Front Burner - ‘Absolutely harrowing’: India’s calamitous second wave

Episode Date: April 26, 2021

In India, COVID-19 has reached catastrophic levels. The health-care system is so overwhelmed that the sick are lying on the ground outside hospitals, and doctors are begging online for oxygen. Amy Kazmin, the New Delhi-based South Asia bureau chief for the Financial Times, joins us for a view from the ground, and explains how things got this bad.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. In India, one of the world's most populous countries, COVID-19 has reached catastrophic levels. The scenes and stories at hospitals where there is a desperate shortage of oxygen are simply devastating. Crematoriums are burning the dead 24 hours a day.

Amy Kasman is the Financial Times New Delhi-based South Asia Bureau Chief. And she's here with me now to explain what is happening on the ground and how things got this bad. Hi, Amy, thank you so much for making the time to speak with me. Thank you very much for having me. So I know you and I are talking late Sunday evening in Delhi, and we're seeing really distressing videos of chaos outside hospitals where crowds of people are begging for care, of people being brought to the hospital on the brink of death and dying before they actually get help. And can you take me through what is happening on the ground right now there? Yes, I can. The situation is absolutely harrowing for, I think, everybody who lives in this country right now. India thought that it had conquered COVID after a steady fall in cases from September to February.

But then, starting from late February, cases began to tick up. And then they began to tick up with increasing momentum, getting faster and faster. In the last four days, there have been more than 300,000 confirmed new infections a day. I think today it was nearly 350,000 confirmed new infections. But the confirmed new infections are also just a fragment of the actual new infections because the testing infrastructure is so incredibly overstretched that many people who have symptoms and want to be tested can actually not be tested. So the numbers are absolutely overwhelming and it has completely overwhelmed the healthcare system, which is

frankly now on the verge of collapse. Can you tell me more about what these infection rates mean for the healthcare system? What's happening at the hospitals? The situation at the hospitals is absolutely dire. Hospitals are completely packed with very, very ailing patients. The hospitals are just completely unprepared for the magnitude of people desperately seeking help. You have situations where people are basically lying in front of the hospitals with multiple people hooked up to a single oxygen cylinder. They don't even have room for them inside. There's

no beds. The doctors are being pushed to the limits. Many people are running around from hospital to hospital. My husband's in a very bad state. Let me get through. This woman says she's been carrying him around for 10 hours. And for the next few days, he drives from hospital to hospital with his mother in the back seat, breathing through an oxygen mask. Finally, he finds an available bed at a hospital 100 kilometres away. I have a friend that tested positive and needed to get to the hospital

and his wife and family and friends spent nearly a whole day trying to secure a hospital bed for him. He was in respiratory distress. An elderly family that I know spent like six hours trying to get an ailing patient into a hospital. And we've seen the completely distressing sight of leading hospitals in the capital city taking to Twitter to say that they have only one hour of oxygen left and begging somebody to help them and to supply, you know,

to get an oxygen tanker through to refill their oxygen stocks. We don't have enough oxygen to sustain our patients for the next two hours. We are trying since 4.30 in the morning, 4.30 AM. Our vehicles have gone to Bhavana, they have gone to Faridabad, they have gone to Noida, they have gone to greater Noida. We are not getting oxygen anywhere. We have young patients who will die in a matter of two hours. I request you, please send oxygen to us.

We need oxygen for our patients. Please send oxygen to us. Delhi is a big and crowded city, and many of the oxygen plants where the oxygen, you know, the medical oxygen is produced, are in adjacent and neighboring states. And in some cases, we've basically seen the officials of those neighboring states stopping the tankers and not letting them leave the states to come to the capital city

where there's no, you know, industrial scale oxygen plants. Why are they not letting them leave the states? Because they need it in their own state? Yeah, I mean, they're not letting them leave them because they're concerned that they might need the oxygen in their own state. They're such a... Wow. Everything is in short supply right now. And it is absolutely distressing,

the amount of suffering and kind of tension and desperation that is just, you know, affecting so many people and so many families right now. Wow, this sounds truly apocalyptic. The front page of the New York Times on Sunday has this incredibly haunting photograph of a crematorium in East Delhi. It's just like rows and rows of bodies being cremated. And can you tell me more about that? What is being done with the growing number of dead? I mean, it is true that the number of dead is overwhelming the crematoriums because the daily number of dead is so much above the norm and we've heard stories of like wood shortages where people can't actually find the wood to create the funeral pyre there are so many bodies coming we are running out of food

if it continues like this then in four to five days, we will have to cremate bodies on the road. We've heard stories of some of the crematoriums that may be electro crematoriums melting because of like such nonstop usage, which is so much above the norm. So there are a huge number of deaths taking place in this country as a result of COVID. Unfortunately, many of these deaths are not going to be counted as COVID deaths. So the real true total is unlikely to ever be known. Right. Right now, the government is reporting a death toll around 200,000 people. So what you're saying is that it's likely far greater than that, right? Yeah, at this point in time,

it is likely that the daily death toll is far greater than the official numbers. And there's many reasons for that. Part of that is because the testing infrastructure can't keep up with the pace of the actual cases. And so in many cases, you're having ailing people dying without actually ever getting a COVID test. And in those cases, those people, though a doctor or medically they have died of COVID,

officially they will not be recorded as a COVID death. In many cases, people who test positive from COVID and then die may also not be counted as a COVID death. In many cases, people who test positive from COVID and then die may also not be counted as COVID death. They might be, I think there is suggestions that in some states the medical doctors are under a lot of pressure to downplay the extent of the COVID deaths and to kind of attribute the death to something else. So if you're a COVID-positive person in intensive care and you die of a heart attack, will you be recorded as a COVID death or will you be recorded as a heart attack death? And I think that in different states, the medical establishment is under different kinds of pressures to account for those deaths differently, even though there are national guidelines.

Amy, you touched on this very briefly at the beginning of our conversation, but can you tell me a little bit more about how exactly it got this bad? Yeah. So look, just two months ago in February and late January, I think many Indians thought that the pandemic was over and the Indian government definitely thought the pandemic was over. Delhi was having like 150 new cases a day and that's, you know, that's like 15 million people. and 50 new cases a day. And that's, you know, that's like 15 million people. So a lot of people thought this is over. The prime minister made big speeches about how India had conquered the pandemic. He and, you know, proven itself in the eyes of the world as, you know, a country that was able to conquer the virus. There was a lot of people that had been locked up inside their homes for nearly a year, began venturing out for the first time.

There was a huge backlog of weddings. Many, many weddings had been postponed over the course of the pandemic year. And with the drop in cases, many people thought, right, like we can have our wedding now. And there was a huge number of weddings. Some of them followed the kind of government limitations of being just 200 people, which is quite small from an Indian wedding perspective. But others were massive. I heard from a doctor in Mumbai about a 1,000 person wedding in a suburb of Mumbai where hundreds of people subsequently got COVID and the father of either the groom or the bride passed away from COVID after the wedding. So there was a huge number of backlogged weddings that took place.

long weddings that took place. Many people began socializing. It was like, pandemic? What pandemic? And India is having a number of state elections. And the ruling party, the BJP, Modi and his top lieutenant, Amit Shah, began campaigning super aggressively in these state elections. So there were these huge, massive political rallies with tens and thousands, if not hundreds of thousands of people. Prime Minister Modi this week called the viral onslaught a COVID storm, but has allowed mass political rallies and elections to continue. The government needs to be sensitive at this time. The prime minister needs to show up.

He needs to get off the stage of the rally where he's laughing and cracking jokes. I mean, people just threw caution to the wind, including the government, because of the messages. You know, Modi was out there urging people, you know, kind of basking in the adulation of these massive crowds, talking about how he'd never seen such crowds in his life. So it kind of made the occasional chiding of the

health minister saying, oh, don't forget COVID appropriate behavior. I mean, people just didn't really know what was going on. And then it just laid the conditions for this massive tsunami of cases to just hit. And then on top of all of this, there is this new variant, right, that was originally discovered in India, I believe sometime around October, it's the B.1.617. And what do we know about what role this variant may also have had in precipitating this tsunami? So look, India actually does very little genomic sequencing. sequencing. So there is not so much data of the variants that are circulating and what percentage of cases they account for. But there are multiple variants circulating in India. And the state of Punjab, which has strong links to the UK also, has seen huge numbers of the UK variant. So the UK variant definitely made its way into India.

And if you'll recall, that variant is said to be more infectious than the original strain. And then there are Indian variants that are also seen as being more infectious. Indeed, B.1.617 is a kind of Frankenstein made of mutations to the spike protein found in other variants of concern. The key thing is that these are two mutations usually seen in different viruses that have somehow come together.

And what we don't understand quite yet is what the impact of that is. So really still very little is known about these variants and their precise nature and character and the impact that they have, but it does seem that these variants and the precise nature and character and the impact that they have. But it does seem that these variants do spread more easily. Right, right. And I know, you know, there's so much that we don't know about the variant so far. I know there are also concerns that it could be resistant to vaccines, which I think brings me to my next question about India's own vaccine campaign.

And we know that India is a huge manufacturer of vaccines. Canada is actually one of several countries that's been receiving them, though I know in March, India halted large exports to concentrate on vaccinating at home. And for Canadians, more recently, it was announced large exports to concentrate on vaccinating at home. And for Canadians, more recently, it was announced that they would delay 1.5 million doses of AstraZeneca. But how successful has India's own vaccine campaign been today? So I think India's vaccine campaign is an important part of the big tragedy that's playing out here in India now, which is that because the government thought that they'd conquered the virus, the pace of the domestic vaccination campaign was very lackadaisical, like a Sunday stroll in the

park. There was no sense of urgency. So the vaccine campaign and India never really set out a strategy of deciding that, like, they had to vaccinate a huge percentage of the population as fast as possible. The original target announced by the government was to vaccinate the 300 million most high-risk people by July, which suggests that they, you know, which clearly tells you that they did not think there was any need for speed. They were not in a hurry. In fact, India was incredibly late to place any orders. The first order they actually placed for any vaccine was in January 2021, by which time they were sitting there thinking, pandemic, what pandemic? Why do we really need to vaccinate that many people?

So the vaccination campaign began on January 16th, and they spent six weeks trying to vaccinate the 10 million designated healthcare workers and frontline workers, which included people like the army and stuff like that. And it wasn't until early March, when the case numbers were already starting to climb, that they opened it up to seniors from the general population over the age of 60. In the meanwhile, in February and March, India exported more than 60 million doses of vaccines around the world to various countries that needed them. But the problem is this. India's domestic manufacturing capacity for COVID vaccines at this particular point in time is actually not that high. They can only do around 2.5 million vaccinations a day. Right.

So they were merely exporting these vaccines to the rest of the world and having a very leisurely pace of the domestic vaccination campaign. At this point, around nine out of every hundred people has received a vaccine dose. So far away from the number needed to kind of slow the pace down. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections.

Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo, 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this control this within their own borders is wrongheaded. First, these variants are coming out of places where the virus is so widespread.

these variants are coming out of places where the virus is so widespread. And in India's case, in particular, the country has been producing vaccines for the rest of the world, Canada, as we mentioned, but also many poorer countries around the world. And, of course, what is happening right now in India is a humanitarian crisis in its own right, as you have made so abundantly clear today. So what kind of calls are there right now for what could be done to help India? So anything that, you know, that countries can do to kind of facilitate a rapid scale up of vaccine access in India, I think would be helpful. But I mean, vaccination is about kind of trying to stop the spread of the disease in the long term, but there is truly a humanitarian crisis unfolding. And in fact, as someone who's covered major natural disasters, this now has the feeling of that kind of calamity on a par with,

like, say, the tsunami in Southeast Asia in 2004. And I mean, on a humanitarian level, I think India urgently needs certain kinds of medical equipment. Certainly they need more infrastructure that would allow them to more rapidly distribute oxygen. What we hear is that oxygen itself is in ample supply. There's a lot of heavy industries that have the capacity to make the oxygen. What's missing is the logistics and distribution infrastructure. And in fact, I believe Singapore, for example, has airlifted or provided oxygen tankers that are being airlifted to India. So that is really the need of the hour,

because in the coming weeks, I mean, this tide of gasping patients, you know, and this brings us back to the kind of tragedies unfolding in front of hospitals and in fact in hospitals of patients desperately needing oxygen and, you know, gasping for breath. You know, I think that's really the real need of the hour. You know, every extra cylinder and every extra kind of piece of oxygen distribution infrastructure may be a few families that you know get help instead of getting no help so it's going to be a very brutal time here in the next few weeks and very heartbreaking and there's a lot of trauma and devastation taking place frankly and I do hope that the world will pay attention to what's happening here and pitch in what help they can because people are absolutely desperate and beside themselves with grief and panic and struggling and really everything that anybody can do to help. Okay, Amy Kazman thank you so much for

this. Thank you. Okay, so before we go today, Procurement Minister Anita Anand said on Friday that Canada was ready to supply India with medical supplies and equipment. On Sunday, there was no specific update, but a government spokesperson said that officials were engaged on the issue. We'll keep you posted on this front. And later on Sunday, after Amy and I talked, the White House also announced that the U.S. will be sending supplies and support. According to a release, this apparently will include things like therapeutics, rapid tests, ventilators, also money and raw materials to make more vaccines. All right, that's all for today. I'm Jamie Poisson. Thanks so much for listening to Front Burner. We'll talk to you tomorrow. For more CBC Podcasts, go to cbc.ca slash podcasts.