The Daily - Fear and Loss: Inside India’s Coronavirus Crisis

Episode Date: April 28, 2021

At the beginning of this year, many people in India thought the worst of the pandemic was finished there. But in the last few weeks, any sense of ease has given way to widespread fear. The country is suffering from the worst coronavirus outbreak in the world, with people being turned away from full hospitals and a scarcity of medical oxygen.  How did India, after successfully containing the virus last year, get to this point?Guest: Jeffrey Gettleman, the South Asia bureau chief for The New York Times, based in New Delhi. Sign up here to get The Daily in your inbox each morning. And for an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. Background reading: In a dispatch from New Delhi, Jeffrey describes the fear of living amid a disease spreading at such scale and speed.Fatalities have been overlooked or downplayed, understating the human toll of the country’s outbreak, which accounts for nearly half of all new cases in a global surge.The new wave of the virus in India will hurt global efforts and vaccine supplies, experts say. And researchers are scrambling to assess whether new coronavirus variants are playing a role. For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, inside the COVID crisis in India, I spoke with my colleague Jeffrey Gettleman about how the country went from successfully containing the virus to having the worst outbreak in the world. It's Wednesday, April 28th. Jeffrey, where in India are you right now? I'm in New Delhi, the capital. And I wonder if you can describe the scene in Delhi at this very moment.

It's really unsettling. People are getting sick all across the city. I feel it closing in around me. I know so many people firsthand, neighbors, friends, colleagues, people that I see in my daily routines, the guy who sells us milk, all of these people are getting sick. And there's just a sense of real unease and fear. And a lot of us just aren't going outside. We're really scared to interact with anybody. And across India, we're seeing the same thing, this really sharp spike of cases from like 100,000 per day to 200,000 infections per day to 300,000 infections to 350,000 where we're at right now.

And that's just the official numbers. It's a ferocious second wave of coronavirus described by Prime Minister Narendra Modi as a storm that has shaken the nation. So many people have gotten sick so fast. Hospital, no more beds. No more beds in hospital. The hospitals are totally full. They're turning away thousands of people. People arrive in ambulances, cars, scooters and auto rickshaws pleading for admission. I had a friend call me the other night late, and auto rickshaws pleading for admission. I had a friend call me the other night late, and he had a friend who was very sick with coronavirus,

a young guy, maybe in his 30s. And my friend was trying to find a hospital for him to go to. He tried every contact he had. He called around himself, and they couldn't find a space for this guy. And he ended up dying in the back of an ambulance because no hospital would take him. The final few breaths taken by this man came after his brother had begged for oxygen for him for six hours. There's a real scramble for medical oxygen. They're using Air Force planes to airlift oxygen tanks from one part of the country to another. That's like the number one most obvious shortcoming right now. This family brought their mother, but saw her die minutes after reaching what they hoped was health. This hospital is useless, she's shouting.

It's really scary. It's very difficult getting help. Makeshift cremation sites like these are springing up to deal with the rising death toll. They're burning bodies in mass cremations. And the end result of this is this really grim scene of these cremation grounds. In Hinduism, cremations are very important. Even if it is night, we will try to finish the last burial for the day because no mortuaries will keep the body. These cremation grounds are totally overloaded and they're working around the clock. And sometimes they're burning 10, 20, 30 bodies at a time, these like mass burnings.

And it's just exhausting everybody and overloading the system. It's chaos. It's very like a heavy burden, you know, on your heart that you don't know who is the next one to go. want to go. And what's so striking about what you're describing, Jeffrey, is that it's reminiscent of the absolute worst scenes of this pandemic a year ago in places like Wuhan or New York or parts of Italy. And it felt like that really acute phase of the pandemic was supposed to have passed. So help us understand how it's possible that India has gotten to this point this late in the pandemic at a time when so many countries are beginning

to really conquer and contain the virus. What is that story? Well, it's sad because India did well in the first wave at the beginning of the pandemic. Last year in the spring, there was very few cases here. As the rest of the world was really staggering under this, the government here saw the disease coming toward it and they took swift action and locked down really early last March. And it was a total lockdown for two months. Don't leave your house. I remember once I went out with my kids to go buy some milk around the corner and somebody stuck their head out of a window and yelled, go home.

The lockdown was so complete that the entire transportation network was shut down. The train system, which is one of the world's biggest train networks, totally stopped. The government stopped all flights and the entire country was basically frozen. And Jeffrey, what was the impact of such a strict and strictly observed lockdown on the Indian economy? It was devastating. It was devastating. India is a developing nation that needs a growing economy to put people to work. And the biggest impact was on the poorest people. India has an economic system where many people are very poor, as poor as the poorest people anywhere in the world. There are hundreds

of millions of people in India who live on a few dollars a day. And those who had gravitated to the cities, they're referred to in India as migrant workers. They had maybe grown up in villages and come to these big cities for work as rickshaw drivers, as vegetable sellers, on construction sites, as maids, as cleaners. There are tens of millions of people like that around India. And when this lockdown was dropped, it was dropped with no notice. The prime minister of India, Narendra Modi, declared it at 8 p.m. and said it's effective four hours later. So you had tens of millions of people who were trapped in cities with no hope of making any money,

no hope of paying their bills, of paying their rent, of being able to buy food. They live hand-to-mouth. They have no savings. And so you had this panic that spread through these cities of what are we going to do? How are we going to survive this lockdown? And it created this migration of tens of millions of people who poured out of the cities that put their belongings on their backs and walked or hitchhiked or rode bicycles across the country. I did a story about a 15-year-old girl whose father was hurt and they needed to leave

and there was no way to get out of the city of New Delhi where they were living. And she got a bicycle and rode her dad like a thousand miles across India with him sitting on the back of the bike because they were that desperate to get home. And you've had stories like this happening across the country. Wow. So the lockdown was a real trade-off. And I think there was a real worry that if it continued for months and months and months, poor people across this country would suffer terribly. So in June last year, the government lifted it in stages. And by the end of the summer and early into the fall, people went back to work. Many kids went back to school. Social lives resumed.

And India kind of felt like we're just going to move on. And so was the virus more or less under control at that point in India? So after the lockdown was lifted, there were waves of ups and downs with the virus, but there was never a great healthcare crisis. There was never the sense that the hospitals couldn't handle the number of sick people. And as that time passed, so as we went from the fall to this winter, the sense of victory grew. Mission accomplished that we beat this, that India was somehow different. I remember other journalists coming to India and stories being written of how did India do it? What explains how India sort of ducked this second wave of the pandemic?

Wow. And in the winter in the US, it was really hard. There was a lot of people who got sick and died. And in India, people here were coming up to me and saying, hey, I'm really sorry about what's happening in America. You must be really worried. And, you know, they were looking at it like it was just this other world. And the government kind of ran with that. And a lot of officials took credit for that strict lockdown earlier in the crisis and for their policies. And people began to get complacent. So as the year was ending, people in India were feeling pretty good about how they had handled the pandemic

and the sense that maybe India would evade a second wave, when in reality that's exactly what was headed towards the country. We'll be right back. So Jeffrey, what exactly is the story of how everything starts to unravel in India in 2021 after some pretty meaningful success in 2020 in containing the virus? So January was a really interesting month. It was almost like the virus disappeared. The cases went down to 10,000 cases per day for a country of 1.4 billion people, remarkably low.

And that same month in January, India begins what's going to be the world's largest vaccine campaign. And what's interesting about India is it's actually the world's largest manufacturer of vaccines. Right. And they were contracted to make the AstraZeneca coronavirus vaccine. So India felt pretty good in January about its abilities to vaccinate its own people because it had this long history of making lots of vaccines, and it had tied up with one of the major producers of one of the most promising vaccines at that moment. So, so far, so good. How does the vaccination process unfold?

There wasn't a lot of interest in it, partly because of the sense that the pandemic was over. There was lots of doses that were going unused. There just weren't many people that were lining up to get the vaccine. And India was even exporting lots of its vaccine doses to neighboring countries because it was manufacturing so much and because there just wasn't this local demand for it.

So there's kind of a lack of urgency around the vaccine, even though India seems to have a fair amount of it. Exactly. There was just this sense among society, among government, among so many people that India was going to escape the worst of this. And so January, February, it was really interesting how little fear there was. I was out in central India in a place called Madhya Pradesh in the middle of the country, a very rural state, a very big state of 100 million people. That one state is bigger than most countries in the world. And I drove miles and miles around for stories I was doing, and nobody was wearing masks. I mean, nobody. Police officers, officials, intelligentsia, people were telling me that the virus is over, there is no corona here. And there was just the sense that India would be spared. And as this complacency and

in some ways magical thinking is taking hold across India, what is the government doing to try to counter it and encourage people to take the virus seriously as it did during that lockdown at the beginning of the pandemic? So the government was encouraging vaccines. It was telling people, you know, please get vaccinated. This is the best protection. It wasn't like it was in total denial that there was a coronavirus threat out there. That was not the case. But the government was also sending out this mixed message.

But the government was also sending out this mixed message. The prime minister campaigning in Asensol said he was delighted to see the large crowds. One of the biggest states in India, West Bengal, was having a very close election. And so the prime minister was holding these enormous political rallies up until just a week or two ago. Where thousands of people would gather to hear him speak. Campaigning relentlessly, in person, in an effort to win votes. And at the same time... Lakhs of devotees continue to camp in Haridwar

for the world's largest religious gathering, the Mahakam. There was a big religious pilgrimage that was happening in northern India and millions of people were gathering on the banks of the Ganges River at a time that was believed to be auspicious in Hinduism. And you can see behind me, there's a sea of people. COVID protocols simply not being followed, whether it's about wearing masks or maintaining social distancing. And the government was supporting this exercise.

This government is a Hindu nationalist government. Right. Its ideology is rooted in this idea that India is a great Hindu nation and the government should really support its Hindu identity. So they were reluctant to kind of drop the hammer on a very important religious ritual.

And a lot of scientists and public health experts were saying, this is crazy, guys. These are super spreader events. But is such a complete and wanton throwing out of COVID norms in any way acceptable? And this happened many, many times in the past few months. Hmm. So from everything you're describing, conditions are now very ripe for an unvaccinated population of this country, which is moving around to religious pilgrimages and political rallies and generally unafraid of this virus to suddenly be engulfed by this virus. Exactly. In early April, we started to see this really steep rise in cases. Like, the world has never seen anything like this before. From 50,000 to 100,000 in a couple days, from 100,000 to 150,000 in a couple more days, to 200,000. Wow.

And then it just kept going. And don't forget, testing here is nowhere near the levels of the U.S. So for all those reported numbers, public health experts think the real number is 10 times the amount. So if India is reporting 200,000 new infections a day, that could mean that there's 2 million people who have just gotten a coronavirus that day. So as this outbreak begins to explode, what steps does the government start to talk about or think about taking in response? Modi has been really reluctant to do another

national lockdown because that first lockdown last year was effective in terms of public health containment of the virus, but it was devastating economically. So the government's hands are kind of tied. If they do the lockdown, they just throw millions of people out of work and create this misery again. But they have these cases that are going out of control. So one strategy was the central government won't declare a lockdown. Different states, different cities will declare their own lockdowns. So that was like the first step that started happening about a week ago. But it didn't make a dent in the number of cases.

And why would that be? Why would any form of lockdown not be working? One reason may be that there are new variants here. One of them is B.1.1.7, which is the British variant of the coronavirus. And it created a lot of sickness and death in England earlier this year. And its prevalence has been increasing in the last couple weeks. There are other variants that they found across India, and those could be really contagious as well. We just don't know. But there are even more obvious reasons why this surge is so big. One is just this overall relaxed posture and dropping of the guard by so many people in India in the past couple months. The vaccine campaign also has been really sluggish.

Less than 10% of the country has been vaccinated. And that's left hundreds of millions of people very vulnerable to this new surge. And then the government. The government has been blamed across the board by many people for not sending clear messages, for not taking this seriously, for not being prepared for the second wave. Right. I mean, what you are describing is systemic failure. So what is the plan to get past this horrific phase of the pandemic in India?

Is it to seek outside help? Here in the United States, we know that requests have come from India for supplies, which are now being sent. But I have to imagine that that is just a drop in the bucket for a country of more than a billion people. Is there any indication that perhaps the government will take drastic and perhaps unpopular action in the name of saving lives? What is your sense of that? My sense is the government is totally overwhelmed. People now are very scared. And so the government is considering more drastic lockdowns. There were just some rules that came out that were instructing all areas of the country where there's above 10% positivity rate that they need to begin to shut down and to establish containment zones. Everybody says the same thing, that the speed of the spread just took everybody by surprise.

The doctors and public health experts we speak to say we had no idea the virus could spread this fast, that we could reach 350,000 known cases in a matter of days. So yes, they are asking for outside help. And yes, that's not going to save lives tomorrow. They're asking for more oxygen production capabilities. They're asking for vaccine ingredients to vaccinate more people in India. But this will play out over the next few months, not the next few days. Jeffrey, what is the meaning and the lesson, if it's not too early to ask in the middle of such a horrible crisis, of watching a country go from meaningful success in containing this virus to such mismanagement and watching it run wild? India was always in a very dangerous situation. And people had been predicting that it could pay a very heavy price from the coronavirus.

And I think some of the lessons, I mean, are that this is a really scary moment for humanity. And if you drop your guard and you're vulnerable, you could get hit really hard. And that's what's happening in India. It dropped its guard and it's getting hit really, really badly. And it could jeopardize so much. It could jeopardize the economic progress this country has made. It could set this country back years. So many people's lives have been destroyed.

So many families have holes in them. It's just cutting through households and communities and cities. And what's really scary is, when's it going to end? India is enormous, and this virus is out of control. And there's just a lot of fear that it's likely to get a lot worse, even though that's hard to imagine right now. Well, Jeffrey. Thank you.

I hope you stay safe. We appreciate your time. Thanks. Over the past few days, a growing number of foreign governments have pledged to help India. Britain, Germany, France, Saudi Arabia, and the United Arab Emirates have promised either oxygen generators or ventilators, while the United States has said it will send India doses of vaccines in the coming

weeks. But at the same time, several governments are now restricting travel from India out of fear that the outbreak there will spread to their countries. So far, those include Australia, Britain, Canada, and Singapore. We'll be right back. If you're fully vaccinated and you're outdoors, you need, and not in a big crowd, you no longer need to wear a mask. On Tuesday, the Biden administration said that vaccinated Americans no longer need to wear masks outdoors when walking, running, hiking or biking, alone or with members of their household, or during small outdoor gatherings. or with members of their household, or during small outdoor gatherings. In remarks from the White House, the president said that the new guidance reflected the effectiveness of vaccines and the low risk of open-air transmission. But he cautioned that some outdoor activities would still require vaccinated people to wear masks.

I want to be absolutely clear. If you're in a crowd like a stadium or at a conference or a concert, you still need to wear a mask, even if you're outside. Today's episode was produced by Asla Chaturvedi and Austin Mitchell. It was edited by M.J. Davis-Lynn and engineered by Chris Wood. That's it for The Daily. I'm Michael Bilbaro. See you tomorrow.