Hundreds of thousands of Indians are testing positive for the coronavirus every day while thousands die, and while the official numbers are worse than at any point during the United States' surges, experts say they are undercounts.
India, like Italy, New York City, Brazil and other worst-hit places over the course of the pandemic, does not have enough hospital beds for the sick and the dying. There is not enough oxygen to go around. And while the nation is a leader in biomedical manufacturing, its production of vaccines has been kneecapped for its own citizens.
Dr. Vineet Arora, a University of Chicago professor of medicine and assistant dean for scholarship and discovery, has family that has been affected and said in an interview that she does not know of a person of Indian origin in this country who does not have family affected there.
"One of my best friends, who's a physician of Indian origin, has 15 people in her family who are sick right now, and she's looking for oxygen for them. So waiting for bad news is just kind of the name of the game right now," she said.
India had been doing well, especially compared to the U.S. during this country's massive fall-and-winter surge. But the virus does not care about complacency, Arora said, and when people got lax about masking and especially distancing — which she said simply not possible in such a densely populated country — a situation for exponential growth arose.
"We've seen that here in our hospital," she said. "One week it's fine and the next week it's not. With the blink of an eye, you see a big surge of patients coming in, and that's why we follow the numbers closely here. And I think the challenge has been there's not much you can do overseas except help counsel and support and also help raise awareness."
A group of Indian-American scientists and physicians started the India COVID SOS group, indiacovidsos.org. Arora, for her part, is trying to amplify information with the platforms at her disposal.
The U. of C. has established a website via its Center in Delhi, uchicago.in/covid-19-crisis-support-in-india, to direct aid to staff and faculty both in India alongside links where people anywhere can donate, including to the affiliated Guru Teg Bahadur Hospital Complex, through the UChicago Alumni Club in India and through two graduate students in the Department of South Asian Languages and Civilizations.
"These are all very, very personal issues for people in the university community and in Hyde Park," Arora said.
Asked why things have gotten so bad, Arora said again that this exponential growth is the result of not flattening the curve, but she also pointed to a disconnect between government messaging and "major, major need of the Indian people to follow mitigation measures." India is the world's largest supplier of vaccines and agreed to supply vaccines to lower- and middle-income countries for equity's sake. Then came the variants.
"The availability of hospital beds is also very low per their population," she said. "Even though they have elements of a health care system, they don't have the support they need for the number of people they have."
Mitigation strategies like masking will be the way India gets out of this surge, Arora said — the numbers are too high for mass vaccinations to work along. She said India COVID SOS group members are discussing ways for a "humane" lockdown, unlike the initial one at the beginning of the pandemic that was horrible for the poor and wrecked the Indian economy. In some ways, Arora said that could be similar to the way the U.S. got through its fall-and-winter surge, with its stay-at-home advisory, not order.
"It's not that there are no mitigations in place. Just like in states where state leadership has historically opposed mitigation, counties and municipalities stepped up and implemented mandates for masks and shelter for stay-at-home advisories and things like that," she said.
"Cities like New Delhi has a stay-at-home order. There are places that have implemented these types of mitigation. It's just that when you have a leader, government messaging that the central level matters. And we've seen that in the U.S. We're still struggling with that, given vaccine hesitancy, for example, among Republicans."
She expects this surge to have long-term, catastrophic consequences for India.
"When you see young people dying, the PTSD that's going to be associated with working in a hospital, the burnout of health care workers, where the political wind is going to go from there — I don't know. A health care system collapse creates the conditions for political collapse, and that's what worries me, because India, like every place, has a history of corruption.
“And that corruption is magnified right now. Everything that's scarce is even worse. People are paying their entire life savings and then some, trying to get a hospital bed for a family member who might die. Those are the things that make you really, really concerned."