“I have never seen such a terrifying situation. I can’t believe we are in the capital of India,” Jayant Malhotra told the BBC.
“People do not receive oxygen and die like animals,” he adds.
Malhotra is helping out at a crematorium in New Delhi, the city where hospitals are collapsing in the face of an unprecedented surge in coronavirus infections.
The country reported a world record of new cases diaries confirmed for the fifth day in a row on Monday.
As India suffers from this latest wave, China, the US, much of Western Europe, and parts of Africa and Southeast Asia saw deaths decline during the two weeks leading up to April 25.
In fact, some countries are lifting restrictions and even the European Union has even hinted at a reopening for American travelers who have already been vaccinated.
So the question arises, can the dire situation in India become a major problem for the rest of the world?
How big is the crisis in India?
In February, when daily COVID-19 deaths were in the hundreds and new cases per day hovered around 12,000, many in India had reason to believe that the country had managed to escape the worst of the pandemic.
But little by little they began to see how the reported infections increased, exceeding those of the highest point of the first wave (93,000 per day).
This is how the current crisis was reached, so sudden that it went from 200,000 confirmed infections in mid-April to more than 350,000 this week.
The deaths also multiplied. An average of 2,336 people died daily in the week ending April 25, the double of deaths in the worst part of the first wave.
“India is clearly struggling,” notes BBC Health and Science correspondent James Gallagher. “The palpable fear reminds me of the beginning of the pandemic, when the coronavirus was still an unknown disease.”
“Covid-19 can be deadly even with perfect medical care, but when hospitals are overwhelmed, lives are lost that could have been saved,” he adds.
- The funeral pyres that had to improvise in India due to the devastating coronavirus crisis that the country is going through
The situation is particularly dire in New Delhi, where there are no intensive care unit (ICU) beds left.
Many hospitals are turning away new patients, and at least two of them have died after oxygen supplies ran out.
Relatives of people who contracted the virus ask on social networks for help to get space in hospitals, oxygen supplies and ventilators.
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The picture is further complicated as labs are also crowded and test results take up to three days to deliver.
Meanwhile, crematoria have to run the 24 hours of the day.
Similar scenes occur in other major cities. In total, India confirmed nearly 17 million infections and 192,000 deaths since the pandemic began.
But it is very likely that these figures are below reality.
- India surpasses 300,000 daily cases of covid-19 while oxygen is scarce
The country’s huge population and logistical problems make it really difficult to conduct massive covid-19 tests or accurately record deaths, making it much more difficult to know the exact magnitude of the crisis in India compared to those that Europe or Europe went through. The United States, for example.
How difficult can the situation get?
For Gallagher, “unfortunately in the coming weeks the situation will get significantly worse.”
“One lesson, learned over and over again, is that an increase in cases leads to an increase in deaths a few weeks later,” he says.
“Even if India could stop the spread of the virus overnight, deaths would continue to increase exponentially, since many people have already been infected. And there are no signs that the infections are going to stabilize, “says the journalist.
Gallagher points out that the increase or not of cases will depend on the success of the closures and the rate of immunization.
India does not have the highest number of cases or deaths on record. The United States reported as of April 26 about 32 million infections and 572,000 deaths, according to data compiled by Johns Hopkins University.
Nor does it top the list of infections or deaths per million inhabitants. Much of Europe and Latin America reported higher margins.
But it is the size of the population in India and the dramatic increase in cases and deaths that is causing so much concern.
“We have never seen a situation like this, in which the health system is unable to cope with the magnitude of the figures in the context of a strong and continuous increase in new infections,” Gautam Menon, professor of Physics and Biology and expert in infectious disease measurement models.
When health services collapse, people die of all causes in far greater numbers. They are deaths that are not reflected in the coronavirus statistics.
Furthermore, healthcare providers in India are very challenged to reach their vast population and therefore many in that country have no access to healthcare at all.
What does it mean for the rest of the world?
The pandemic is a global threat, that is known.
Since the earliest days, scientists and health experts have tracked how the infection moves from country to country, driven primarily by air travel and a highly globalized world economy.
Until now, national borders have represented a very limited barrier to spread and it has been found almost impossible to impose travel bans and close accesses indefinitely.
So what happens in India will most likely spread all over the world, especially since the country has the largest diaspora in the planet.
James Gallagher believes that “the pandemic taught us that the problem of one country is the problem of all.”
“The coronavirus was first detected in a city in China and is now everywhere. The record number of cases in India could spread to other countries, so many have already introduced travel restrictions. And these high levels of infection are a breeding ground for new variants, “he says.
Was a new threat born in India?
Conditions in India can be very bad news for the global fight against covid-19.
“The large population and its density is a perfect incubator for this virus to undergo mutations,” says Ravi Gupta, professor of clinical microbiology at the University of Cambridge.
If time is allowed for the virus to mutate under such conditions “ideals“could significantly lengthen and increase the severity of the pandemic worldwide.
“The more opportunities the virus has to mutate, the more likely it is that it will find a way to infect even people who have been vaccinated,” adds James Gallagher.
The new variants of the United Kingdom, Brazil and South Africa already caused problems during this pandemic, spreading throughout the world.
Professor Menon believes that this danger is latent with India and notes that “it is really impossible to put a limit on the spread of variants.”
“Variant B.1.617 (which was first identified in India) was already found in several countries and most likely arrived as an imported virus,” he explains.
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The expert warns that mutations and evolutions will continue and will be an obstacle to immunity that could lead to a previous infection or vaccination.
The question now is how quickly that could happen.
“We know that covid-19 can mutate to achieve a higher transmissibility from our observation of the multiple variants around the world. So far we believe that vaccines should remain effective against these new variants, but this may change in the future, “says Menon.
How cann India (and the rest of the world) stop the spread?
International efforts are already underway to help India manage its critical oxygen shortage and combat the devastating increase in cases.
The UK began shipping ventilators and oxygen concentrating devices, while the US lifted the ban on shipping certain raw materials overseas, allowing India to produce more AstraZeneca vaccines.
Several countries also offer to send medical personnel and equipment to help.
The government of India approved plans to install more than 500 oxygen generation plants across the country and have more supplies.
But these are measures to try to prevent deaths, not infections.
Experts say the world needs a dramatic increase in lndia’s ability to vaccinate its population and prevent the spread of the virus.
In its favor, the country has that it is a power when it comes to the manufacture of vaccines.
It runs a mass immunization program, produces 60% of the world’s vaccines, and is home to half a dozen major manufacturers.
“A large-scale adult vaccination program against a virulent pathogen such as SARS-Cov2, the virus that causes covid-19, poses unprecedented challenges,” according to BBC India correspondent Soutik Biswas.
India’s vaccination campaign, the largest in the world, began on January 16 and aims to reach 250 million people by July.
It is estimated that around 118 million people received a first dose until April and this represents less than 9% of the population.
Initially limited to health workers and front-line personnel, the massive plan was expanded in stages to reach those over 45 years of age.
But the magnitude of the task of immunizing such a large population and the logistical and infrastructure problems posed by the country continue to complicate deployment.
Therefore, it is pointed out that the vaccination campaign must be accelerated much more to achieve its objectives.
“It is not clear if the country has enough vaccines and state capacity to accelerate and expand coverage to include young people,” Biswas says.
Until such a large population is successfully vaccinated, India poses a risk to everyone.
“The problem of infectious diseases like COVID-19 is not a matter for a single nation or even a small group of nations. It is truly global in its implications,” says Professor Menon.
“We need more international cooperation in tests, vaccines and research for the good of the world“, he concludes.
As public health officials and politicians have said since the early days of the pandemic: “No one is safe until everyone is safe.”
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