India Needs Help. Now

India Needs Help. Now

Last month, BofA’s closely-watched Global Fund Manager survey revealed that for the first time since the onset of the crisis, COVID-19 (or something related to it) was no longer seen as the top tail risk.

It was an anecdotal assessment, but it nevertheless spoke to waning anxiety. The vaccine push in the US was accelerating and the stimulus writing was on the wall in big letters. The world’s largest economy was poised to boom, and the Fed was unequivocal in its commitment not just to countenancing an overheat, but to playing an active role in engineering one.

Sure, Europe was struggling to coordinate inoculations. And, yes, everyone realized flare-ups were inevitable. Finally, no, Brazil wasn’t fixed. But generally speaking, the assumption was that science had triumphed and the virus was on the back foot, even if it was likely to keep exacting a tragic toll on humanity for several months longer.

The April vintage of the same BofA survey showed fund managers were still relatively sanguine (figure below).

It made more sense, investors reckoned, to worry about inflation or, relatedly, a bond market tantrum in the developed world, than to fret over vaccine rollout, or anything else to do with the virus, for that matter.

This week, the world was reminded that, in fact, COVID is still the top risk.

Five days ago, I called the rapidly worsening situation in India “a nightmare.” By Thursday, I called it a humanitarian crisis. By Friday, I suggested the US might need to intervene.

Read more: ‘To Go Out Is To Get Infected’: In India, A Nightmare

On Saturday, The New York Times ran a feature story called “As COVID-19 Devastates India, Deaths Go Undercounted.” The images (many depicting the mass burning of bodies) are nothing short of horrific.

In the simplest possible terms, the country has lost control. India is reporting in excess of 300,000 new cases per day, but as the Times wrote, experts now believe the figures (which are records for any country during the pandemic) likely represent “just a fraction of the real reach of the virus’s spread.”

The seven-day moving average for new daily cases was around 60,000 at the end of last month. It was near 294,000 on Saturday, according to WHO (figure below). If these figures do, in fact, represent “just a fraction” (as the Times put it) of the virus’s reach in India, that would appear to suggest that at least some observers believe a million people or more may be contracting COVID each day in the country.

I quoted a friend from Delhi on Monday in the linked article (above). She told me that the general sense among the populace is that venturing outdoors (let alone going to a vaccination site) is seen as a risk too big to take. The Times echoed the sentiment, noting that “millions of people refuse to even step outside.”

The official numbers show more than 2,000 people dying from COVID every 24 hours (figure below). But, as documented here earlier this week, those figures are likely nowhere near accurate.

Crucially, one gets the distinct impression that this situation is orders of magnitude more acute than other instances of countries undercounting COVID deaths, either deliberately or simply because they didn’t have the resources. In India, it sounds as though the real daily death toll could be exponentially higher.

One epidemiologist at the University of Michigan called the official numbers “a complete massacre of data.” In remarks to the Times, he suggested the death toll could be as much as five times higher than officially reported. In other words, it’s conceivable that as many as 10,000 people are dying every 24 hours in India from COVID.

At cremation sites, workers simply ascribe deaths to “sickness,” sometimes on orders from superiors. Political pressure is surely a factor.

Over a period of a dozen days this month, one site in Bhopal reported just 41 COVID-related deaths, even as a survey conducted by the Times showed more than 1,000 fatalities.

During the same timeframe, official tallies for daily deaths In Gujarat were as low as 73, but local reporters who visited cremation and burial grounds said the real numbers may have exceeded 600.

“On April 16, as per the State health bulletin, total deaths were 78, but from seven cities 689 bodies were either cremated or buried following COVID-19 protocols on disposal,” The Hindu reported, adding that “the State, overwhelmed by the second wave of the pandemic, is witnessing a tale of two sets of data: One from the Health Department and the other emerging from hospitals and crematoria/burial grounds, and there is a massive mismatch between the numbers.”

The video (below) was sent to me this weekend by my friend in Delhi. I can’t verify its authenticity, but I have no reason to doubt it. It’s entirely possible it came from social media and it mirrors the visuals now being broadcast to the world by every major media outlet, including the Times.

 

The surge in India is being blamed, in part, on a so-called “double mutant” variant, B.1.617. A quick check of outbreak.info, a site that utilizes data from GISAID, shows the cumulative prevalence of the lineage in India is up to 14% from 11% just days ago. For the rest of the world, that figure is listed as <0.5%.

The Times went on to lament that “less than 10% of Indians have gotten even one [vaccine] dose, despite India being the world’s leading vaccine manufacturer.”

This situation isn’t tenable. It likely requires an international response. At this juncture, I’d have to agree with former Lehman trader Mark Cudmore who, last week, warned that this presents a serious risk to global markets.

Travel bans, flight restrictions and other protocols taken as precautions will prove woefully inadequate to contain an epidemic spreading unchecked in a nation of 1.4 billion people. The variant, to the extent it’s something the world needs to be concerned about, will almost surely become more prevalent globally if something isn’t done to bring things under control in India.

“Scientists caution it is too early to know for sure how pernicious the new variant emerging in India really is,” the Times went on to say Saturday, noting that scientists are concerned that “huge setbacks in India, Brazil and other places raise the likelihood that the virus will mutate in ways that could outflank the current vaccines.”


8 thoughts on “India Needs Help. Now

  1. It’s a reminder that there was a calculus to the lock downs in Western, developed nations.

    The human suffering. It’s hard to read about. But, quite honestly, I made decisions decades ago that I just can’t live cheap in a suburban tract home in the Sun Belt, sufficing on losing sports teams, Doritos, and flat beer.

    All the while, there are “love them from afar” family members on both sides of the family in my household who refuse to get vaccinated, citing distrust in the government. I’m still not sure which government they are referring to. So far, they haven’t been able to articulate who, or what, they mean exactly. I thought for a while they were motioning with their lips that they were fearful of getting injected with a tracking chip.

    My “love the from afar” family members don’t care what happens in India…they are privileged…and lucky, and don’t think so. Preferring instead to believe that they deserve what they have, that no one can take it away from them. I can’t make them watch India. But, I do wish they had enough awareness to make the connection from the polio and smallpox vaccines, to burning bodies in public and the COVID vaccine.

    When I think I have it bad, I remind myself that there are maybe seven billion people who would love to exchange positions and balance sheets with me. My vacant family members, of course, would discount such footage of burning the dead in public as some kind of Hollywood propaganda funded by a Hungarian-born billionaire. They can still plan trips to Walmart….so, I know they do still have a functioning, frontal cortex.

    We think we are special. We are lucky.

    1. Manaus, Brazil, was thought to have reached herd immunity in the spring of 2020 through widespread natural infection. Roughly six months later, Manaus was hit again by a significant outbreak, with apparent widespread reinfection of previously-infected people–this was the source of the P1 variant which has subsequently spread throughout Brazil and South America (and now Vancouver, BC, etc). The concept of “herd immunity” doesn’t apply when your previous infection does not actually give you immunity to reinfection.

  2. And then there’s the oxygen shortages. Hospitals are running out of oxygen. People who are A) lucky enough to get a bed in a hospital, and B) would live if they just get some ordinary O2, are dying.

    [You may have mentioned Oxygen shortages in a previous post]

  3. The US needs to permit export of the raw materials and supplies that Serum India is near to running out of. We should also send some of our unused AZN doses.

    Other than that, I am at a loss to think what other countries can do for India fast enough to really help. India is the world’s largest producer of vaccines, and surely has enough medics and nurses capable of giving an injection. Foreign medical teams will be like a drop in a bucket. PPE and oxygen might be something we can help their medical system with. We should do everything we can, but how do you quickly help 1.3 billion people?

    The fundamental problem is the Indian government’s shambolic response. A rich country like the US can screw up bigly – as we did – and get bailed out by its resources. A super-organized country like China can screw up bigly – as it did in Wuhan – and get bailed out by its ability to clamp down on people and movement. India doesn’t have either luxury.

    1. In a rational world, this would spell the end for both Modi and Bolsinaro. (Not to mention countless Republican officials and talking heads in this country.)

    2. Points on US and China responses very well taken. To defeat a pandemic takes a global effort which takes global leadership, something we abdicated with 45. Might the covid pandemic be a drop in the bucket compared to what climate change will do to our rocky little spaceship.

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