How India went from a ray of hope to world record for most Covid cases in a day
npr.org
npr.org
I have friends in India that are losing their jobs and are becoming hopeless for their future. What impact long term psychologically can we assign a cost to this?
Are we okay with telling people: you lucky ones who can quarantine, hunker down. You lot who are the undesirables, fetch my water in the world amongst the other masses.
There needs to be an operations research department that has the gimp from that John Travolta movie that comes out and says: “here is our cold hearted calculation. For Covid, everyone needs to get healthy, survival rates for under 30 BMI are pretty much perfect, over that, we will see 87% of fatalities amongst this group.” Instead, of getting this sort of information, we got: “everyone can get sick, equally!” We knew early on the mortality was higher for older folks, did this delineation happen, nope.
Instead of isolating the elderly, Cuomo sent infected back into the old folks homes! Then lied / hid the data of deaths.
Point is that it is NOT good to compare COVID and non-scaling death factors.
But I do agree it is a more difficult overall problem than this - think the main failure is the rigid-as-steel top-down governance models that takes ages to react to even major environmental changes and make borderline idiotic decisions when being too far removed from their effects.
India's massive COVID surge puzzles scientists - https://news.ycombinator.com/item?id=26898889 - April 2021 (146 comments)
India’s second wave - https://news.ycombinator.com/item?id=26886829 - April 2021 (438 comments)
> A few months ago the US had a few days > 4K:
Note that this was with 9 million active cases (official). According to official numbers, india is at 2.5, yet already reaching 2200 daily deaths.
And if you look at the correlation between daily deaths and active cases, the daily death maximums occur around the inflexion point in case growth (either peaking for the 1st and 3rd surges, or plateauing of the 2nd).
The same occurred in India with their first wave (active cases peaked mid-september, so did deaths). Right now it's shooting straight up, they've already smashed through the US' maximum daily new cases, and the US reached theirs as the DNC's increase was slowing down.
We are now well over a year into this pandemic. The original justification for the lockdowns in the US was "15 days to slow the spread," i.e. that we would self quarantine to buy time to add ICU capacity, secure PPE and supplies for hospitals, etc. Instead ICU capacity was kept flat and economy-wide hospital staff were reduced and we were told "nope, keep doing this until we have a vaccine."
Is there a single country in the world that has actually beefed up ICU capacity and secured basic supplies like oxygen for itself?
> Confirmed deaths from the coronavirus also broke an Indian record Thursday, with 2,104 fatalities recorded in the previous 24 hours. But deaths too may be drastically undercounted, because many of the people dying outside hospitals never got tested.
In 1918 Spanish flu time, 5% of India died from what I read.
I mean folks come from all around India into 1 super-duper-massive gig of high density, they largely ignore any safety measures including masks (at least from photos I saw), and then happily go back home. Sounds like the best way possible to spread virus literally across whole subcontinent.
Even without any new indian variant spreading, this must have left some significant effect on the numbers.
Use Google to search for "India Coronavirus" or something similar. Check the 'news' items.
In my searches, the top results all have similar political leanings.
Is this still politicized? I can't imagine why, if it is.
Now the Prime Minister and the Home Minister have mostly left it to the states to deal with this.
When numbers (to the extent that they could be relied on) started going down around August or September last year, a lot of complacency set in. Prime Minister Narendra Modi and the Home Minister Amit Shah (along with many others in the ruling parties) declared victory. Many politicians themselves have been irresponsible and got infected by participating in large gatherings (following the adage, “do as I say, not as I do”).
The PM even boasted early this year in an international economic summit about how India had shown the way to the world in handling COVID-19 — what way, I have no idea.
The beliefs that Indians were generally immune to SARS-CoV-2 and that a country with more than two thirds of the population being quite young didn’t have much to worry about were quite strong.
There have been unsubstantiated beliefs in technology as something that can single handedly beat this. Last year, the central government and its bureaucracy decided that app based contact tracing would defeat this and released apps (announced as open source but with late and outdated releases of the source code)...this in a country where smartphone usage is minuscule and having GPS and background location tracking on 24x7 for it to collect and save data on servers without good privacy policies was necessary. That app became a gatekeeper to get into places that wanted to see your status (which was just a set of questions to answer) as green. Now that vaccines are available, the same push for using the flawed biometric resident number (called Aadhaar) to track and even decide whether to provide vaccines has been slowing things down a lot. Officially, Aadhaar is one of several identity documents accepted for vaccination. But practically, providing any other government identity document means having to argue with data entry operators (who have been instructed to insist on Aadhaar) or waiting to speak to senior officials to escalate matters. Recently, they have been making it mandatory to authenticate with some sort of biometrics when the Aadhaar number is given (one of the aims of this is to capture more/better photos and use for facial recognition).
With a massive population of nearly 1.4 billion, I don’t understand how all these barriers are going to help (note that there is also an uninformed unique health ID being created for people on the back of the vaccination efforts). Vested interests and those who have only one technology solution for every problem seem to be running the show.
Late last year, India got truly lucky with this pandemic. One can only hope that we get lucky once again, with how things have been handled by the governments.
Then, the British variant arrived and here we are, world champions in deaths per thousand people.
There's still no Armageddon happening anywhere.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e3.htm#F1_down
It's "percentage point change," which I read as absolute percentage points. It's different from you what said, "masks reduce transmission by all of 2%," but it also looks like a garbage number because you can't average percents like that and get meaningful data, and the result is hard to interpret. If masks drop the growth rate by 2 percentage point, two percentage points from what?
The West needs to take a long look at itself in the mirror, seeing as some of its fundamental ideas are inadequate when dealing with a blind, pure-numbers threat that only cares about statistics.
I'm not saying some of the collectivist excesses seen in some parts of the "East" are okay, but the other extreme turns out to be maladaptive, too.
My gut feeling is that it can be traced back to Ayn Rand & Co, but it's hard to say. But around that time, and near that environment, some spectacularly evil things came to be accepted as "reasonable".
Like someone who almost drowned in the ocean, and then thinks showers are evil.
Florida and Texas did not have extended lockdowns, and their numbers are not worse that the states that did, and in many cases better. Also, Texas cases went down 3 weeks after mask mandate was lifted. Watch Bill Maher - New Rules from last Friday.
As for Texas and Florida, I'd love to see some more details on how you're comparing them to other states. It seems like there are a lot of variables you would need to control for (population age and lifestyle, existing healthcare infrastructure, voluntary compliance with guidelines exclusive of legal requirement, etc.). But suffice to say, Florida is in pretty bad shape right now relative to the rest of the U.S., so I'm not sure it makes a good example for your argument.
My area had effective mayors who enforced policies, checked businesses, and spent a lot of energy in keeping people safer, and we did much better than many parts of the state where no one cared. Mask use everywhere I go is high which I think is the biggest measure of what works. There are parts of Florida where no one wears a mask or cares to do anything. I always wanted to see per capita cases/deaths per zip code or even voting district, but no one does that.
Los Angeles - 234.6 deaths per 100k residents
San Francisco - 46.3 deaths per 100k residents
Austin - 178.7 deaths per 100k residents
San Antonio - 81.5 deaths per 100k residents
There's strict and then there's strict:
> “This comparison isn’t an accident. [COVID deniers] are stacking the deck by choosing outliers that favor their argument,” she said.
> The data bears this out.
> North Dakota and South Dakota are both among the least restrictive states in the country with the higher per capita case rates of COVID-19 in the country.
> North Dakota has had 13,036 cases per 100,000 residents while South Dakota has had 12,585 per 100,000, according to data tracking from the New York Times.
> Vermont and Hawaii, on the other hand, have some of the lowest per capita case rates in the country (2,341 and 1,912 per 100,000, respectively) and among the most restrictive policies, according to data analysis from WalletHub.
> This doesn’t necessarily prove that more restrictions are better than fewer, either — and that’s just the point.
[…]
> “Even the very restrictive states weren’t all that restrictive when you compare to places like Spain, Italy, Australia, New Zealand,” Robinson said. “Without good quarantines, income supports, worker rights, a lot of what was done in a state like California was nibbling around the edges — closed schools and churches but open restaurants and bars.”
* https://www.healthline.com/health-news/why-do-california-and...
I think it's more about how well people follow restrictions than how strict the policy is.
Even when authorities get some responses wrong, but people follow them, it helps because you can correct them. If you have cynical attitude, that government was wrong on this detail, so everything is now bullshit, nothing will work.
I keep hearing this but is there any hard data or studies to back it up? The numbers I've seen comparing e.g. Google Mobility data to case transmission rates haven't shown much correlation at all, let alone causation.
We (in the West) are big on theater: we've closed public parks, we wear masks outside, and we loooove sanitizing surfaces. Those things are expensive, distracting, and totally ineffective.
South Korea and Vietnam don't have super strict lockdowns or quarantines. Instead, they wear masks indoors and have effective contact tracing.
FYI, reverse contact tracing is even more effective, because most people aren't highly contagious, which means new cases likely came from a relatively rare super-contagious case. Step backwards to find that person, then contact trace them. Like fire against a grass-type, it's super effective.
> reverse contact tracing is even more effective
Yes, but in some cultures that type of measures is seen as running against the idea of "freedom", however they choose to define it. This is the root cause. It's a cultural thing, a set of shared ideas.
Turns out, when you're dealing with a nanoscale replicator that only operates on statistics, individuals and their "freedom" are irrelevant. What really matters is how the collective strategy is shaped.
Well, with effective measures to control the virus. Places like Taiwan never really locked down - that's more an emergency measure to use after things have run out of control.
> For example, apartment buildings where people test positive for the coronavirus have been sealed off, with no one allowed to enter or exit. Police patrol their perimeter. In India's two biggest cities, Mumbai and Delhi, local lockdowns are already in place. Only essential travel is allowed, with a permit. Everyone except for front-line workers have been told to work from home. Residents aren't allowed to go for a stroll or jog, or they'll be fined.
It seems that Modi previously had announced a charitable policy of exporting half of India's vaccine doses to other countries that need it. One article (https://indianexpress.com/article/opinion/indias-vaccine-com...) notes that over 60 million doses have been exported, and 52 million were administered to Indians. Another article (https://timesofindia.indiatimes.com/blogs/jugglebandhi/vexin...) notes that India even donated vaccines at no charge to some countries. I'm sure Modi is facing immense pressure to focus on Indians first, and some articles note that they've temporarily paused exports, but their export approach hardly seems like it deserves blame as much as applause.
India is the world's largest vaccine producer, and while they pursue a charitable strategy, they're themselves facing export constraints from countries like the US. India's Serum Institute (world's largest vaccine manufacturer) has asked Joe Biden to relax export constraints for vaccine components (https://apnews.com/article/joe-biden-global-trade-india-coro...). While many are using this moment to find a way to critique India's handling of the virus, it makes me feel bad as an American to see others attempt to be generous leaders for the world while we do the opposite. I don't think anyone is "evil" for putting their nation first - but putting COVID to rest requires we eradicate it worldwide.
- immediately recognize the risk and call on domestic producers to increase mask production
- freely, easily and regularly distribute masks to everyone, either for free or subsidize
- rigorous regulation (not necessarily lockdown) of mask usage in places with either centralized(china) or decentralized(taiwan) contract tracing in every building.
- a leadership that publicized and communicated the risks regularly
- a leadership that led by example by wearing masks themselves
- and a population that had some sort of sense of unity(common enemy)
ALL countries that downplayed the pandemic ended up with second or third waves. I don't understand why you think it's bad luck.
From some quick web searches, it seems to me that India did many of the things you mentioned. I'm not sure if they did all of them, or to what extent they did each one - understanding that precisely is probably not possible without being involved in those particular actions. But it doesn't seem to me like they did nothing.
> ALL countries that downplayed the pandemic ended up with second or third waves.
Do you think India downplayed the pandemic? I don't get the sense given that they did building by building lockdowns and have police patrols ushering people back into their homes. We should keep in mind that each country is different - they have different population sizes, city densities, wealth levels, infrastructure quality, Internet access, cultural priorities, and so on. China is not India - it has an authoritarian governmental system. Taiwan is not India - it's small and rich and is an island. I'm not sure these comparisons are fair.
And other countries had fourteen months of rolling half-assed lockdowns, and have achieved a few million sick, with tens-to-hundreds of thousands dead.
At this point, I can't imagine who in their right mind would prefer what we got, compared to one hard lockdown that solved the problem, requiring only minimal follow-up measures.
I don't understand this argument against public health measures. People should die because we have an unchecked mental health problem?
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
Also, I said "regardless of suicide statistics." Did you miss that part?
I’m not sure what you wanted, depressed people to feel a little better but have rampant covid?
You're not sure what I want? I've clearly spelled it out.
We locked down hard and kept New Zealand’s death toll to 26. Other places have done other things, but I prefer our approach.
New Zealand and Australia likely won't open until 2023 because vaccination campaigns are slow and public health authorities are afraid of variants. I'm perfectly fine with people in these countries making those decisions. I just think they should be a little more understanding about the rest of the world that prefers open borders to hysteria.
Also:
https://www.theage.com.au/national/victoria/five-hour-ambula...
> Patients with heart attack symptoms and spinal injuries are being forced to wait in ambulances outside hospitals for as long as five hours in what paramedics and the Australian Medical Association have described as a deadly public health emergency.
> Ambulance response times are at their worst since 2016-17 and Ambulance Victoria has instigated emergency protocols – where patients can be instructed to take taxis to hospital instead of waiting for ambulances – three times more this year than in the previous two years combined.
I've been reading a lot about how NZ's health system is overwhelmed too.
I am allowed to criticize other nations just as you have criticized the US. Debate is allowed here.
You're quite rude and unpleasant yourself.
> I've been reading a lot about how NZ's health system is overwhelmed too.
What has this got to do with covid? There isn’t any in the community. It’s eradicated.
This is an odd thread and it isn’t contributing anything, altering prior comments also makes this hard to follow.
https://www.wsws.org/en/articles/2021/03/30/nzhe-m30.html
If it's so odd you can cease responding if you like. It's pretty clear you can't handle criticism at this point and choose to lash out instead.
HN was slowing down my posts so I edited the one above this one.
You answer seems very mask focused. Masks are good but my unexpert opinion of why things went well here include more;
- We had strict lockdown early.
- We has free and fast readily available testing. Generally fast both for walk in and get swabbed plus results back in less than 24hr both times I had a cold so got tested.
- There was restricted travel, so states locked themself off from other states. This I feel had a double effect as some state leaders were US style 'cant hurt the economy' and trying to keep things open. The lockdown states essentially erraticated covid and went back to normal while keeping the other states with covid locked out. This put pressure on less strict states to deal with covid more effectively + stopped them spreading across the country via their lack of containment.
- Keeping covid levels low allows contact tracing teams to work effectively on mini outbreaks and be effective. Essentially once overwhelmed govt can't deal with the issue well.
- We have fast and short lockdowns as soon as there are any cases to restrict spread, these lockdowns tend to be regional or state so only parts of the country are effected.
- Our population has largely supported government. Recently my state of QLD had a lockdown and people distanced in shops and wore masks without question or complaint for about 2 weeks even though there was only a handful of cases. Now it's gone and life is normal. These people online that scream about govt trying to control you seem so stupid... Deal with it quickly and you are more free.
Anyway, loads more detail and while I agree masks are great tool for COVID, I think the lockdowns, testing, keeping it under control initally and fast reactions are worth recognising as key components.
After this second wave is done, people will be more compliant again towards covid-safe behavior at least for a short term. Ultimately a large section of the population will need to be vaccinated to meaningfully end the pandemic.
This is not a world I would want to live in.
What way would you have it?
I’m in New Zealand and saw your lockdowns as very soft compared to ours. Here almost zero shops were open - supermarkets and some dairies. Medical practices and pharmacies were open. One could not associate with anyone outside their household.
However Australia’s approach worked. It does make me wonder if ours was too strict.
* Border controls. Including internal borders in large countries.
* Tests
* Lockdowns implemented when needed and kept till cases zero, then lifted. These can be really short if you do it with small caseloads
* Acting fast with whatever action they take. No wait and see.
Masks are a great complematary tool, and they help limit the damage of reintroductions when they do happen. But if everyone wore masks but travel were open and testing was insufficient, you’d have plenty of covid.
1. Implement border controls so few/no cases get in 2. If you already have an outbreak, do a lockdown (possibly targeted to a city or province) 3. Once you have few cases, aggressively test/trace. This is not possible with lots of cases.
If you have an open border though, this won't work, because you're going to import lots of cases, and those people, by the nature of being travelers, are going to be staying in hotels, eating in restaurants, taking public transit, exposing lots of people. They then leave the country and so are hard to contact trace.
If you look at the countries that have the fewest per capita deaths, they essentially universally implemented early border controls with supervised quarantine for arrivals. Everyone talks about SK, Taiwan, Hong Kong, Australia, and New Zealand, but there are lower income countries that succeeded with this too like Vietnam. Rwanda has also done very well with a requirement that arrivals test on arrival and undergo supervised quarantine for 24 hours while waiting for test results.
Here is an article about Indian orders for vaccines early this year: https://i.redd.it/r4ybk9b3w3u61.jpg
Regarding the raw materials export ban I agree we should share but I wonder if it is just supply constrained. I've read even in the US they have washed and reused single use filter bags to extend life. I've read that despite the US not exporting AZ vaccines, AZ was exporting vaccine liquid to Europe to overcome their shortfall in production.
https://www.politico.eu/article/astrazeneca-vaccine-shortfal...
https://indianexpress.com/article/india/serum-institute-covi...
- The Indian government had never placed a substantial order or prepaid for an order to the SII in order to ramp up production until the numbers started spiking.
India had placed order for 14M vaccines in January. an by March 16 had placed order for around 120M vaccines. Cases spiked after that.
- The SII at one point was running out of storage space so they resorted to selling to western countries at higher margin to free up some space and get more capital.
The space has nothing to do with the exports. SII is obligated to export vaccines as per their licensing terms with AZ. (Indian government might engage in coercion and prevent them from honoring it, but that is a different tale).
> https://i.redd.it/r4ybk9b3w3u61.jpg
This article is some kind of shoddy job of stiching unrelated facts to create a story.
Indian government made a major goof up. They put unreasonable price controls on the vaccine manufacturer and harassed a lot of people involved in the process. With low price controls there was no way for SII to raise capital, not to mention their gamble of stockpiling vaccines did not pay off because of that. Indian government passed down the responsibility of subsidizing the vaccine to SII instead of taking it on itself.
Some government folks even openly wondered why GoI should even bother paying SII. This is the old socialist mentality.
You don't even have to believe me. Just look up covid deaths for your city and then go to the city's largest crematorium and count the number of bodies in covid body bags.
(I know you just posted a tl;dr of the article and this is not necessarily your opinion.)
What would be the incentive for India's government to do this?
What's the source for this data?
Cases are underreported, but deaths to a lesser extent. While the situation is bad, it isn't helpful to throw random numbers around.
However I'm not defending anybody in this mess. From the US and EU blocking patent waivers to India's government being chronically under capacity, to having people fly to Maldives for late last year. This is a cluster fuck of how stupid humans are at the end of the day.
Please donate whatever you can, we'll get out of this mess.
-- This was one anecdote by me here. In reality its all over the news.
-- There are literally thousands and thousands of SOS tweets asking for hospital beds, O2 cylinders and Meds all over the country. Its even live right now.[1] Are you not on social media?
What do you mean "easy to spiral into more fear mongering and FUD" ?? This is literally explaining whats happening and asking for some accountability is somehow bad?. If this is isn't talked about today then when is it going to be fixed?
There are hospitals sending people back because they don't have oxygen supply!
I have lost 2 of my friends and I'm insanely angry at the appalling conditions that I see. Please don't go around asking people to not talk about problems cause it may induce fear!!
[1]https://mobile.twitter.com/search?q=%23OxygenCrisis&src=tren...
[2] https://mobile.twitter.com/search?q=%23CovidSOS&src=trend_cl...
Me now living in rural areas now can say, it better here than urban areas which I initially thought due to lack of health infrastructure would suck, but people have started working on making beds and health infra incase this waves comes to our villages.
They've gone from 15k new COVID cases a day in early March to 300k in mid April. No other country has seen a 20x rise in cases during that time.
No they're not, because India is in the middle of a case explosion right now. That's a completely different situation than a country with awful per-capita numbers but a low-slope linear growth (like france).
That's not saying france has handled this well (they have not, at all), but next week odds are France will still be seeing 40k cases / day, while India could be closing in on a million.
The article really talks about how India is doing in comparison to how it was doing a few months ago and then paints a picture of how dire the situation currently is. I think the raw numbers actually do a better point of getting both those points across.
All this when some nations have imposed strict restrictions on the export of raw materials for producing vaccines, their own infra crumbling, selfishly procuring 10x the number of vaccines than necessary etc.,
Ok. We get it, Sure.
USA is also stockpiling, glass, containers and other raw material which USA is not technically short of.
On top of this German Chancellor yesterday said that "we allowed India to become a pharma powerhouse but now we have to rethink". This is because India is producing cheaper vaccine.
They are worried the surge in India will delay shipments to the EU. The EU wants cheaper vaccines! That's why they took so long to negotiate the contracts. They thought a vaccine wouldn't be produced in record time and because of that they felt they had a lot of time to negotiate.
> “We now have a situation with India where, in connection with the emergency situation of the pandemic, we are worried whether the pharmaceutical products will still come to us.” [0]
[0] https://www.opindia.com/2021/04/angela-merkel-laments-they-a...
Well yeah eventually but that's mostly not going to be in time for the present wave.