India reported more than 300K new COVID-19 cases for a 12th straight day on Monday as the country's tally of total cases climbed to 19.93M, just shy of the 20M mark, a level that only the US has surpassed. The latest daily tally was 368.15K, which is down from the peak of 400K+ cases reported on Friday.
Offering a glimpse of progress, the health ministry reported Monday that the number of new positive cases relative to the number of tests had fallen for the first time since at least April 15, a sign that the peak might finally have passed.
But deaths, meanwhile, climbed by more than 3,400, falling short of the record daily number reported over the weekend, while still pushing India's death toll higher to 218.96K.
Experts have estimated that the total number of cases and deaths could be as much as 5x or even 10x the official number, which would put India's tally of cases at just shy of 200M, roughly 1/7th of India's population of 1.4 billion.
As the government struggles to boost oxygen supplies, Reuters reports that volunteer groups have stepped into the breach.
"No one should die because of a lack of oxygen. It's a small thing otherwise, but nowadays, it is the one thing every one needs," Gurpreet Singh Rummy, who runs the service, told Reuters. He called it an oxygen "langar", the word used by Sikhs for a communal free kitchen.
At least 11 states and regions have ordered new restrictions on movement to try and curb infections, but Prime Minister Narendra Modi's government is reluctant to announce a national lockdown, concerned about the economic impact (and political blowback). Modi ordered multiple lockdowns that kept the country under tight restrictions for more than a year. While those measures helped tamp down COVID-19 cases, they helped destroy the Indian economy while having a disproportionately negative impact on poor farmers and others.
One public-health expert quoted by Reuters claimed that only a new national lockdown could save India from this crisis.
"In my opinion, only a national stay at home order and declaring medical emergency will help to address the current healthcare needs," Bhramar Mukherjee, an epidemiologist with the University of Michigan, said in a post on social media.
"The number of active cases is accumulating, not just the daily new cases. Even the reported numbers state there are around 3.5 million active cases."
Despite being the world's biggest producer of vaccines, India does not have enough for itself. Just 9% of a population of 1.35 billion has received a dose.
Following Sunday's defeat of Modi's Hindu Nationalist Bharatiya Janata Party in the state of West Bengal at the hands of a rival party, investors are bidding up Indian stocks and political commentators are cheering a sign of Modi's weakening popularity in the face of the country's devastating second wave, which some have blamed on Modi-approved political rallies (and Hindu holidays that saw millions gathering in the streets).
"What Bengal does today, India does tomorrow," columnist Shobhaa De wrote in The Print, paraphrasing a quotation by 19th century liberal Gopal Krishna Gokhale.
Writing for the Strategic Culture Foundation, Jayati Ghosh blamed Modi and India's government of "complacency, inaction and irresponsibility...even when it was eident for several months that a fresh wave of infections of new mutant variants threatened the population."
The incomprehensible decision to allow a major Hindu religious festival — the Mahakumbh Mela, held every 12 years — to be brought forward by a full year, on the advice of some astrologers, brought millions from across India to one small area along the Ganges River and contributed to ‘super-spreading’ the disease.
The exponential explosion of Covid-19 cases — and it is likely much worse than officially reported, because of inadequate testing and undercounting of cases and deaths — has revealed not just official hubris and incompetence but lack of planning and major deficiencies in the public health system. The shortage of medical oxygen, for instance, has effectively become a proximate cause of death for many patients.
Modi has held an iron grip on Indian politics since sweeping to power in 2014 and winning a bigger victory in the 2019 national election on the back of a strong Hindu ideology. But shortages of everything from vaccines, to medication, to hospital beds, to - most critically - hospital oxygen have inspired a major public backlash.
International aid has poured in, with foreign governments - including the US and UK - and western corporations - including Amazon and Blackstone - sending ventilators, oxygen supplies and doses of remdesivir and other therapeutics approved to treat COVID-19.
India has struggled to increase capacity beyond 80M doses a month due to lack of raw materials and a fire at the Serum Institute, which makes the AstraZeneca vaccine. Pfizer is reportedly in talks with the Indian government for "expedited approval" of its vaccine, said Pfizer CEO Albert Bourla in a post on LinkedIn, where he also announced a donation of medicines worth more than $70 million. Last month, India said its drugs regulator would hand down a decision within three days on emergency-use applications for foreign vaccines, including that of Pfize
However, there's also a fear that mutant strains detected in India are continuing to evolve, potentially posing a threat to individuals who have already been sickened, or vaccinated. Some worry that a "variant" first identified in India has now reached at least 17 countries including Britain, Iran and Switzerland. A growing number of states, including the US, are shuttering travel with India over concerns about the mutants. Nigeria became the latest state to ban travelers from India on Monday.
Finally, even as Modi has pushed back against calls for a new national lockdown, India's economy is still suffering from the new outbreak. India's unemployment rate rose to a four-month high of nearly 8% in April as 7M jobs were destroyed while cases surged and hospitals saw a flood of patients across the country.