Tragedy of India: Leaders focus on damage control, not help

"We are praying that we do not catch the coronavirus in the next few weeks" she said. "If we do, we are dead."

"There are no beds available in hospitals," she continued, "and no oxygen and no ventilators."

She was calling from India to raise funds for a group of volunteers who were burying COVID victims because none of the usual cemetery workers were willing to do so. In addition to burial grounds, these volunteers were also taking bodies to crematoriums. They were protecting themselves with PPE and had their own hearse.

The tsunami of COVID infections and deaths in India is reminiscent of the historic plagues that killed victims with abandon in previous centuries. The last pandemic of this level of mass death was from the plague in the 14th century. No one would have imagined that anything of this scale would happen in the 21st century.

The rapid rise of infections in just four weeks appears to have stunned everyone. People are dying in homes, roads, cars and parking lots waiting for hours trying to get into a hospital. Even when they do get in, there are no ventilators, high-flow oxygen or other needed equipment.

Many were predicting an increase in infections but not at this scale or speed. Friends who had been to India before this second wave hit, reported a general sense of complacency. Big, fat Indian weddings with thousands in attendance were back. Movie theaters and shopping malls were packed. Streets and public transportation were crowded, and masks were rarely visible.

This unworried attitude was due to the general impression that by some miracle India had beaten COVID. Infections were going down. The most reliable data, the numbers of admissions into government hospitals that were designated for COVID patients, had declined. There were many theories as to why India appeared to have beaten the virus. Hot climate and possibly herd immunity were commonly invoked.

The proximate cause for the increase involved many super spreader events, with two that stand out.

One was midterm elections in five states. Large gatherings with no social distancing and no masking were the norm. Elections in India are raucous affairs with thousands packed together listening to speeches by political leaders and processions that roam the streets. Prime Minister Modi and his right-hand man, some say his Svengali, Amit Shah led the campaigns. Unlike the U.S., where Biden campaigned with masking and social distancing, the opposition in India mimicked Modi's huge rallies. Like practically all institutions in India, the Election Commission, intimidated by Narendra Modi's authoritarian rule, did not enforce its own rules and allowed these mass rallies. The Madras high court was so enraged by this that it called the Election Commission "murderous." The campaigns were most intense in the city of Kolkatta (Calcutta) where the positivity rate is now reported at 50% or higher.

The other super spreader was a Hindu religious event called the Kumbh Mela. Over 2 million gathered for a dip in the river that is considered the most important ritual of the event. Many outsiders were furious that it was being allowed to be held in the middle of the pandemic. One commentator remarked with prescient sarcasm that these devotees will spread the virus to their hometowns like prasad (offering from a deity.) This is exactly what appears to have happened.

When the first wave hit Modi locked down all of India with a mere four-hour warning. Making sudden decisions is his modus operandi that he considers a sign of a strong leader. The lockdown was needed, but the lack of any warning created a human catastrophe where hundreds of thousands of day workers and their families with small children hit the streets carrying their meager belongings with them. These workers, who live literally from hand to mouth, were trying to get back to their hometowns.

The authorities simply ignored them. Modi came on TV and urged Indians to exorcise the "Corona devil" by turning off electric lights, gathering outside their homes, beating metal cooking utensils and singing "Go, Corona, go."

Can India overcome this catastrophe? It can but the problem is a leadership busy denying and covering up. A quick review of how different countries have handled the pandemic tells us that good governance saves lives.

The Indian administration can mobilize its resources on a war footing to set up field hospitals. It can acquire ventilators from outside the country. India needs a Biden but what it has in Modi instead is a leader who appears clueless and an administration busy doing damage control to its image than providing real help to its people.

Like the young woman who called, there are lots of volunteers ready to help and many are doing it on their own.

• Javeed Akhter, M.D., is a physician and freelance writer. He is president of a group of American Muslim physicians from India who help run free medical clinics in India.