxygen exports by over 700 percent in 2021 compared to the previous year. 

And soon, the supply shortage of vaccines and medical oxygen brought the country to a reckoning.

The surge in recent days has seen patients' families taking to social media to beg for oxygen supplies and locations of available hospital beds.

In a meeting with Prime Minister Narendra Modi on Monday, the Chief of Defence Staff General Bipin Rawat said oxygen would be released to hospitals from armed forces reserves and retired medical military personnel would join Covid-19 health facilities.

The country currently has more than 2.8 million active cases and the healthcare system has collapsed in some states. New Delhi and several other most affected parts of the country extended lockdown measures for two weeks to curb the spread which has yet to reach its peak.

A total lockdown across the country seems to be the only option to curb the immense rise in numbers, but it can also be economically disastrous. However, so is the second wave as is already being seen.

The mass vaccination campaign has now reached 10 people per 100 and 138,379,832 doses.

India needs to ramp up vaccination efforts, inoculate millions in a day and force people to adhere to strict restrictions.

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