India’s second wave of Covid-19 feels nothing like its first | Hacker News Reader

India’s second wave of Covid-19 feels nothing like its first

economist.com

288 pointsdivbzero366 comments

The most puzzling thing about this wave is that even the young aren't being spared. From the start of the pandemic, I assumed it was patently clear that it's the old (>60 age) are vulnerable.

What I am seeing in Delhi is people from all walks of life without any comorbidites succumbing to the disease - peoples in 30s, 40s, and even 20s. Granted death rate of younger people isn't absolute zero, but in India, it's happening way too often. Could it be because of lack of hospital care? Maybe, it would interesting to see death by age group for hospitalised patients.

Unfortunately, there's no way to investigate this since I don't think there any publicly available data that shows deaths by age group.

Being infected isn't a binary thing. There is a big difference from swallowing 30 Coronavirus particles from touching your face to breathing in 300,000 from someone coughing in your face.

If you're young the first is probably a mild cold while the latter is a trip to the ICU.

Part of bringing the virus under control is reducing the amount of particles people are exposed to so they have a better chance of fighting off the virus.

How do you know?

It depends on how fast the virus population doubles. And how fast the immune system kicks in.

If the virus population doubles every second then the person who swallowed 30 virus particles will be at 300,000 in just 14 seconds.

If it doubles once per minute, it is 14 minutes. If it doubles once per hour, it is 14 hours.

The question if that is a meaningful headstart depends on how fast the immune system reacts. And if it reacts faster to 300k viruses than to 30.

It doesn't only react faster, it will react differently. Up to a reaction called "sepsis" that can kill you even without the virus doing anything anymore. Research points to most covid complications being such (there are lots more, the immune system is the worst kind of spaghetti code you can imagine) massive immune reactions gone haywire.

I'm not saying you are right or wrong. I'm saying that immune reactions aren't linear, straightforward, harmless or predictable. And that "more virus" usually isn't better.

As a type1 diabetic, I love the 'spagetticode' reference. Our biology is amazingly complex. And in a somewhat constant broken state. My immune system decided that crucial pieces of my own body, are dangerous invaders, and it then decided to attack it. The attack is ongoing, and successful: a crucial subroutine of me is being destroyed faster than another part of me can rewrite it.

>If the virus population doubles every second then the person who swallowed 30 virus particles will be at 300,000 in just 14 seconds

That was also my intuitive response at the beginning of the pandemic. I assume one virus was plenty due to exponential growth. Having read every article I could in the past year, it's extremely rare to run across any details but:

1. I've read that scientists believe a coronavirus takes hundreds of viruses to successfully infect us. Not, for example, several dozen like some other viruses.

2. Next obvious question to me is, is this because one has to land on a lucky spot on the body and the rest somehow die before they can reproduce (so it's statistical odds that one virus gets the conditions it needs just like one sperm makes it to the egg)? Or can the body fight off a dozen or two dozen covid19 viruses so quickly that they never take hold? I only see two possibilities here.

3. If it is the latter, an answer I can't find anywhere, why did we need to waste so much time developing a vaccine? Wouldn't it be equally efficacious to introduce one virus to the body on day one, four on day two, and so on until immunity is achieved? Evidence of this possibility would be mixed in with the population they believe are asymptomatic, so unless researchers look for this they won't find it. (Basically a natural immunity hypothesis - based on repeated low viral count exposure.)

A virus that doubled in a second would be perceived as a swarm that dissolved people before our eyes as it quickly ate the biomass of the planet. Think 2^86400 in one day. Fortunately it would need faster than light travel to keep replicating at that rate for long.

Why would it need ftl?

Aren’t all the doublings local?

I'm assuming it would consume all local mass shortly.

Anything that keeps replicating exponentially will eventually have its growth limited by the speed of light, because the amount of space you can reach while traveling at a bounded speed only grows polynomially fast. Because the formula for the volume of a sphere is cubic. You’ll run out of space and the things in the inside of the ball won’t have room to replicate.

to your last question—when we develop a vaccine or treatment, it’s about making sure as many people as possible get the minimum degree of protection with the least amount of risk. giving live virus is a tremendous risk, even if you found a way to just give one particle at a time effectively.

What you are referring to is the viral load. How much does it take to make you really ill. It matters because your body can fight a few dozen virus cells more readily that it can a few thousand. Sure it can make more antibodies but they take time, time the virus has to replicate, so now you need more antibodies, and yiu aren't exactly sure which ones work.

https://www.bmj.com/content/371/bmj.m4763

That's called variolation [0], and it was floated early on by some pundits, but not seriously. It faces the same sort of pushback as challenge trials.

[0] https://en.wikipedia.org/wiki/Variolation

Sort of. Variolation also involved intentionally inoculating with a naturally occurring less deadly strain. Also, introducing intentional Covid infections in a naive population would likely infect many contacts of the inoculated patients before they got inoculated, which would defeat the purpose.

> If it is the latter, an answer I can't find anywhere, why did we need to waste so much time developing a vaccine? Wouldn't it be equally efficacious to introduce one virus to the body on day one, four on day two, and so on until immunity is achieved?

Introducing the virus like this, you’ve created a live virus vaccine. The work involved in creating and testing such a vaccine isn’t really any less than creating the vaccines we did make. You still have to develop technology to grow the virus and distribute exactly the right quantity. Moreover, the risk of complications is far greater if someone fails to fight off the small viral load infection.

The vaccines such as Moderna only took a week or two to prototype in January 2020. The entire rest of the time was scaling up production and running tests to prove it worked in the population. We could have skipped running the trials and deployed the untested vaccine instead. A lot of lives would have been saved but no way to know that without doing the trials, I suppose.

Viral reproduction rate is not that fast. It's about 8 to 72 hours depending on the type of virus. This is why low viral load is generally associated with milder disease outcomes, the body has a significantly longer time to generate an immune response before the viral load becomes significant.

Parent was referring to the doubling rate.

Cells produce more than one additional particule per reproduction cycle, so the doubling rate is lower than 8 to 72h.

Won't the immune system acts better when it gets infected by 30 (say) virus particles than swamped by 300k viruses (say).So my guess (as layman) is when infected with 30 viruses the growth might not be as uncontrollable (doubling per second). I think the virus load indeed matters too.

A very important thing is the topology of the infection. I had COVID last year and it progressed linearly over time, from the back of my nose(probably from a big water droplet I breathed)forwards(towards my nose) and downwards towards my lungs. I could measure the progress day after day.

It progressed linearly because the breathing system is a duct. Like a fire needs a boundary to expand, a frontier. It is not 3D but 2 dimensional.

You just can not do an exponential calculation, without taking into account the physical limits of the environment.

Just before entering the lungs I did beat it. I coughed for a month or so,specially for the irritation in my glottis, but nothing serious.

This year I got it again, the progress rate was very similar but my immune system reacted sooner.

What is interesting is that I did not developed antibodies, my antibodies test were negative but the PCRs positives. This means that my T cells were already fighting the infection.

That probably had something to do with living in China in the past and having developed immunity against SARS.

> That probably had something to do with living in China in the past and having developed immunity against SARS.

Only about 8000 persons have been recorded to come down with SARS. Were you one of them with a diagnosed case of SARS (10% fatality rate)? The vast majority of residents in China would have no exposure to SARS.

> Just before entering the lungs I did beat it.

How long it took / how fast it progressed from one drop almost to lungs (with what treatment)?

Do you think this could have helped early in your case:

Use of Povidone Iodine Nasal Spray.. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3563092 (March 2020)

or this: nasal rinse and mouthwash, Listerine Antiseptic https://doi.org/10.1002/jmv.26514 if the virus landed on the throat ?

Alternative theory: you had something else for at least one of those reported illnesses, and your PCR test was a false positive. The rest is conjecture, anecdote, and speculation.

This isn’t really accurate because it fails to take into account how infections work. Viruses don’t replicate like bacteria, so they don’t just double every X amount of time. They infect a cell and hijack the cell to produce copies (sometimes millions) of the virus until the cell exhausts itself and dies, bursting open and releasing all those copies of the virus. While this is happening, the body is attempting to fight this. What is particularly relevant are several of the varieties of T-cells, or killer cells. They are attempting to find cells infected with the virus and destroy them before they burst. While some copies of viruses escape cells as they are producing them, the overwhelming majority escape when it dies and bursts.

What this means is that 30 viral particles do not become 300,000 in 14 seconds. Say that all 30 find cells and infect them, and T-cells destroy 50% before they burst. You have 15 cells that burst and release viruses to infect nearby cells. If you start with 300,000 infected cells, and T-cells destroy 50% before they burst, you have 150,000 cells that burst and release viruses to infect nearby cells.

Low initial infections can often be well controlled and managed by the immune system in this way until antibodies are produced. High load infections can often spiral out of control due to so many initial cells being infected, the physical damage of higher numbers of killed cells, either burst or destroyed, and the high numbers outpacing the body’s ability. Of course this is also a simplification, but I think it demonstrates how initial viral load can have a big effect on outcome.

You absolutely don't know that. Disease severity vs. contaminant load correlation is unknown.

You are right, but in the early phase of the pandemic this was raised by medics in the UK as a reason why some of them were dying. The pathology mentioned then was that a cytokine storm got kicked off in people with strong immune systems exposed to high load. This prompted changes in PPE for hospital staff - from light gear that would be worn in the face of flu patients (of whom, as we know some 1000's are hospitalised and die every year) to the space suit style gear that is now used in ICUs with COVID. If you are young and nursing a bunch of relatives at home it's reasonable to say that you are effectively exposed to ICU risks without ICU gear.

I work in an ICU. Bedside staff is equipped with PPE2. No space suit. I've spent months of my life wearing only a surgical mask in what is basically a COVID aquarium, with patients on non-invasive ventilation in open-space units spraying virus everywhere. Our staff case count of hospital-acquired infection is currently zero. So, I don't know what the ground truth is but it certainly seems like exposure is not the only factor.

So - that's amazing to me. In the beginning of the pandemic the stats seemed to show that hospital staff were at significant risk. I think that this has faded from the numbers in the UK and my assumption was that this was because staff were now able to protect themselves with good PPE and vaccination.

https://www.bmj.com/content/371/bmj.m4763

It makes logical sense, is there any study to support this

I mean, the current accounts suggest the entire reason hospital care is being denied to some is because there is no room.

When we have seen total healthcare breakdowns (Wuhan, Italy, NYC, etc.) the efficiency of hospital care drops like a rock due to both overstressed medical staff and the staff themselves also catching COVID. I would expect India to follow the same pattern, but exacerbated by the lack of capacity.

NYC didn't have a healthcare breakdown, it did send covid positive people to nursing homes.

NYC sent the elderly, covid positive people to nursing homes, where they died. Is that not a breakdown?

According to...well, everyone, that was a NYS thing, not NYC specifically.

More broadly it was a nationwide CDC advisory and not only that, the same shuffling of elderly infected back into nursing facilities happened in countries across the (mostly western) world. Probably based on shared implementations of policy briefing/ pandemic planning documents.

The order by Governor Cuomo sending infected patients into nursing homes was preemptive, which then led to strain on the health care system.

https://en.m.wikipedia.org/wiki/New_York_COVID-19_nursing_ho...

It’s worse because then they go and infect the rest of that vulnerable group.

I can understand not being able to treat them but at least isolate them…

This is the first I’ve heard of this. If it’s true they were sending known-covid positive cases into nursing homes, whoever gave the order should be tried for mass murder.

Unbelievable!

It is true, and Cuomo ordered it. Fully agreed that he should be tried for some serious crime. https://www.empirecenter.org/publications/the-hospital-lobby...

WSJ, March 26 2020: https://www.wsj.com/articles/hospital-capacity-crosses-tippi...

> New York, home to the nation’s largest outbreak of Covid-19, the illness caused by the new coronavirus, is rushing to build a temporary hospital in a Manhattan conference center in the hope of staying ahead of the fast-spreading disease.

> Hospitals in parts of New York City have become so full of critically ill patients that they have steered ambulances elsewhere. The full-to-capacity morgue at Elmhurst Hospital in Queens is using a refrigerated truck to hold some of the dead. Thirteen people died in the hospital in the last 24 hours, said NYC Health + Hospitals, which operates Elmhurst.

Having some hospitals be full is not a system-wide breakdown. Even before COVID emergency rooms would be "on diversion" when particularly busy, and ambulances would go elsewhere.

For about 4-5 hours at a time,max, and believe you me it wreaked utter hell on my nights in the back of the ambulance when it happened.

Mine too!

No patients were ever turned away at NYC hospitals. There is a highly sophisticated patient transfer system in NYC.

Morgue capacity makes sense simply because of the population who was coming down with COVID at the time.

This makes it seem like not the case: https://www.nytimes.com/2020/04/19/nyregion/new-york-new-jer...

It very much depends on the definition of breakdown. Some people see a breakdown if hospitals run out of beds, others will pretty much never accept there is a breakdown in health care because it’s contrary to their conviction that COVID-19 is ‘just a flu’. To be fair, it’s a continuum, there’s not going to be an easily agreed fine line between broken down and not broken down. So the real question is, what constitutes the health care system breaking down, and did that happen in NY.

Without agreement on that though, we’re just shouting at each other.

Let me add one data point: Hungary has currently the highest mortality for covid-19 in the world, and still currently higher than India, for apparently the same reason, healthcare over capacity.

(The trend is different though, there's hope)

I would not believe any numbers coming out of India right now. I have family in the medical field and they all agree that deaths are underreported by a factor of 5-10 based on where you are located. The FT did a story on it as well that showed the deaths were grossly undereeported

Yes, correct. The govt reporting of every figure is less by a factor anywhere from 10-50, or maybe even more as well. The ground reality in India is way worse than what even the media is able to show. And, at present no light in the tunnel. Heart cries at this but it is us at fault only for putting such incompetent people at the helm.

India reports 155 deaths per million. Hungary is at 2,874.

The cases are being under-reported too. The question is whether deaths are being under-reported to a greater degree than cases. Even the test-positivity rates vary from state to state not only because of the extent of infection in different states but also because some states contact-trace and test while others don't. Its a mess. And to see people try to fit models to this data and fight amongst each other is darkly hilarious.

Plus, at least in the first wave in Bangalore (where I grew up), there were no instances of crematoriums melting down and such. So the under-reporting of deaths was likely not as bad in the first wave as it is right now, but the under-reporting of cases was certainly quite large as testing capacity took a while to come online.

Psychologically average Indian young person is more unhappy and unstatisfied than ever, this is both because of lack of new opportunities and employment and now Indians are able to see on YouTube and compare living standards to people in foreign countries, psychologically most Indians are devastated because of this new found info.

When you are in doom and gloom state, probably immune system also doesn't perform quite as well and it doesn't help that even basic medicines and healthcare facilities are not available to many of us in India now.

I don't know why you're being downvoted, but what you said applies to everywhere not only India, of course chronic stress means higher cortisol, which lowers immunity.

Because that's a constant and would have been present the entire time and would not adequately explain why a second wave would have more young people succumbing to the disease.

During first wave, many people would have savings. After that they expected recovery but now stuck in 2nd wave.

Price of things that people want have shot up considerably while for most income source has dried up.

There have been numerous headlines in media about the psychiatric illness epidemic resulting from social distancing measures, and all the downstream effects of the whole situation, including continuing uncertainty. Common sense alone would tell you that mental health has worsened since last year, particularly in those who were already on the edge.

Maybe better healthcare. Kerala case fatality ratio is around 0.3 that is many times better than other states.

One feature of the Kerala case, which does not get discussed much, is that the load is more or less evenly distributed throughout all the districts. This makes it easier to handle critical cases well.

Someone who is from UP and lived in Kerala for few months, that state is world apart in terms of basic facilities. I mean computers in primary school (not to mention Linux)!!! In U.P., you won't find teachers teaching in most scholls.

How were they able to achieve this?

96% literacy rate. It is one of the two states with strong socialist presence/governance.

I've lived in Kerala for twenty years. Can attest to this being due to better healthcare. There's also very little underreporting of deaths happening (my sister's a doctor directly involved with the government effort).

It's a bit like Cuba, with the Communist past and healthcare/life-expectancy that stands out (compared to say, per-capita income which is average).

And we used the calm times to ramp up the infrastructure. But if cases are rising beyond control, this will fail too.

Kerala setup 23 Oxygen plants - most of them setup in the last year. It is now exporting oxygen to the other Covid-hit states. The vast majority of beds now have oxygen supply - even all medical colleges.

People actually planned and did things right in Kerala. No one did so at the capital.

There is so much focus on oxygen, but is scaling healthcare facilities actually a solution?

It seems that even in rich countries hospital capacity is overwhelmed as soon as infection rate is out of control.

No, because a significant proportion of people who enter the hospital (and especially intensive care) will still die, even with proper care.

The biggest problem is that it is a really tough sell if you run out of capacity. Even if it would be better to use that capacity for other cases.

But if the number of cases increases its very difficult to manage. Recent reports indicate Kerala might face shortage. Karnataka which also had enough oxygen can face a deficit in coming days if the cases keep up.

Maybe it's a very mutated strain?

There is no such thing as "very mutated". Something is either mutated or not.

Your comment goes aligned with the governement propaganda that this is happening only due to the more dangerous strain. I would agree with it if people were dying AFTER GETTING proper medical care. You cannot solely blame the mutation as people are dying without any treatment. It's the dismal healthcare system and the governments who should be blamed. We are not seeing a surge of death among patients with this strain in UK, and US.

The central government's hubris, and every government's not listening to the experts, behaving relaxed which are to blame.

It’s certainly possible for one strain to have more mutations than another (relative to the variant that initially spread in China), though that doesn’t necessarily correlate with dangerousness.

>> There is no such thing as "very mutated". Something is either mutated or not.

Well if there are 1 billion genes and one virus strain has 1 mutated gene while another virus has 1,000,000 mutated genes then the latter is "very mutated".

Like a white human and a black human are somewhat mutated relative to each other but both humans are "very mutated" as compared to a chimpanzee. Although 98% humans and chimpanzees are the same animal, let's call it humpanzee.

The cases spiked after April. If it was not mutation the total number of active cases would have still going up from last October. Active cases suddenly dropped from October with no good factors to indicate why it dropped.

I have been to 3 wedding after the drop. Almost no one was wearing mask. As far i know govt was still asking people to wear mask. There were major Hindu festivals after October and coming winter were everyone was worried the cases would rise. Did the virus simply hide and rose rapidly?

I also observed this - the slow rise from end-Feb to end-Mar and then the sudden very very steep rise in covid positive cases from end-Mar.

In India, people started opening up during Sep/Oct 2020. I too relaxed the strict restrictions/rules that I was, till then, sticking to. Went to restaurants with friends and teammates (with masks wherever possible) and many people were doing inter-state travels, political events started happening, many festivals/gatherings started happening etc. Life was returning to normal. My important observation is that from then (Sep/Oct 2020) onwards, lots and lots of people were not following covid protocols properly. Social distancing was not followed. Many people did not even put on masks. Am not sure why, but even with all these behaviours which should result in increasing covid positive numbers, the covid positive numbers were continuously going down. I think it hit bottom during second half of Feb 2021.

And then the numbers started to rise - slowly from end-Feb to end-Mar and then suddenly very very steeply rise from end-Mar 2021. And by mid-Apr 2021, things got very alarming. Most of my circle of friends knew that generally the second wave will hit harder than the first. But we also that because vaccination has been going on for 2 or 2.5 months by then, it can help. The strictest (to follow the restrictions) among my friends also started to loosen up a bit. The previous reports that the second wave will hit us during Jan/Feb did not come true. So, we were hoping that there won't be a second wave. Even the US thought that they can start banning the export of raw materials needed for the production of vaccines in India.

So, I do not know if anyone predicted (with numbers to backup their estimates) that the case load will be this bad during Apr 2021. The second wave caught lots of us by surprise. But I believe, like the US and UK survived their second waves and are doing pretty well now, India too will hopefully emerge better and stronger.

* >> But I believe, like the US and UK survived their second waves and are doing pretty well now, India too will hopefully emerge better and stronger. *

and scarred. Some of the stories I read in newspapers, and heard are gut wrenching; reports like families losing more than one person in quick succession, quite young folks dying.

I returned to Bangalore on April when cases were barely going up, Vaccine drive was the way and all seemed good. And now were are in a lockdown!.

The CFR in Mumbai is half that of earlier waves.

See https://postimg.cc/Xpn7hthc

-----

Delhi looks more severely affected, likely due to its air pollution. See https://aqicn.org/city/delhi/

I'm from India. I extremely doubt that the air pollution has anything to do with this. Our healthcare system has completely collapsed. People are struggling to find medical oxygen and are dying outside hospitals without getting any care. Hospital are literally begging for oxygen on Twitter every single day. Significant number of these could've been saved if the Government had prepared for this by improving the healthcare infra. Instead they overconfidently declared victory, kept on hiding data, organized religious and political rallies. The worst is that it has just gotten started and would keep getting worse in the coming days.

At least 2 car factories stopped to let oxygen to hosiptal.

The Maruti Suzuki plant shutdown is from May 1 to 9. Which means it's starting from today and hasn't provided any of their oxygen to hospitals so far. Too little, too late.

At this stage, it's evident that the primary mode of SARS-Cov-2 transmission is through aerosols, not droplets nor fomites.

The level of air pollution affects the duration of suspension of bioaerosols as well as the performance of the innate immune system. Low humidity is also linked to higher transmission.

See

https://www.medrxiv.org/content/10.1101/2021.01.04.21249249v... https://www.medrxiv.org/content/10.1101/2020.10.19.20215236v... https://www.medrxiv.org/content/10.1101/2020.04.07.20057216v...

The level of air pollution is relatively the same now as it was last year for the first wave though. The air pollution isn't helping things but if it were that one thing, why would the second wave look any different from the first?

> The level of air pollution is relatively the same now as it was last year for the first wave though.

No, they are not. See table 1 of https://www.orfonline.org/research/air-pollution-delhi-filli... - it hit a low point in October, but was much better during lockdown and relatively better post-lockdown although trending towards worse levels.

Delhi has screwed up badly. In the South Indian states, in Karnataka and especially Kerala, Oxygen is well provisioned. Karnataka is also ramping up further everyday. Looks like someone in the Delhi state govt forgot capacity planning.

A disease that affects peoples' breathing and you don't think air pollution has anything to do with how severely the outbreak has affected people?

Delhi weather is also extremely hot right now, with highs of over 40degC, and lows of at least 30degC, six out of seven days a week. While it's a dry heat, heat stroke might still be a factor in the higher death rates.

I was in India ~10 years ago, upon entering the airport i was shocked to see smoke everywhere and assumed there had been some kind of fire. Nope, i was seeing the air, i could see the normal air inside the airport terminal. Pollution is a huge problem in Delhi which surely contributes to bad covid outcomes.

It was like that 20 years ago. You can see the pollution.

The air quality was bad for the first wave (H2 2020) as well though, so it can't be helping, but it can't be what's causing this second wave to be such a catastrophe.

That was my thought, though the whole nutritional aspect of diet may also play a factor.

I wanted to find a map of Indian pollution averages, pull that up and a map of covid deaths - https://aqicn.org/map/india/ does real-time air-quality and does give some idea.

Also other factors that may or may not play a part would be the climate, we know how well virus's do in winter over summer, equally peoples health. Now India climate wise - the only difference that sticks out this time of year would be that on average the humidity is at it's lowest point of the year, as is rainfall. Are they factors, maybe and equally less rain would also mean more particulates in the air and that we can measure with air quality.

[EDIT ADD] AS for nutritional - let us be mindful that the impact of a whole year upon business and income in India may well of seen peoples nutritional intake decline due to trickle down economics being quick to pass on the bad times over the good, and for many income wise this year not been good and not everybody gets paid to stay at home in every country.

A whole year ago early in the pandemic (may2020), dutch pollster / data entrepreneur Maurice De Hond was purged from google indexes, for suggesting there was a link between covid spikes and weather.

His research [1] indicated that brazil (manaus) and ecuador (guayaquil) - both hit early on by the disease- showed a very strong predictive basis for spikes in covid19 deaths/cases, and massive rainfall.

Now, its important to note that this was not referring to classic "rain". The previously mentioned cities lie on a specific latitude which has torrential rainfall, the kind that floods roads, etc. This was moonson-style rain happens near the equator (it was remarkable early on how south America and africa were mostly spared, except for the aforementioned 2 cities)

Fast forward to india.

Would an early moonson season, together with a latent pool of virus already Within the populace, be the driving factor here?

[1] https://www.maurice.nl/2020/05/21/the-blind-spot-with-huge-c...

I'm curious to know, why he was de-indexed from Google?

Early on in the pandemic, information about covid19 not coming from official channels seemed to disappear from search engines quickly.

That was the claim. I dont have information that would point the motives behind any such action, besides pure speculation (govt request, genuine awkward attempt to help, etc)

You always can tell you're about to land in Delhi because you can smell the air before you touch down.

That said, I don't think this alone is an explanation, since COVID is currently also tearing through Indian cities like Bangalore where air quality is better. (Not good, mind you, but nowhere near as bad.)

> You always can tell you're about to land in Delhi because you can smell the air before you touch down.

What a great description. It sounds like Terry Pratchett describing Ankh-Morpork.

The air pollution was there even the last year. But, the situation was not this bad. Surely the air pollution is a problem, but there must me more to the current crisis which was not there last year.

Chris Christie spoke about when he got Covid prepping for the debate. 7 people contracted Covid during that prep session. He got it the worst, the second worst was Donald Trump, the next worse was Hope Hicks who was in her early 30s and a daily runner.

http://tal.fm/736 about 49 minutes in

Exactly - the enormous population of India means that there are definitely going to be huge numbers of younger people who scum to the disease. Straightforward arithmetic.

*succumb

> What I am seeing in Delhi is people from all walks of life without any comorbidites succumbing to the disease - peoples in 30s, 40s, and even 20s.

Roughly 10% of people need hospitalization when infected with COVID, and when hospitals are full, some of those people are going to die when they wouldn't have had they received care.

I think the 10% ratio against all infections will turn out to be a significant overestimate.

It's off, but maybe not as much as I'd have guessed.

CDC estimates for the USA is 4.9%.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

There was a report today in the news here (Netherlands) that more younger people are hospitalized as a percentage of the total. This could mean many things, my guess here would be the elderly are more and more vaccinated and thus less likely to need ICU/Hospital care, but maybe there is more happening on a global scale.

In Belgium too. Younger people in ICU, don't remember about comorbidities.

Obviously if one group is hospitalized less, another group will be hospitalized more, as a percentage of the total.

You have to be careful not to end up with one old guy in the hospital and stating ‘wow 100% is male and old’. That’s not a useful statistic.

Absolutely true, but the question remains if that is the only cause which also muddies the numbers a bit if there are different factors at play. I mentioned it as it is seen elsewhere too and I think adds to the discussion.

You can’t solve that question using these statistics. You need to carefully define your question and then look up the data. A lot of it actually is available!

second wave of Spanish flu was also shifted toward younger ages (W-shape). May be some evolutionary dynamics - the second wave is the strains which successfully outcompeted others. May be also the protective measures like lockdowns/quarantines during the first wave provide selection pressure for more virulence.

Or simply a lot more young people are exposed.

I am from India and this is just a personal theory based on interactions with my doctor and pharmacist friends. Most Indians are dying because of lack of medicines and oxygen, and it’s due to the inept Indian government.

I heard once someone needs oxygen, their chances aren't all that great anyway. Something like 65% I think?

Even so, what would be their chances without oxygen? You might easily be doubling the overall death rate without it

Are you sure that statistic wasn't for ventilators, not oxygen?

Yes, you're right - my bad!

FWIW, just anecdotally I know of quite a number of people whose saturation levels dropped below 80 and then recovered after being hospitalized and given oxygen.

I am hearing the same. Cases that would have been treated with O2 and dex are otherwise turning into fatalities. There was very little health-system to begin with. Now it’s just a humanitarian disaster.

Not sure what virus (or rather media) you witnessed, but just because the death rate was rather low with younger people never ment the infection rate was too. Long covid is much more evenly distributed between age classes for example

A new variant arose that combines the Californian L452R mutation with an E484Q mutation as well (similar to the E484K mutation in the Brazilian and South African variants). It's not really the same virus that hit India earlier.

> Granted death rate of younger people isn't absolute zero, but in India, it's happening way too often. Could it be because of lack of hospital care

Lower standard of living, if not poverty, seems like the simplest explanation. You're comparing the richest countries with an emerging market country that has an astronomical number of poor people. They'll have worse health outcomes in general. Also, polution in India is terrible drom what I understand.

It has hit upper middle class as well, who otherwise have access to best of food/healthcare.

Is the quality of life and are the health outcomes the same as those of the countries they're being compared to for thier middle class? Is it not a relative term?

"According to The Economist, 78 million of India's population are considered middle class as of 2017, if defined using the cutoff of those making more than $10 per day, a standard used by the India's National Council of Applied Economic Research"

So, apparently no probably not to my first question and yes to the second.

The virus uses our immune system against us. Think Aikido using your opponent's strength, or a gravity assist for interplanetary flight. A modern virus attack is higher order, which is what makes designing vaccines so hard. Screw up, and you're just helping the virus. Early variants of COVID-19 were hardest on the old in part from weakness, but in part because of a well-developed immune system to target.

Anyone who's been to India can see that even the young have robust immune systems. Virus variants have finally dialed this in.

Anyone who's been listening in on research seminars since the pandemic start has heard many versions of this. Here is a recent lay account: https://www.newyorker.com/magazine/2020/11/09/how-the-corona...

Could the mRNA vaccines be used to convince the body to NOT make antibodies?

It’s not puzzling it’s because the so called “double mutant” variant is common there. It affects younger people more. It is escaped into my city Vancouver and kept death rates high despite our old people being vaccinated. This variant is stronger and more spreadable.

https://www.nationalgeographic.com/science/article/this-doub...

Could it be some sort of pathogenic priming [1] due to the vaccination? There are more people < 60 vaccinated (58M) than > 60 (53M) [2].

Also, after vaccination the immune system gets quite a hit and needs to recover from it. When being infected during that time, isn’t a person more vulnerable for the virus?

This is just me in layman terms grasping what’s going on. Other arguments aren’t different now opposed to the first wave

1: https://pubmed.ncbi.nlm.nih.gov/32292901/

2: https://en.m.wikipedia.org/wiki/COVID-19_vaccination_in_Indi... see: Vaccine administration by age group

One explanation I heard from a doctor recently is this:

the younger population is infected/affected more this time because they have been infected and has been asymptomatic or mild all these months and with that the virus has mutated more amongst younger people. So the second wave is affecting the younger population much more intensely this time than before.

I don't know how scientific this explanation is.

My own gut thinking is that lockdown nowhere nearly as effective this time as last year. Even simple social mechanics that were in effect last year – like telcos changing their ring/busy tone to covid PSA message isn't there. People are not being reminded to take social distancing, washing hands, wearing masks precautions seriously.

And people are not doing it as seriously as they did last time. This has been the reality for the months of March and April where it seem to have spread silently. The weather change between Feb-April (very windy, cold to dry heat conditions) could also be a factor. And now, it is too serious and now people may change their behavior but it is too late.

If that were true, we'd be seeing the mutation in sequencings. We all know India is doing pretty badly on that front, but it's also a huge huge population. It's rampant enough that it seems to me they'd have found at least some samples of what you're saying. As it is, B1.617 seems to be the most common there (though it seems hard to find absolute numbers a la [1]), not your friend's speculative mystery strain. Whether they are a doctor..; since what I heard from other doctors near the beginning of the pandemic, it seems they're no better equipped to deal with this than the rest of us and will speculate unscientifically just as much, except people parrot it more.

[1] Table with sequencing results for the Netherlands. If someone knows where to find this for other counties, I'd be very interested! https://www.rivm.nl/coronavirus-covid-19/virus/varianten

Bonus link: latest WHO update contains some info about variants (unfortunately not much, e.g. just saying a country has had a case of <insert variant> without any info on its prevalence there): https://www.who.int/publications/m/item/weekly-epidemiologic...

GP's friend is clearly referring to the B.1.617 variant, not some mystery strain.

If you want more detailed info you should probably check out https://nextstrain.org/.

The latest report about SARS-CoV-2 is from August 2020, or am I missing something?

The demand for oxygen in the National Capital Region and surrounding North Indian states brings up an important question - is respiratory distress worsened due to air pollution? I hope researchers are studying this because, if true, this could be a potential trigger to ramp up the need to tackle air pollution now rather than kicking the can down the road.

I have a feeling air pollution is not that important politically because people haven't felt adverse health effects in the short term.

It is possible, Delhi has one of the worst air qualities of major cities. It could be a factor in the disease progression in Delhi.

Mumbai has been hit quite badly too.

I have a feeling everyone in the districts lands up in Indian cities during such events cause the district/block level health care facilities in India are a crap shoot.

According to the sustainability dev goals India has 10 docs per 10k ppl. 30 per 10k if you include nurses and other support staff.

What can anyone do with such numbers when the tsunami hits other than say send the patient to the nearest city with the most resources.

> I have a feeling everyone in the districts lands up in Indian cities during such events cause the district/block level health care facilities in India are a crap shoot.

While this is true, the opposite is also happening, where people from Mumbai/Pune are being admitted to hospitals in smaller cities where beds might be available. Patients from Mumbai, Pune, Goa, and other neighbouring districts have been reported in my district.

Good point. Last year when the north of Italy was particularly affected it was during a huge air pollution episode. At the time I had heard particulate pollution helps the virus circulate, but maybe it also worsen the symptoms.

My asthma flares up everytime I go to Bangalore, forget Delhi. There is merit to this idea.

Bangalore air has very high pollens, so that triggers allergy for many people.

I have the same thing. I consider my asthma very mild now, it hasn't really bothered me at home since I was 16 or so. Except when I travel to India (which I did a lot for work until COVID hit) - every time I need to use an inhaler every day.

The polluted air in Delhi, parts of Mumbai (e.g. Navi Mumbai), Pune and others is just horrible. Especially at night when the temperature drops a bit, it's like it hangs in the air like a toxic cloud from a Marvel comic - the air almost seems semi-solid.

https://indianexpress.com/article/opinion/we-are-all-respons...

The author is a surgeon. He says things that many of us have been saying all along. Hopefully, his professional background will help wake some people up.

Opinion columns are not scientific sources. To the article's credit recklessness from people are is the reason for the spike. But doesn't absolves a leadership that claimed to have concurred Covid-19 and have no clue about disaster management. Indians deserved better.

There have been more than enough scientific sources published for the effectiveness of masks. I hope you still don't doubt that part. I will not cite them. People have been crowding and not wearing masks across the country. Do you want a scientific source for that? There may never be one. The Indians who step out of their homes are aware of this already.

No government or healthcare system can keep up with people flouting the scientific recommendations on such a scale.

I was not disagreeing with the articles claim people flouting rules caused a spike. But the people or the country isn't by itself responsible. Rather a callous government that was indifferent to this pandemic is. It had an year to prepare. It did nothing more than PR works

- If the health infrastructure could not take it, what was the reason for this narrative ? https://www.thequint.com/news/india/in-january-pm-modi-had-e...

- Did they not know about vaccine demand ? https://www.timeslive.co.za/news/world/2021-01-20-india-phar...

- Why did they take away the states ability to prepare ? https://www.newindianexpress.com/nation/2020/apr/09/as-per-n...

> It did nothing more than PR works

What's with the hyperbole? To disprove your point, I just have to point to one thing that the government did that was not PR?

- What narrative, specifically?

- At the time, I too was in support of supplying vaccines to countries who were in desperate need of it. I still don't mind waiting a few months if the vaccines that should have come to me go to a healthcare worker in some other country instead. https://news.ycombinator.com/item?id=26346021

- There is no reason to take anything Shiv Sena says at face value. This is the single worst party in India. If law and order had worked in India, these people would have been declared terrorists long before most of us were born. They continue to mistreat doctors (https://www.youtube.com/watch?v=2vUUQEpJEG4) and threaten hospitals (https://twitter.com/amitsurg/status/1299352826636722176) across the state. Also, while all other states had the pandemic somewhat under control at one time or another, MH consistently stayed at #1 or #2 among the worst affected states.

Shiv Sena is for sure known for their thuggery and being a party of regionalistic goons. They're hardly very different from their erstwhile allies the BJP though.

Any thoughts on their current allies? https://www.youtube.com/watch?v=JXtH0NQFqZI

The response from the government for this wave is pretty bad and they took way too much time to act for sure. But, what you are saying is polar opposite from the article that OP posted. The reason isn't one or the another, it is the combination of both. Yes, Indians deserved better but the people's recklessness is so out of bounds in large cities (speaking from my own experience) that many knew this type of wave can happen and it did happen. The worst part is people ignored all the self-precautions and acted like everything is back to normal. So in the end, it is the combination of both, people's recklessness and delayed (unplanned as well) response from the government.

India was quite successful in handling the pandemic until this second wave, which rose from a low case count to new peaks within a month. Cases lag infection events, and it takes time for the data to be reported, for people and governments to react to it, for changes to be made, and so on. It's easy in hindsight to say some action must have been taken by some date, but while it's happening live, it's hard to tell a new and different pattern apart from "normal" fluctuation. For example, when I was looking at the case graphs a couple weeks ago (https://ourworldindata.org/grapher/daily-tests-and-daily-new...), there was a temporary dip in case counts between the initial portion of the second wave and subsequent faster rise. That dip is no longer visible, and likely got filled in by delayed data, but my point is that it's hard to figure out what's an under-reaction or over-reaction to a live and chaotic situation. For leaders without the luxury of hindsight, it's challenging because they need to carefully balance health impacts with social and economic impacts.

> (from the Indian Express article) We need to accept that the politicians do not decide what we do in our everyday routine.

The federal government of India, for its part, was very much cognizant of the surge. Their press releases noted the surge in a few states as early as February 20th (https://pib.gov.in/PressReleasePage.aspx?PRID=1699596), which was a very fast reaction. The federal government provided updated guidance to the affected states the very next day (https://pib.gov.in/PressReleasePage.aspx?PRID=1699735), but did not force any decision on individual states, in keeping with the cooperative federalism that governs the health ministry's decisions. Regular guidance updates and interventions continued thereon.

Like your article suggests, my feeling is that this situation will end up being attributable to a mix of increased general mobility across society, combined with the unfortunate advent of more infectious variants, rather than any singular factor. Looking at the latest mobility graphs (https://ourworldindata.org/grapher/changes-visitors-covid?co...), we can increasing mobility preceding the surge and then a big drop in mobility around March 27th, when the daily number of cases was 3x the low point but half the prior peaks. We can wish for earlier change in behaviors now, but the timeline of how society reacted is not entirely unreasonable - it's simply the reality of seeing data and reacting to it with some natural time delay. As for the risk of new variants, per a breaking Reuters article (https://www.reuters.com/world/asia-pacific/exclusive-scienti...), some scientists identified that certain new variants were responsible for many cases and that they also seem to be able to escape antibodies:

> A version of that draft, seen by Reuters, set out the forum’s findings: the new Indian variant had two significant mutations to the portion of the virus that attaches to human cells, and it had been traced in 15% to 20% of samples from Maharashtra, India's worst-affected state.

> The draft statement said that the mutations, called E484Q and L452R, were of “high concern.” It said “there is data of E484Q mutant viruses escaping highly neutralising antibodies in cultures, and there is data that L452R mutation was responsible for both increased transmissibility and immune escape."

The findings were shared with the Health Ministry on March 10th, and publicly released on March 24th. This article notes that it is unclear if this report was ever sent to Modi. Interestingly enough, this Reuters article mentions many possible missteps or contributing factors, but also quotes a scientist who is careful not to place singular blame on anyone, just like the Indian Express article you linked:

> To be sure, some scientists say the surge was much larger than expected and the setback cannot be pinned on political leadership alone. "There is no point blaming the government," Saumitra Das, director of the National Institute of Biomedical Genomics, which is part of INSACOG, told Reuters.

This wave is showing that it was Dumb luck that made it possible to handle last year.

> It's easy in hindsight

In a whole year of time to prepare, with examples in numerous nations, who could possibly have fathomed that a rapidly mutating virus would evolve to overcome the immunological barriers presented in India?

Many people! Not only were experts and opposition members warning about a possible disastrously second wave, we even have district collectors who acted on such fears.

And it is apparent today, to normal people, that creating reserves of oxygen, vaccine and preparation was possible last year. It is entirely the failure of this government to instead have indulged in its beliefs of "naturopathy, homeopathy, unani, cow urine" and the rest.

Not to mention, this is Modi being hoisted on his own petard. He has built a system that bows to him, waits for his decisions and his action. He has built that image and acted according to it. He has weakened every independent body and applied pressure everywhere.

So if he is adding his image to COVID vaccine certificates, is it also not his charge to have protected the country from this disaster?

"If only 1.7m tests are being conducted per day, what can that 386,000 really mean? Is it that 0.0004% of the country has come down with the virus since yesterday, or that nearly 23% did? Obviously, the true number lies between those absurd extremes, but who knows where?"

Why is there not a proper estimate on how big a part of the population is infected? And with which strains? Surely with a randomized, representative survey you could find this out, instead of all this speculation? It also would give authorities better grounds for their decisions.

> It also would give authorities better grounds for their decisions.

The authorities need to do those studies or commission them. Instead, the authorities are busy politicising vaccine distributions (vote us in for free vaccines) [0] and polarising on religious fault lines.

The country has gone to the wolves.

[0] https://archive.is/dNYo4

In general it is quite hard to get accurate representative samples if there is an unknown or high degree of variance between locations (are you scaling up the right samples to arrive at an accurate estimate). As for knowing which strains, that would certainly be useful but it requires significant sequencing infrastructure, which is not easy to scale up. The Washington Post noted (https://www.washingtonpost.com/world/2021/04/29/india-surge-...) that India is #102 among nations in sequencing per capita. It notes:

> Sequencing takes a high level of infrastructure and funding. India, which spent very little per capita on health care before the pandemic, has not been able to quickly make the investments to scale up, said Gupta.

If I understand your calculation, it seems like the lower bound is around 0.03%, not 0.0004%.

Tests are not randomly distributed, but estimates of actual cases is 4-10x. It also varies by state. Some states have very active tracing and testing. Some are actually trying to undermine tests, death count.

This is happening everywhere in the world (except a few countries where most people are vaccinated and/or tested heavily): people ran out of money, goverments failed to help them, and at this point it's worth to take the risk of getting COVID for much more people than to stay hungry and get homeless.

Alternative explanation. In japan people dont care anymore and we are hit by a new wave which is definitely looking like a new peak of infections. Add to that absolutely no border control and lazy authorities and thats a recipe for things getting out of control.

What do you mean by “absolutely no border control”? As far as I know quarantine is required to enter Japan.

Not for japanese nationals

I entered Japan close to two weeks ago from Europe. Super strict and well managed border control. Passengers were supervised and escorted to a special quarantine hotel for the first three days of quarantine. After that they use an app on my phone to keep track of where I am. For 14 days I have to "check in" my location multiple times per day.

The place with no border control i Europe. Not Japan.

If only they did the same thing to Japanese nationals...

The 3 days quarantine is only for people arriving from a list of countries with a known mutated strain. It's much less strict if the passenger did not arrived from the listed countries ([1]; the one in the parenthesis, the table below is countries which PCR result is required).

Officially the rule is to be quarantine in the designated place for 14 days and to report everyday. However, the loophole is the designated place also includes your home, and if you happen to use LINE, the daily report becomes just a button press in the app. Location tracking is only recommended, not required. (The Japanese document on location tracking is just to enable location history on Google Maps or enable Significant Location on iPhone[2])

[1]: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryo... Note the English version of this document is very outdated (Mar 26, 2020 for the English version vs. Mar 21, 2021 for the Japanese version.) See [3] for a more up-to-date one, although in a different format.

[2]: https://www.mhlw.go.jp/content/000652555.pdf

[3]: https://www.mofa.go.jp/ca/fna/page4e_001053.html The list is in Section 2, in the (Note 1), with the most horrendous formatting possible.

... lucky there's no world sporting event that will congregate thousands of people from around the globe in Japan in a few weeks time.

They should have cancelled the Olympics to at least 2022... I hope historians don't look back at sports ball being the catalyst of third/fourth waves and stronger/newer strains all across the globe in 2022.

International spectators are not allowed at the Olympics this time. And there will be strict protocols for athletes. Not sure how this can cause such a massive new wave.

You think Japanese spectators are somehow immune to COViD?

Which countries have this happening?

I'm from Hungary (currently the top on the official list of deaths/millions of people), where people were so scared, that the first wave was almost non-existant. Now it's the opposite, though at least people are getting vaccinated aggressively, they just don't wait enough for the vaccines to get into effect.

Another example is my girlfriend who is from Colombia: people were very careful last year, but now there's a huge demonstration happening because of a proposed tax reform, which shows how desparate people are like, and how much it overwrites their fear of COVID. I'm sure that well see the results in the number of deaths in a month or two there.

Are you just from or currently in Hungary? Is the situation there deteriorating?

I'm in Mexico, but going back to Hungary in a few weeks to try to get my COVID vaccine. There's a soccer match tomorrow (I mean Saturday) with Fradi, the favourite football team of the prime minister, that's why he opened up the country more. Many people just go with it, as they just want to get back to normal, even though the vaccines that people got are not protecting yet.

His main goal is to open up even more to be able to organize EU soccer championship, that's why he's rushing ahead.

Viktor Orban wanted to be a professional soccer player when he was a child, but he wasn't good enough, and now the whole country is suffering because of his childhood trauma.

No. 40% of the population had at least 1 vaccine already. Death and infection rates are also declining.

Friends in Budapest tell me it’s getting better, but they recently opened up outdoor drinking venues for the first time since November and everything was packed, no distancing and no masks, so I hope it doesn’t backfire.

Interestingly, Hungary already has vaccine passports. Not sure if they’re used for anything but I’ve seen them, same size/shape as the national ID card, and chipped. A lot of my friends got Sputnik instead of AZ, they were offered a choice.

There's no chip.

https://www.google.com/search?q=v%C3%A9detts%C3%A9gi+igazolv...

It allows people to go to bathhouses for example. Also it grants exemption from quarantine and PCR testing upon (re)entry to the country.

Thanks, I stand corrected. Guess it’s chipless to be cheaper?

No idea! What would a chip do? How could people use the chip? Verify it? Then why not just make an app!? (Oh, one was announced in February, but absolutely no signal about it since.)

Corruption and competence rarely go hand in hand.

The whole plastic card thing is a shitshow. I got the shot at the same time as a friend. Same day, same hospital, same vaccine type. Said friend already got the card days ago, no word about whether I should have gotten one or what's going on. No way to ask it either. Only thing folks can do is send an official application for requesting the card, which in theory is completely redundant. But it costs nothing, so I sent one. (It's just a nice form on yet another gov site.)

I guess in the US they get a paper card with a CDC logo on it and a stamp for each injection, which will be trivially easy to fake for those who want post-vaxx privileges without actually getting the jab. Saw one on Insta today.

I’m in favor of a vaccine passport but I see a lot of chaos on the horizon as countries with high denialism (US, Germany) but also big outbound tourism and business travel, get real slacky about the passport-ness of it.

Is that going to be a serious problem though? (Not that I endorse it at all.)

The spike is big, but not dead people hanging from the trees big. Hospitals are well over capacity, staff is over-overworked, and there was a recent new change in the law that regulates healthcare workers. 5-6 thousand HC workers declined the new forced change, so even less staff available.

At the same time people are getting vaccinated, but the gross incompetence of the government doesn't help. (Just yesterday the website where people ought to schedule an appointment for getting a vaccine was offline day due to too much load.)

While the death/capita indicator peaked our wise leader opened the terraces of pubs and restaurants.

... I'm aware that a well ventilated terrace on a dry sunny day carries a relatively very low risk of transmission, but still. It's complete bollocks to do this without any contact tracing, any testing, etc. (That said, it's important to note that people were already not social distancing, but now it's trivial to get infected by total strangers, plus now those can infect a lot more random folks. Whereas before the opening at least people were able to do some informal checks and tracing.)

I am seriously worried where this is going. People don’t seem to take precautions (masks etc), the government doesn’t seem to care (they seem more interested in suppressing data/news). Unless you’re rich, Indian healthcare isn’t great even in good times. It is just not equipped to handle this bad of a situation.

This looks like chapter one of a giant disaster, only waiting to get even more worse

This thread is full of people pointing fingers at:

1. Election rallies

2. Kumbh Mela

3. Farmer Protests (Yes, they are still going on)

4. The government's incompetence.

And all of these are completely valid reasons. But does anyone living in the country really believe that these are the only reasons? There are still people who believe that Covid is a hoax. People who had not worn a mask for the last 6 months now wear paper thin masks in large crowds and expect to not get Covid.

My neighbor contracted Covid recently, but they have not told anyone about it. All of their household help is still coming. Some of the family members still go out to meet others.

This situation is really a reflection of the selfishness of the people. I have seen medium-sized business that cut salaries if employees take leaves due to covid. So these employees hide their symptoms and report to work. If you are doing any of these things, please self-reflect.

Yes. These are the major reasons not the "only" reasons. Sure, there will be a few percentage of people who are irresponsible, but we have to look at the big picture as well. Mass gatherings are far more responsible for the spread than a few people not wearing masks.

Absolutely, I am not trying to defend that stupidity here. Also, it was not a 'few' people not wearing masks. It has always been a few people wearing masks. And what qualifies as a mask for most people should really be questioned.

Well, if a country if full of people believing COVID is a hoax and wearing a mask is useless - what do you think you will get? You get exactly what's happening now.

wearing a mask wont do jackdiddly if you organize large gathering with 100,000 people.

Where I live (Germany) all of these actions would be illegal.

I think broadly speaking governments do a lot to set the tone of what's acceptable in the pandemic, by what they say, and what they do. A big government rally is powerful legitimation for being selfish.

From what I have read online, I would say that very few people in news media are blaming the farmers' protests (at least in international coverage), even though those protests are longer-lasting and larger gatherings than most of the others. What I am mostly seeing is Western liberals blaming the conservative government of a developing nation by pointing at election rallies (which only took place in a few states and were held by all parties), religious events (because liberals are often anti-religion or Hinduphobic), or the government (who actually has been highly competent in managing the pandemic overall).

I don't think there is enough evidence (yet?) to call any one factor a "key contributor". We simply don't know. People in India were increasingly mobile as their pandemic conditions improved into a low steady state (https://ourworldindata.org/grapher/changes-visitors-covid?co...). I am guessing that some combination of the things you listed, plus general increase in mobility, plus some new variant of the virus that spreads more easily, is what led to this situation. India went from normal conditions to hitting the previous peaks within a month, and that feels like something more than just a few isolated events.

> This situation is really a reflection of the selfishness of the people.

That might be fair to say in a developed nation that is wealthier. But in many other nations, people simply need to work or go to places where they are around other people. They don't have the infrastructure, wealth, and luxury of remote work or delivery services to just avoid society altogether or reduce society-wide mobility. They also don't have the same amount of home entertainment choices like streaming services or expensive video game consoles or whatever else. I imagine shutting down cities is a much more significant challenge in places that are denser than, for example, American cities, but without the same economies, standards of living, disposable income, and so on.

Deep down in the human psyche, I think we all believe that disease is a punishment for our bad behavior. So we always see comments saying it’s because of X or Y. But from what I’ve seen, this disease is very chaotic in its spread. So I think the discussion has to be less “it’s because of X” and more “things like X have increased the risk factor”

It seems that Indian medical fraternity is placing too much faith in Remdesivir and Convalescent Plasma. In some way it is similar to the Ivermectin fad in South Africa for Covid treatment. These treatments are not recommended by WHO, but medical practitioners prescribing the same is leading to scarcity and blackmarketing of the same.

As I see it there is total chaos in medical protocols for covid treatment, and this could be a significant driver in mortality in this wave in India.

Suppose I know of a number of people in India who have covid symptoms and difficulty breathing but cannot get treatment in any hospital due to overcrowding. As someone who lives in a Western country, what is the most effective way to help them?

I could simply send them money, but they might use it to bribe hospital staff for treatment, or outbid other people for oxygen cannisters. They would benefit but other people would lose out.

Maybe I should buy medicine in my home country and send it to them? Or maybe buy oxygen concentrator machines on Alibaba and have them shipped to India?

Maybe one somewhat-helpful simple thing you could send them would be a pulse oximeter. If they need to get to a hospital and can't get in, it won't help them much, but it might in some cases be helpful to at least have a thing that at least tells them if they're getting better or worse.

Another option is maybe send them a decent quality room air filter if they're in a city with heavy pollution, so it's one less thing for their lungs to deal with.

It's kind of a tough question; I'm neither a doctor nor have I been around anyone who has gotten Covid, so I don't really know first-hand what's most helpful.

Thanks mark for wonderful thought but money won't solve issues India facing. There are multiple problems. I think most important thing is to educate rural people about why they need to follow guidelines strictly. Many people refuses vaccines because they think it is elobrate plan to eliminate them. So education is the way govt.can move forward.

The comment wasn't asking how to solve problems for all of India, but how to help some people he knows who are in India.

For the most part, India's fate over the next month is sealed. It was like when people got really excited about making ventilators, they were already a month late.

Late reply, but Vox had a piece on this a couple days ago, "Here are the most effective ways to donate to help India": https://www.vox.com/future-perfect/22432413/india-donate-cov...

Ground reality-

* 400,000 new infections reported yesterday. Number of deaths is being suppressed- 10x more deaths than reported. Crematoriums everywhere are overflowing, yet only 3k deaths per day as per official record.

* Basic resources like Oxygen, Meds (Favipiravir, Remdesivir, Monitors), Hospital beds keep running out in many cities and towns. Everything is on sale for 2-10x the official prices. For example, Remdesivir selling for Rs 20,000 ($300) instead of Rs 2,000. Ambulances charging Rs 25,000 for a half hour transport, instead of Rs 2,500.

* Beds are a tragedy. People are dying in their cars (https://timesofindia.indiatimes.com/city/noida/no-bed-in-4-n...). Day rent for beds in nursing home corridors (yes, actual narrow corridors) are selling for an amount equal to the average monthly salary of a middle class citizen.

* The government organized election rallies and religious gatherings and overruled the concerns of many educated voices over the last 2 months. Lockdown in election bound states was only announced yesterday, once all rallies and multi-phase election was finished. Votes/Power over lives, that's the mantra. One head of state went as far as to pass an order declaring anyone posting stories of O2 shortage will be prosecuted and arrested. (https://www.telegraphindia.com/india/covid-up-hospitals-defy...)

* People have stepped up as the govt has abdicated responsibility, sharing resources on their stories and working all day to verify their availability by calling hospitals and crematoriums. However the scale of the tragedy is immense and people who could have been saved are dropping like flies. This wave is affecting 40, 50 year olds, without any comorbidities. Apparently the strain is a double mutant (mutation of the strain from UK), and now a triple variant is also being reported.

* EDIT- Also for the sake of PR, the central govt sent more than half the vaccine produced abroad. Apparently the concept of stockpiling and reserves isn't common knowledge with the Indian political elite. So today we are at a situation where we are importing the vaccines we had exported, as we are desperately short on stocks and there is no relief in sight. Only 1.9% of India's population has received 2 doses of the vaccine. Long story short, many people will die.

Agree with almost everything. Health care is collapsing around us.

10x death-undercount nationwide is probably not accurate. Major states like Maharashtra, Karnataka and Kerala are reporting close to accurate numbers. 2-5x nationwide is likely, with places like UP, West Bengal and Gujarat undercounting by 5-10x.

I hope and pray its not 10x and only 5x. You might be right about the state wise discrepancies, sadly don't think we will ever know the real picture, as even crematoriums are fudging records in many places. So much for being better than China.

Btw since this is HN, might there be a way to approximate the number of deaths from the size of one's social circle and the number of circle members who have passed away from covid?

There were similar claims last time as well. It seems Kerala reported 20k less deaths in 2020[1]. There might be disparity but saying 5x or 10x is too much.

[1]https://theprint.in/opinion/if-you-claim-indias-covid-death-...]

Say 1/3 of the crematoriums are seeing 3x dead on average nation wide. That'll be `1400m/(70*365)/3*2 == 36k` extra death per day which is 10x of official number..

[edit]: i used the same logic to predict the number for Wuhan in Jan 2020 which turned out to be fairly accurate

Basic resources like...(...Remdesivir)

I've been following this on social media, and the Indian desperation for Remdesivir struck me (now it seems to be for oxygen, sadly). It's heartbreaking, but also interesting to see how many people are desperate for the drug. Is this based on evidence? What's driving the demand: doctors or the public?

We've seen a similar craze for ivermectin in South Africa, and there was the HCQ craze in the US. It would be interesting to see if there are parallels.

Yes. If given early enough it has been shown to cut down length of stay and severity of disease.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

One big factor that is different in India than this time last year would be economic.

The incomes of your average person in India has declined due to the whole pandemic and can be seen here: https://www.statista.com/statistics/1111510/india-coronaviru...

That would in a country with many living day by day, be one difference over say this time last year, in which air-quality would of also been a factor as much as currently. Whilst not good, combined with a reduced nutritional intake, may of tipped the balance.

Also collapsing oxygen supply.. maybe simply with more stock and distribution capabilities the wave would have been less deadly.

The oxygen supply shortage is due to demand and whilst does not explain the increase demand and certainly would play into the deaths, it wouldn't be at the scale we are seeing as it is the increase in cases and the oxygen supply shortage is a product of the knock on demand and not a causality in that demand. Yes it is a factor in increased deaths, but not the major factor, which is increased numbers of infected.

How did it take so long for India to have a second wave?

Dynamics of the virus spread is quite interesting.

3Blue1Brown made a fascinating video about how an epidemic spreads: https://youtu.be/gxAaO2rsdIs

I'd say it's a third wave by now already

I would like to know this too. Why didn’t it take off last year and why now?

My prior is that the virus took time to evolve to be hyper-infectious in the local conditions. Fits timescale and may fit theoretical models (many suggest viruses become more infectious but less deadly - not sure if this is the case in India).

Would be great to see good research on this but it will take many months. Early reports and analysis are likely to be wrong.

Yes. In hindsight this type of analysis is obviously critical. Sadly it seems india only started focusing on improving sequencing in December 2020.

The US too [1] has been slow to implement large-scale sequencing efforts. We have the technology to track the virus more closely [2] [3] but seem oddly unhurried to deploy it widely.

[1]: https://www.statnews.com/2021/04/06/stem-the-pandemic-nation...

[2]: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/wast...

[3]: https://pubmed.ncbi.nlm.nih.gov/33468686/

> evolve to be hyper-infectious in the local conditions

I’ve never heard that idea before, very interesting. I wonder if we will figure out if certain mutations work “better” on certain populations, environmental conditions, etc.

How did it do that, while not just creating a regular second wave like most of the Western world?

Weather / season is what I've seen speculated the most.

COVID never actually went away. Just that the people and the government ignored it until it mutated to a deadly version.

> until it mutated to a deadly version

Do we know this, yet?

Do we have evidence that the virus has mutated into something more deadly? Such mutation is clearly not beneficial to the virus. My guess would be that the virus mutated into something with a higher R-0. Read more about the optimal virulence here: https://en.wikipedia.org/wiki/Optimal_virulence

Optimal virulence is kinda bullshit with rapidly evolving things on small timescales...

Sure, if a mutation that makes it give deadly miocarditis 50% of the cases pops up, that strain would have a clear evolutionary disadvantage ...but if a strain that gives 2x worse pneumonia (and maybe a 2x death rate, that overall is still low) with 4x more coughing evolve, it will have an evolutionary advantage, more caughing => more virus in the air etc.

So you absolutely can have viruses evolving towards increased lethality, as long as people infected with the new strain spread the virus more and don't die too soon... you won't get to smth. evolving its way to 80% lethality, but it can very well evolve from <1% to ...50% (scary!).

The whole optimism about patterns of viral evolution is 100% wrong, unless you're thinking at very large timescales, and in environments where humans have not added so many accelerator factors!

Of course it didn't go away. So you are saying that Western countries, that took all the Covid precautions, had an early second wave. However, a densely populated country that took very few precautions didn't have a second wave, but a deadly version months later? Do you have any references for the idea that India is suffering from a new variant of Covid?

For that matter, do we have any accurate information about the situation in India, except some choice photos in the media?

I think most of the pics, articles like this one are from Delhi. Which i think is in terrible shape. With cases not decreasing most hospitals would any way be stressed. But i assume it not terrible everywhere. My citie's Govt Hospital and Pvt ones are not over crowded or even anyway looks stressed as of now.

Also note that covid deaths are around 10-100x more than the official records. To be recorded as official death, the person should have tested positive and have died in a hospital. Home deaths are not recorded as covid.

There are also reports from my acquaintances that deaths from private hospitals in grade 2/3 cities are not recorded as covid deaths nor are deaths even in government hospital where a test could not be performed before the death of the person.

Two big reasons for this wave are

1) The kumbh mela with 5-12 million people gathering in a tiny spot. This was supposed to take place next year but was pulled forward to appease the religious hardcore.

2) Election rallies around the country.

Farmer protests are widely believed to be the biggest reason for the spread.

Not the case. The farmer protests have been going on for months and it won't be much of a protest if they all went back home and spread the virus.

Yet another attempt by the BJP IT Cell to divert the attention onto anybody but the BJP government.

They had a rotation policy. They clearly say it in all their interviews, how they are maintaining constant presence in the protests by rotating members every 4 - 7 days. See interviews on channels like Youtube channels like ScoopWhoop Unscripted, that tried to bring the farmer's point of view to the forefront. Let's not kid ourselves, the virus doesn't discriminate based on whether the gathering is righteous or not. Each and every gathering is a super spreader, be it a protest, election rally or a religious gathering.

The farmers protests are almost completely represented by people from 2 States. Even if they did go home and spread the infection the rate of spread is much lower in Punjab and Haryana.

I want them to handle the crisis well and be safe but the narrative that 'Farmer protests destroy India with Covid' needs to be debunked.

In trying to debunk one BJP propaganda, you are spreading another. The protest was not only by the "rich" farmers of Punjab and Haryana protecting their interests, there were protests joining from all neighboring states like Rajasthan, UP, etc., with demonstrating being organized country wide. The rate of spread is not lower in Punjab or Haryana. It's the same as rest of the country, just not as high as the states where election rallies and religious gathering acted as a bigger catalyst.

>It's the same as rest of the country, just not as high as the states where election rallies and religious gathering acted as a bigger catalyst.

Literally what I said.

I am not sure how "the infection the rate of spread is much lower in Punjab and Haryana" is the literally the same as "It's the same as rest of the country, just not as high as the states where election rallies and religious gathering acted as a bigger catalyst". To me that reads like saying the rate of infection is much lower than the country average.

I agree with you that larger mass gatherings have a clear responsibility. However, cherry-picking the farmers protest which was dissenting a government policy when there were multiple other events and a clearly clue-less government feels like government propaganda.

My point is not that farmer protests should be blamed. The blame and responsibility of this surge clearly lies with the government and ruling party celebrating `victory` pre-maturely. My point is that we should not propagate a wrong message that somehow the protests were immune from being a super spreader, making people think it is alright to continue being part of a mass gathering, whatever the cause.

If all this was obvious and the govt couldnt do anything about it, why is such a govt required?

Valid question that needs to be asked. Hopefully, this will wake up people from their populist fever dream.

Is there any source for this? I think the scientific consensus last year (at least in the US) was that big protests didn't turn out to be super spreader events

There isn’t. The protests were at their peak last year. If you look at the case growth, it begins in feb/March. Since case reporting tends to lags infection by 14 days, we know that they have nothing to do with the protests.

Sadly though, the protests continue even today, and I have not heard of any response from the govt.

However the cases explosion is not related to this event.

Bringing this point up sacrifices a chance to save india from future pain just to win political talking points to protect the culpable.

Cases lag events by 14 days. The spike was this year, the protests started last year. The cases didn’t even begin in those states that sent the most protesters. The current strain developed in Maharashtra.

The Govt and all Indians I spoke to throughout the year were complete unaware of how they had dodged a bullet.

Instead of being grateful and figuring out how to prevent it from ever happening again, our govt went ahead and said “we are invincible.”.

This is a behavior we cannot ever afford again.

If we didn’t know why we had such a mild first wave, we should have done everything to understand why and to take preventive measures.

Did Maharashtra had a Khumb Mela? Or an election rally? There is a reason they are being called super spreader, not super incubator. I think all of these replies are somehow missing my point. I am not saying that this one incident is responsible for our current state, it is the government. However, I don't think somehow excluding a mass gathering like the farmer's protest from the list of superspreader's is doing any good, it will just convince some people that the gathering for their cause is somehow invincible, as you right said the attitude has been for a majority of Indians.

By that criteria the migration last year when the abrupt lockdown was called would count as a super spreader event.

However the crucial need is for an event to actually spread the virus. Or more precisely, spread the variant that is currently adapted to india.

It did though? The migration worker did result in a momentary spike in their states when they finally reached their homes, especially after those special trains. Just the variant wasn't as deadly. I am not sure what your point is.

What are the sources of this claim ? A general consensus was the false narrative that claimed India have conquered Covid, resulting in people ignoring the safety measured cause this. https://www.nature.com/articles/d41586-021-01059-y

If you are looking for super spreader events its more likely the large election gatherings caused a spike.

Blaming a protest that was taking place even months before looks like propaganda.

Were people simply not gathering at all other than for election events?

The initial lock down and panic eventually made people deny existence of Covid, along with a narrative that Indians are immune to Covid. Later the leadership started claiming India already conquered Covid. https://www.livemint.com/science/health/we-are-in-the-endgam...

To answer your question, people were gathering for events other than rallies

Where does in the link he claims covid is conquered. He specifically says we are in endgame and to succeed politics should be kept out of the Covid-19 vaccination drive. There were too many guys questioning vaccination. Why twist the sentence?

> Where does in the link he claims covid is conquered. He specifically says we are in endgame and to succeed politics should be kept out of the Covid-19 vaccination drive. There were too many guys questioning vaccination. Why twist the sentence?

"Today, Covid cases are declining rapidly in India ... 18 percent of the world's population is in India, a country that saved mankind from a big disaster by saving its citizens from the pandemic."

That sentence is not there in the link. And it even does not say covid has ended. Let me paste a text from the article to say bad badly the op changed the meaning

He sad " We need to follow 3 steps: Keep politics out of the COVID-19 vaccination drive, Trust the science behind COVID-19 Vaccines, and ensure our near & dear ones get vaccinated on time."

Farmer protests were last year. Cases started spiking late/feb and march.

Protests would have shown 14 day lagged incrEase in cases in Punjab and Harayana, where the bulk of attendees came from. Those cases were not seen.

This idea is incongruous with information we have.

On the other hand The central govt has been declaring mission accomplished since last year.

I wouldn’t blame people for thinking that their respected leader was telling them the truth and acting accordingly.

Risk taking behavior is related to how the people on top act, especially in India which is today, a far more centralized nation.

Protests were in Jan/Feb. Cases rose April. Larger gatherings happened in March and April for elections and religion.

Please take your one sided narrative elsewhere.

Who believes that?

Farmer protests happened during December-feb, while COVID surge started in March.

Govt. is just blaming farmers for everything, instead of kumbh mela, lowering restrictions and election rallies

+ Holi + IPL + Mahashivratri

IPL has 0 attendance, hosted in bubbles. How are they spreading it?

People gathering together in public places to watch it.

Any evidence of that? From my anecdotal experience, each and every place in my town where such public viewing used to be organized was cancelled. I would believe that to be the case throughout the country.

> Also note that covid deaths are around 10-100x more than the official records.

So up to 350,000 people died just yesterday. And over the last ten days, up to 3 million people died?

While deaths are certainly underreported, it isn't helpful in a pandemic to throw random figures around.

Those numbers are based on the lack of crematorium facilities and the obvious queues of bodies lined outside for cremation. I know of at least 7 people dying in the last 7 days. The official numbers mean nothing anymore.

Can you please read my comment again? Please don't turn this forum into a political propaganda platform.

Political propaganda is the last thing on my mind right now. Here's some sources for the lack of cremation facilities.

https://timesofindia.indiatimes.com/city/delhi/pushed-to-the...

https://abcnews.go.com/Health/wireStory/indias-crematoriums-...

https://www.hindustantimes.com/cities/delhi-news/at-delhi-cr...

https://economictimes.indiatimes.com/news/india/104th-in-the...

This is not in line with only 3500 people dying all over the country. This is in line with the range the above comment mentions. My anecdote of people dying my inner circle is not political. Neither is my opinion that the official numbers are to be not trusted given the evidence.

Can you say the actual facts and/or calculations that lead to 10x? From what you've said, it could be that crematoriums were already operating just below capacity and are now just above capacity, causing growing backlogs even with only a very small increase in demand.

>From what you've said, it could be that crematoriums were already operating just below capacity and are now just above capacity, causing growing backlogs even with only a very small increase in demand.

Can't be the case throughout the country in all affected districts and all densely populated states.

You see reports of crematoriums running 24/7 and still not able to fulfill the demand for cremations and find it reasonable to land on any other conclusion but people are dying. I think I've presented enough.

Even NYT estimates the real numbers might be 10x reported, and I would also expect that to be a reasonable estimate. Roughly a quarter of the people I know tested positive in the past month, it's not possible with such a high infection rate only 3000 people die in a day.

https://www.nytimes.com/2021/04/24/world/asia/india-coronavi...

The UK peaked at ~1200/day, with a population 1/20th the size. That's "only" 24K scaled up, looking at India now it's hard to picture things as being only a bit worse than the UK peak.

My guess is that for a lot of processes, crematoria included, capacity is not some fixed number below which everything is fine and above which the backlog piles up.

It's like my parents' restaurant, you can get busier and busier without there being a wall. When you "hit capacity" you find you're doing many things that you weren't normally doing, like being open a lot longer, asking for longer shifts from staff, rationing things that you wouldn't normally ration.

Well, I am only objecting to unsupported numbers being thrown around. How do you go from "crematoriums being pushed to the limit" to 10-100X Covid deaths?

Extraordinary claims (such as up to 3 million deaths in ten days) require extraordinary evidence. My response, if you notice, was specifically about that claim. And I also did not fail to mention that deaths are underreported.

Are you objecting specifically to the 100? It seems clear enough to me that it's not supposed to be a very tight estimate. Would "an order of magnitude or two" be better? Or "an order of magnitude or more"?

And it definitely suggests that the amount of under-reporting varies by area, so it's even more unfair for you to multiply the entire country's number by 100 as your goalpost.

I am objecting to people making up numbers, when no such data is available. Like the parent post for instance, connecting reports of crematoriums being full to order-of-magnitude scale (10X or more) undocumented Covid deaths.

There are however, other reports you can quote:

- The Print (not govt-leaning) "If you claim India’s Covid death toll is 2x govt figure, it’s understandable. But not 10x" [1]

- NYTimes: Bhramar Mukherjee, an epidemiologist at the University of Michigan who has been following India closely. “From all the modeling we’ve done, we believe the true number of deaths is two to five times what is being reported.” [2]

In short, I strongly feel throwing numbers around without basis simply widens the chasm.

[1]: https://theprint.in/opinion/if-you-claim-indias-covid-death-...

[2]: https://www.nytimes.com/2021/04/24/world/asia/india-coronavi...

Well, I would agree that the actual death count is bigger than what is reported but 10x is a LOT and claiming extraordinary 100x is ridiculous unless someone gives proper evidence for that. All the shortages in crematorium facilities are really unfortunate but they are basically near Delhi region. Basing your overall 10x figure for the ENTIRE India on 1 region (granted it is one of the biggest in the nation) is not right unless you provide evidence for that. The figure in Delhi might be 5x-10x but for entire India? I don't know and one should definitely stay away from "I guess" or "I believe" in this situation unless you provide resources in my opinion.

https://www.nytimes.com/2021/04/24/world/asia/india-coronavi...

The lack of cremation facilities are reported throughout the country. It is not just about one region or the other. The under-reporting is reported in most places. The lack of tests in places like Kolkata shows that people even after showing symptoms can't get tested. All these point to the official government numbers being a fraction of the actual numbers.

In an environment where the government is under-reporting and the news reports are the only ones showing the ground reality we can only speculate the actual number for the whole country. We may never do. Until that we can only opine and point to the evidence we have.

As I said earlier, I'm not saying that there isn't under reported death count. I said we cannot say anything about entire nation based on currently reported cases. Those report point out to that region and may not be applied to the whole nation. Eg. suppose 4 cities have 5x under reported cases, we cannot expand that to the entire nation until we conduct thorough research first. On top of that the OP stating 10-100x is mind numbingly large range. My earlier point was respect to that statement. Claiming 100x under reported deaths is too large of a number that if you put a number on that, it would empty most of the cities in matter of a month which clearly is not a case AFAIK. So, throwing these random numbers based on one's own opinion is not right especially when it is presented as a statement.

I'm sorry to hear about the people you know dying. It's a horrible tragedy.

100x is not what I’ve heard but I’ve definitely heard of 10x the number of cases actually reported.

Sources are crematorium staff describing how many additional bodies they have to burn and epidemiologists.

From 15 to 100 as reported here by a crematorium worker. So slightly below 10x. https://www.ft.com/content/39ad9165-fc31-42ff-86d5-317d32ecf...

It's like a game of Chinese whispers where the multiplier keeps on growing everytime the number is mentioned.

Well that's an unfortunate phrase to choose.

While 100x is unlikely all over the country, it's surely happening in some places at least.

In my district of Kolhapur in Maharashtra, the district officials report 30-40 deaths per day, while official numbers stay at 1-3. That means the state is under reporting by 10x to 40x. And this is still counting only those people who, 1. died in hospital after being tested +ve for covid 2. did not have any comorbidity, as then they'd be classified under that comorbidity, however ridiculous it might seem(e.g. person dying of diabetes when infected by covid)

So actual numbers are likely to be much higher, given that all beds were full already last week itself.

Note that this is an opposition ruled state. Situation is even worse in BJP ruled states, where for example, 1. Tests are done only for few hours a day. 2. People are being charged with spreading misinformation for asking for oxygen cylinders on social media. 3. Deaths are being under reported heavily. 4. crematoriums are not accessible to reporters.

Hello, fellow Kolhapuri here. Maybe we can connect.

> Situation is even worse in BJP ruled states

I happen to live in Bangalore (BJP ruled). There's certainly no evidence of 10-40x underreporting of deaths happening here. I don't doubt at all that they're underreported though; but to a smaller extent.

Do you have any links?

I haven't heard of data fudging in Bangalore from media, so far.

Here are some reports about Gujarat[1][2]

[1] https://scroll.in/article/992217/as-the-dead-pile-up-in-guja... [2] https://caravanmagazine.in/health/how-gujarat-is-undercounti...

Do give credit where it is due, Karnataka state government has been quite transparent in reporting Covid data, and there isn'a a deliberate misreporting or suppressing. There is a even a telegram channel run by the government where Covid updates are provided at regular intervals.

There is a known lag in underreporting of infection counts in all Indian states except for a few. This is not being done maliciously - folks are struggling with uploading the infection and death count.

About Covid not being listed as cause of death in cremation houses - this is a definite problem in North India. Southern states do not suffer from this social stigma. Cause of death is being properly mentioned here.

Numbers are being significantly underreported. Although it might not be 10-100x everywhere. It is a mix. Some places it is 2x, some places it is 100x.

Have a look at this article to get a sense of the scale of the problem.

https://www.article-14.com/post/bjp-states-hiding-covid-19-d...

Multiple models predict daily new infections to be anywhere between 20 - 30x under reported (uni of Michigan and I think u of w) There are enough and more ground reports from various cities of data from crematoriums being >10x more than official counts

There is large scale, govt backed effort to not report in a few states for ex UP which is most populous - govt was directing labs not to take samples. and no admission to hospital as corona patient until you provide RTPcr test id(this is from a friend who's in the state capital and father's in the hospital now). Death rates 10x official counts overall wouldn't be surprising at all.

>So up to 350,000 people died just yesterday.

There were 200,000 cases and 1,200 deaths yesterday as per official reports.

Unofficially yes, more than 10,000 people died. Not sure where you got the 350k numbers from

Yeah right, Maharashtra had massive gathering for Kumbh Mela at Bandra-Worli Sea Link, and Delhi had election rally for Assembly elections and newly appointed CM Arvind Kejriwal had merely days to manage mess left by LG.

Kolkata has a 54% positivity rate now, and nobody is able to get tested due to lack of testing infra. Just because it wasnt reported, doesnt mean it didnt affect.

Sure now, but Maharashtra has been overflowing since early March when other states where there were no gatherings, didn't have cases. Point is, not single govt alone has failed. Pretty much everyone failed, including citizens like us who forgot precautions in January and February when cases dropped considerably.

I still see public ignoring safety norms like nothing has happened.

As for people running for hospitals, a primary reason (as per a doctor who treated my dad for Covid) is that people are ignoring symptoms for days (over a week at times) after which virus does enough damage that only option they're left with is getting oxygen assistance.

I agree with the first part, but the one with the biggest power center must also take the biggest responsibility. When the literal head of the nation gleefully boasts about the size of the election rally crowd during a killer pandemic wave, yeah, its on him.

>As for people running for hospitals, a primary reason (as per a doctor who treated my dad for Covid) is that people are ignoring symptoms for days (over a week at times) after which virus does enough damage that only option they're left with is getting oxygen assistance.

Hospitals will give the same protocol as people are following at home. In fact add the empathetic environment of home with proper food (compared to the sheer lack of care in any hospital right now), and people are recovering faster at home. Yes, there are many cases though where people had serious damage and they neglected to go early. Just saying this issue is complicated and I can understand why someone would hesitate to go to a hospital with 99F fever and slight bodyache.

The inaction of the government has much more impact. The government got complacent once the first wave receded, and didn't give heed to any expert opinions. There were reports that the Covid expert committee meeting itself didn't happen in past few months . In addition there was no concerted focus on vaccination, either to increase its capacity to cover majority of the population, or steps to dispel vaccine scepticism. In last few months except for the caller tune message one gets in mobile when you call someone, I didn't see any efforts to publicise the vaccination drive. These publicity efforts have stepped up now, and given the rampage now most of the people are willing to take vaccines but alas there is a shortage.

> but Maharashtra has been overflowing since early March when other states where there were no gatherings, didn't have cases.

And none these vultures in the media will talk about it because it does not fit their agenda.

I noticed a slow but steady rise in cases in Maharashtra since mid-February. A few reports suggested something was brewing in the Nagpur/Vidharbha region. No one paid any attention to it because of the war between the State and Center on the police corruption/extortion issue.

Soon, cases started appearing in Kerala and Punjab. Only THEN did other states start reporting cases in massive numbers. Did religious events and election rallies have an impact? Of course. But that came weeks later.

This is speculation and no better than saying all the COVID deaths are overinflated because they include anyone who happens to have COVID when they die.

Please see https://www.nytimes.com/2021/04/24/world/asia/india-coronavi...

Its not like people were not dying before Covid. Covid just increased the number of deaths. If you visited hindu cremation before covid you would have seen 2-3 funerals on a day(just based on my small city).

Bangalore i think now has the highest case in India. Kumbh mela or elections did not cause that spike or the spike all around India.

Per my experience(and seconded by local newspapers), crematoriums would allow the family to pick up the ashes on the next day. Assuming 8 hours for cremation(it takes less than that), this suggests that there was at least 2x the buffer available. Probably higher than that, as I've not seen(or heard of) all pyres being occupied at the same time.

This means in places where there is shortage of pyres, deaths must be at least 3x the earlier one.

Exactly. In fact, the under-reporting is closely linked to how well developed a state is.

It's unfortunate that even in these times, propaganda (from both sides) has completely taken over rational analysis.

How are these states getting all the home death numbers or deaths without covid tests?

But Kumbh happened in Uttar Pradesh while highest cases are being recorded in Maharashtra way before Kumbh happened. I'm against any social gatherings but this seems to defy logic , isn't it?

I'm really surprised from where someone forms conclusion of the reasons like these. Please see my comment to understand better.

> The kumbh mela […] was supposed to take place next year but was pulled forward to…

Not strictly COVID-related, but this was the first I'd heard of this and it sounded surprising to me, so I looked it up. I picked an older version of the Wikipedia article (from Nov 2019, just to rule out recent changes that may have been made because of COVID-19) and it (https://en.wikipedia.org/w/index.php?title=Kumbh_Mela&oldid=...) says:

> The weeks over which the festival is observed cycles at each site approximately once every 12 years[note 1] based on the Hindu luni-solar calendar and the relative astrological positions of Jupiter, sun and moon.

where [note 1] gives as reference a 2008 book that says:

> About once a century the Kumbha Mela returns to a site after eleven years. Jupiter’s orbit is actually 11.86 years, so after each twelve-year cycle it moves a little further into the sign, which the eleventh year celebration corrects.

Another 2019 book cited in the article is more clear, and its second chapter explicitly mentions 2021 for Haridwar:

> The Mela is organized when a specific astronomical combination (kumbha yoga) of the Moon, the Sun, and Jupiter occurs in specific zodiac signs. The Moon takes around one month (27.32 days) to orbit the earth during which it transits through the 12 signs. The Sun transits through the 12 signs in around one year (365.2425 days), the time taken by the earth to orbit the Sun. Finally, Jupiter transits through the 12 signs in nearly 12 years (11.8618 years), the time taken by it to orbit the Sun. The transit period of Jupiter being the longest—12 times that of the Sun and around 159 times that of the moon—the kumbha yoga for a location repeats when Jupiter enters the same sign again. This is why the Kumbha Mela is held once every 12 years at a given venue, as a general rule.

> The seventh Mela after six melas held in 72 years (each held 12 years after the previous one) is held 11 years after the sixth Mela, giving us seven melas in 83 years. The reason is that Jupiter completes seven transits of the zodiac in nearly 83 years (11.8618 × 7 = 83.0326), and moves to the next sign in the 84th year. This is why the Haridwar Kumbha was held in 1938 after 1927 and the Prayaga Kumbha was held in 1977 after 1966. The last Kumbha in Haridwar was in 2010 (1938 + 72), but the next one will be in 2021 (1938 + 83 = 2010 + 11).

I wonder where the idea of "was supposed to take place next year" comes from: my guess is that someone extrapolated the approximate "takes place every 12 years" and just naively added 12 to the previous year (2010) at the same location. These festivals are based on the assumption that a certain conjunction in the sky indicates a sacred time, to be marked by bathing in holy rivers etc. One can of course reject this notion entirely (and with it the festival itself), but it doesn't make much sense to treat the festival like a sports event or conference that can be moved around. The government of India can no more change the date of the Kumbh Mela than, say, the government of Italy change the date of Easter. All a government can do is restrict people's movements, etc. The accusation that crowds were allowed to gather obviously makes sense; not so much the accusation that the date was changed. (Incidentally, Wikipedia has multiple articles on the date of Easter: https://en.wikipedia.org/w/index.php?title=Easter_controvers... https://en.wikipedia.org/w/index.php?title=Date_of_Easter&ol... https://en.wikipedia.org/w/index.php?title=Reform_of_the_dat... .)

Is there a study that tells if the current wave is related to Kumbh Mela that was celebrated extensively?

No there's no such study. There has been a lot of focus on election rallies and Kumbh Mela in press, but it seems to be mostly due to people turning the tragedy of the second wave into a political opportunity to attack Modi. But Kumbh Mela is one event, and elections are only taking place in a few states. The reality is that India was handling the pandemic quite well through a policy of highly localized containment, and general mobility among the populace was increasing in response to improved pandemic conditions and the trickling of vaccines (although India gave away tens of millions of vaccine doses to other nations and hurt its own drive as a result of that generosity). I suspect that the reality of this wave is that many factors contributed - increased general mobility, some large events, and likely new variants that aren't well understood yet and may spread more easily. Prior to that, everything and everyone being blamed right now is just speculative and opportunist.

> But Kumbh Mela is one event, and elections are only taking place in a few states.

Kumb mela gathers tens of millions of devotees at a single point in the most densely populated state in the sub continent.

Just on April 14th 2021, more than 900,000 people taking a dip in the same river. The central government is the authority responsible to stop the event this year given the impending crisis, but only encouragement was seen from the ministers except that the event was cut short to 30 days instead of the many month ordeal it usually is.

> There has been a lot of focus on election rallies and Kumbh Mela in press, but it seems to be mostly due to people turning the tragedy of the second wave into a political opportunity to attack Modi.

> everything and everyone being blamed right now is just speculative and opportunist.

This thread is a testament to the aggressive brigading to deflect all blame from the Central Government. Contrarians spewing random questions to avoid focus on anything being discussed. It has been a pattern for the past half a decade now.

Nobody is denying that there are multiple factors and people responsible in the current crisis, but this line of excuses is a steady pattern of a concerted effort to deflect blame on the untarnishable image of a strongman Modi emanates. It happens on every crisis. every blunder Modi makes.

But Maharashtra had been seeing record cases even before Kumbh which happened in Uttar Pradesh. How come Maharashtra had those cases then?

If anything, the data suggests the contrary. They were testing people extensively in Haridwar when the event took place. The cases that were detected from the city during the time the festival was happening represented less than 1% of the total number of cases happening in India.

https://www.thehindu.com/news/national/coronavirus-over-1700...

> Medical workers conducted 2,36,751 tests over the five-day period in the mela site. Out of these, 1,701 came out positive for coronavirus.

For context, at this time, India was already registering over 200,000 new covid cases a day. The test positivity rate (<1%) from the mela site is also much lower than most other parts of the country (~5-10%).

Basically, covid had already spread so much in India by the time Kumbh Mela happened that the cases from there were only a drop in the bucket.

COVID has an incubation time of 7-14 days.

Why would people be positive at the event?

The amount of nonsense data coming out of India is just ridiculous.

> COVID has an incubation time of 7-14 days.

That's for symptoms. Covid is usually expected to show up in tests after 4-5 tests.

>Why would people be positive at the event?

The Kumbh Mela is not a one-day event. The event had already been underway for 10 days for the period under discussion.

In any case, testing data is available from Haridwar for the entire month now. Is this a fourth mutant of Covid that never shows up in tests?

I hate to bring up this point but I think it's not totally irrelevant.

India in general has a problem with hygiene and public health being compromised out of offending people's political / religious sensibilities, inability to follow rules and impose requirements on people, inability to lay down the law consistently. There's just a little too much democracy in this country.

Hygiene of people preparing food and in daily life (for many) -- not good. Regulatory oversight -- not good. Animals wandering the street, garbage thrown anywhere, pollution of water supplies for religious rituals -- not good. Agricultural fires allowed to burn for fear of clamping down on farmers -- not good.

And you see people in government saying meaningless assurances that the wave of infection will pass -- not good.

This sums it up:

India’s devastating second wave was fuelled by a series of crowded events, including mass rallies addressed by Prime Minister Narendra Modi [0].

> Fuelling the catastrophe was a series of crowded events, like mass rallies by politicians such as Prime Minister Narendra Modi, religious holidays and pilgrimages on the Ganges river.

> As governing Bharatiya Janata Party (BJP) ministers, including Modi, touted victory over the virus, people relaxed their vigilance and stopped wearing masks and maintaining social distancing.

[0] https://www.aljazeera.com/gallery/2021/4/29/indias-deadly-vi...

But those rallies were conducted in West Bangal and highest COVID cases are in Maharashtra. I'm definitely against these rallies but logic seems to fail us here, isn't it?

Any Modi/BJP (or otherwise government permitted) rally anywhere sends the signal that people can be more lax.

Even if they're in two opposite ends of India? Also, I don't want to take sides, but all other parties rallied during elections so why single out BJP? Once again, I'm strictly against these gatherings and I firmly believe that they should be banned without delay but this selective outrage is rather obvious that the agenda or the narrative is something else altogether.

There very well could be a selective outrage, but I'm almost as far removed from this as possible. HN as a groupmind usually scolds the official government, because the assumption is that they have the most effective control over behavior of people.

I simply said that Modi/BJP is responsible wherever they are.

Of course the other parties are responsible too.

And we can simply apply the Spiderman rule: more power, more responsibility. Modi is the PM, BJP is the ruling party. (And yes, of course in some states BJP's influence is lesser than some other party's. And there the responsibility of that particular party is greater.)

On top of all this it also depends what was the rhetoric of the other parties. Were they also loudly claiming victory over the pandemic? Naturally Modi trapped himself into a bit of a corner with that. (Even if facists can usually disregard/bend reality, but we shall see how the electorate takes this dissonance.)

A certain section of western media is distinctly biased against the ruling party. So there seems to be a lot of marketing for a certain point of view, nudging the facts aside.

Might be because BJP is a right-wing nationalist party.

any data to back your statement? I'm genuinely curious as to how one label a political party as right or left wing? BJP is a nationalist party no doubt about that though.

Testing per capita is not same across the country. Maharashtra has been doing a lot of testing. I have been in touch with my friends in UP and it is really hard to get tested there. So the current official numbers are not accurate there.

It is very unfortunate that a single guy using one single resource is creating a false narrative about an entire country and is misusing this forum to spread false narrative. While even scientists are puzzled on the cause [0], a few like the above commenter for sure knows the causes conclusively

India unlike U.S. and other western countries needs more careful analysis due to its diverse nature, larger informal economy and lack of proper data collection practices. Any simple attribution like the commenter is doing is simply false narrative

1. Anyone who has been tracking India covid cases closely knows, the most affected and contributing (72%) states for the second wave have been Maharastra and Kerala [0]

2. And, as second wave picked-up just 6 states contributed to 86.37% of new Covid-19 cases as per the data tracking [1]

3. Why did it spike in Maharastra ? Read [3] & [4] Importantly note the point on variant "This surge has started from Vidarbha, and it is hard to believe that mutant variants didn’t have a role to play"

4. Now, lets talk about variant found [4] "Two leading experts recently contended that a new coronavirus mutant strain was reportedly detected in Amravati, Yavatmal, and Akola, all in the Vidarbha region in the eastern part of the state"

5. Above comment talks about religious event which is kumbh mela which took happened in Haridwar, Uttarakhand state. Do you see the state in any of the listed states contributing to the raise ? No. Let's put today's status, is that state even in the top: 10 [5]

6. And do you know you need a permit and negative covid test report to participate in this religious event ? [6]

7. He talks about Narendra modi rallies. Seriously ? He took rallies in the states where elections being conducted by Indian election commission, like all all other political parties he has to support his party. This is saying like Biden cannot take election rally while Trump goes on giving daily speeches. Importantly, do you see the state of Westbengal where election allies happened in the top ?

8. As Maharastra went into curfew, poor migrant labor mainly from Bihar and UP and people from other states rushed back home and there is no data how this might have affected

9. Did BJP declare victory over virus ? Yes. But there is no scientific or data based attribution of spike Or the commenters indirect attribution of peoples laxity and not wearing masks to victory declaration is misguiding

[0] https://www.scientificamerican.com/article/indias-massive-co...

[1] https://www.thehindu.com/news/national/coronavirus-updates-f...

[2] https://www.hindustantimes.com/india-news/6-states-contribut...

[3] https://indianexpress.com/article/explained/explained-why-is...

[4] https://timesofindia.indiatimes.com/india/maharashtra-hits-1...

[5] https://www.business-standard.com/article/current-affairs/ne...

[6] https://www.covid19india.org/

[7] https://www.ndtv.com/india-news/kumbh-2021-limited-to-30-day...

>6. And do you know you need a permit and negative covid test report to participate in this religious event ? [6]

We dont have capacity to test the number of people who were attending the Kumbh mela daily. 10k tests may be the capacity appx, while appx 10 million people will be attending over a month.

https://www.hindustantimes.com/india-news/over-9-1-million-p...

Please understand India as reported by media is way different from the ground reality.

https://www.downtoearth.org.in/news/health/kumbh-amid-covid-...

> We dont have capacity

By we, do you mean you personally? Or do you have the entire state machinery reporting to you.

You keep talking about ground reality. You mostly seem to be adding to the chaos.

Maybe when all this is over, have the government setup a commission to investigate negligence, profiteering and other acts but how exactly are you helping anyone by spreading more panic

>7. He talks about Narendra modi rallies. Seriously ? He took rallies in the states where elections being conducted by Indian election commission, like all all other political parties he has to support his party. This is saying like Biden cannot take election rally while Trump goes on giving daily speeches. Importantly, do you see the state of Westbengal where election allies happened in the top ?

He is the head of the nation. The larger the power center, the larger the responsibility. This guy literally boasted about the size of the crowd less than 10 days back, in the bang middle of the pandemic.

He deserves to be tried for murder, as well as the election officials.

> negative covid test report to participate in this religious event

It depends on the type of covid test, if this is going to be useful. Tests range from negligible error to significant false negatives.

> 6. And do you know you need a permit and negative covid test report to participate in this religious event?

Well if this were true, how were hundreds of people there found to be infected [0]? In any case, there was absolutely no need to allow it at a critical time like this. We're probably very lucky that the event did not end in absolute catastrophe, like it very well could have.

[0] https://www.bbc.com/news/world-asia-india-56742231

> 7. He talks about Narendra modi rallies. Seriously ? He took rallies in the states where elections being conducted by Indian election commission, like all all other political parties he has to support his party. This is saying like Biden cannot take election rally while Trump goes on giving daily speeches. Importantly, do you see the state of Westbengal where election allies happened in the top ?

Yes he was not the only one conducting mass rallies but as the leader of the nation, was it not his responsibility to set an example in the country's fight against covid? Should we not hold the Prime Minister to a higher standard? Yes, every party held mass rallies and shame on all of them - it does not excuse Modi though.

He has a termendous fan following in India ready to do what he says (lighting lamps, clanging vessels) - he just does seem to be able to channel that devotion into something positive.

This is a narrative to protect a naked emperor.

The vidarbha strain is also spread through out the country, and its not like the same mutations cannot appear elsewhere independently.

The most populous state in India, UP, with 220 mn people, the worst medical infrastructure has better numbers than maharashtra. However having a Chief Minister who has gone ahead and threatened people for asking for help and even arresting/threatening journalists.

This was a preventable apocalypse. Modi spent all of last year talking about how India is self sufficient and we are magnanimously helping other nations.

The promoted cow urine, homeopathy and naturopathy when those resources could have been used last year.

The Major religious events were brought forward. When 8 phases of elections were allowed and the opposition asked for shorter elections, the BJP was the one who objected.

The data has been intentionally fudged to leave governments, local and central looking better and the most partisan calculus has been at play when the center decides who gets help in the states.

> When 8 phases of elections were allowed and the opposition asked for shorter elections, the BJP was the one who objected.

The 2011 elections were held in 6 phases.[1]

The 2016 elections were held in 6-7 phases.[2]

Why should it be any different this year?

If everyone was so concerned about the pandemic, they should have requested that president's rule be declared in Bengal till the pandemic is over.

Every Indian knows how violent Bengal elections generally are[3] and how voters are intimidated. Hundreds of BJP political workers have been terrorized and murdered in Bengal over the last few years.[4]

When it comes to the Bengal elections, COVID is just an excuse. Shorter elections with reduced security is a nice way to murder democracy.

1. https://en.wikipedia.org/wiki/2011_West_Bengal_Legislative_A...

2. https://en.wikipedia.org/wiki/2016_West_Bengal_Legislative_A...

3. https://www.thequint.com/news/politics/polling-advances-in-b...

> Taking advantage of this slackness, some state police personnel and TMC supporters became active in pressuring rural voters and taking recourse to unfair means. The most serious incident of TMC intimidation occurred in Shalboni’s Adharnayan villages where about 100-150 ruling party activists attacked some journalists and the CPI(M) candidate Shaymsundar Pande.

> According to reports, the TMC goons beat up Pande and the media persons, snatched away the camera of one news channel, damaged vehicles and tried to set fire to a few parked vehicles. The reports alleged that CPMF jawans stood by without taking action against the TMC cadres. Despite repeated appeals to rescue the journalists, the jawans did not move.

> Additional reports suggested that in Nayagram area under West Medinipur constituency TMC workers threatened villagers with dire consequences if they dared to leave their homes to cast their vote. The villagers complained that since they were BJP supporters they were ordered by the TMC workers and state police personnel not to leave their homes. The BJP candidate there was also similarly threatened by them. In Taldangra, Bankura, a state police assistant sub-inspector was seen taking bribes inside a polling booth.

4. https://indianexpress.com/article/india/amit-shah-in-west-be...

There wasn’t a pandemic in those years.

Modi is responsible, but not due to rallies and religious festivals. Surge in cases weren't related to these events.

The trend lines were rising a month ago and government was waiting for someone sort of miracle to change its direction.

No one really knows why cases in India fell to such low numbers and why they increased suddenly.

I want to add that the overall chart shows that there was a small bump in, an uptick around 19th feb. However this trend was only actionable in a better data oriented environment.

People explained away or ignored that small bump.

Hello, It was election time in few states and all parties organized rallies not just Modi. I'm from Kerala, India.

I would not really take AlJazeera as a un-biased source. For one, in the article above, it mentions the massive rallies by the ruling party, BJP, but does not mention anything about rallies by other political parties, like Congress, TMC and others.

A google search highlights only rallies of BJP.

I found only 1 site that talks about other rallies.

https://www.hindustantimes.com/india-news/all-bengal-rallies...

If you're claiming AlJazeera is biased and then linking the Hindustan Times, then I question your perception of bias.

For an American audience, this would be like saying MSNBC is biased, here's an article by Newsmax or OANN.

For all practical purposes Al Jazeera is Fox News. Who takes them seriously in the US?

Just in case, here is Arundhati Roy in her own words[1]. She is one the brightest activist voices from India. She paints a haunting tale of what’s been happening in the past year and beyond leading us to today.

  > “Let’s try and not be a cry baby.” — Tushar Mehta, India’s solicitor general, speaking for the government of India

[1]https://www.theguardian.com/news/2021/apr/28/crime-against-h...

Probably due to opening of schools and colleges across country. That's why it's hitting young people harder.

A friend went to a presentation about covid.

There they said that lead in the air ( eg. Car heavy cities) had a direct consequences on covid particles that get more and deeper into your body.

So cases there would be more severe.

( It's 6 months ago that i heared it and didn't hear any research about it. It does make sense when India has it worse)

i've heard many people talk about the catastrophic situation in india, and yet i see numbers of 4k deaths a day.

Which is a lot, but still way below what for example france had at the pic last year ( 1k a day, for a 60 millions people country).

Is there something i'm missing ?

The 4k number is the official number which you cannot trust, it will be more than that, some comments here are saying its 2x - 5x the official number.

I still tend to think that this can most easily be explained by the fact that India hadn't been hit hard up until now and that a lot of people started to believe magical theories about how they were immune, and now we're just seeing the virus ripping through high population density cities and overwhelming the health care system.

If you want to talk about variants, though, then there's a couple of things to consider. The first is that the "avirulence" theory that pathogens evolve to become less virulent over time was pretty decisively falsified in the 90s, so forget everything you think you know about that idea being true. There is a fairly well-studied tradeoff which has replaced that between transmission, virulence and in-host viral replication. That doesn't suggest the direction of evolution though. However, there have been studies of incomplete vaccination and immunity which suggests that it actually works to increase selection pressure for higher transmission variants and for virulence. This intuitively makes sense since as, say, half the population has immunity that increases the pressure on the virus to increase its fundamental transmissibility since an R0 of 3.0 will no longer be anywhere near as effective -- and the mechanism to do so is to just increase viral load and thereby increase virulence and kill more infected.

And this may have been observed in 1918 with the more lethal later waves of the pandemic which affected younger people. That virus later evolved into seasonal influenza, probably as a result of widespread immunity producing pressure for immune escape variants which came at an overall cost to fitness by mutating all the epitopes on the surface proteins so that it could re-infect already immune individuals. That will probably happen here as well, there'll be a limit to how virulent and transmissibile this virus can get and it'll have to start making costlier immune escaping mutations eventually -- but in the short term I wouldn't be too surprised if we start to see a lot of dead younger people in third world nations that don't have as much access to vaccines going forward.

But at any rate, none of this particularly matters. The lesson is still all the same which is to lockdown and avoid catching and spreading the virus until you have a chance to get vaccinated. Which is what it has been all along. People still try to argue with the virus and engage in magical thinking about how certain populations have magical immunity to it, but that continues to keep getting falsified. India most likely just got lucky that they didn't get hit early, then the prior wave they had was their "seeding" wave which was likely just tamped down by people voluntarily taking precautions. Then based on their success everyone dropped their guard and thought it would all be over in 2021 and the virus just took advantage of that.

People in the US who are vaccine-hesitant should also consider that if they've managed to not catch it so far and develop any immunity that you really want to avoid rolling the dice with later versions of the virus. Also it should be noted that while the virus kills a lot more people over 80 that the doubling rate of fatalities is every 8 years of age while the doubling rate of hospitalization is only ever 15 years -- so a 40 year old person is 32 times less likely to die than an 80 year old, but they're only 6 times less likely to be hospitalized (although it falls off a cliff once people get under-20 and the very young are much less likely to be hospitalized). The way that American culture is so focused on our mortality to the exclusion of all other outcomes means that we're heavily discounting the possibility that we could survive the virus but be physically crippled by it.

> "Virulence evolution and the trade-off hypothesis: history, current state of affairs and the future." > https://onlinelibrary.wiley.com/doi/full/10.1111/j.1420-9101...

> "The Origin and Virulence of the 1918 “Spanish” Influenza Virus" > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720273/

I have had multiple Indian co-workers (from our Chennai office) test covid positive and get sick. Young healthy people.

Don't need to be panic and also don't create panic. We at tamilnadu India has solution via traditional siddha. Acalypha indica ( 7 leaves ) and pepper , to be boiled cup of water until one third. Once in three days.

It's very clear that we destroyed our ozone and polluted , so it's nature turn to set it back. One such act is this Corona worldwide......

so let's get back to minimal life style and reduce consumption, stop polluting etc.

Please tell me you forgot to add a sarcasm tag.

You have no idea bud, just because this is HN doesn't mean people dont believe in BS. He might be serious too, how else do you think Patanjali products have a good market in the cities otherwise.

https://archive.is/jJB4A

The first lockdown in early 2020 was very well timed, and ruthlessly enforced using police violence on a massive scale. The streets looked like something out of 28 days later. The lockdown was executed on a national level. Freedom to travel between states was curtailed. Freedom to gather together was curtailed for 1.3 billion people.

As a result it was very effective. We never experienced the full brunt of Covid infections and deaths. We used to look at European and American news and wonder why we haven't seem to have been affected much at all. Most people, including myself, started to think that maybe there is something in the climate, and something in our genetic makeup that makes us less susceptible.

This time, the Central government has refused to do any sort of national lockdown. Travel between states is totally open. States are also careful not to restrict too many liberties,since business disruptions greatly deteriorate the state's revenue. It also pushes people to the edge of starvation and desperation. People are not as careful as they were the last time, because of the previously mentioned superiority complex. The result is what you're seeing.

The problems with oxygen and vaccine availability are another problem. But that is true for almost anything else. The government imposes very high taxes on any kind of machinery or anything that is used in manufacturing or construction. On top of that there are very tight controls on movement of material. You have to apply for a license from the central government for any item that you are moving across state lines. The truck driver who transports your product will be stopped by police at various points, and he will have to pay them off to be able to continue. In this way, the market is heavily distorted, and natural flow and ebb of supply and demand is subdued. That's why, despite having more than enough oxygen production in the country, we couldn't transport it where it was needed. That's why despite having the world's largest vaccine manufacturer, and several indigenously developed vaccines, we are still waiting to be vaccinated.

It is very unfortunate that some are creating a false narrative about an entire country and is misusing this forum to spread false narrative. While even scientists are puzzled on the cause [0], a few commenters here for sure knows the causes conclusively

1. Anyone who has been tracking India covid cases closely knows, the most affected and contributing (72%) states for the second wave have been Maharastra and Kerala [0]

2. And, as second wave picked-up just 6 states contributed to 86.37% of new Covid-19 cases as per the data tracking [1]

5. Some comments talks about religious event which is kumbh mela which took happened in Haridwar, Uttarakhand state. Do you see the state in any of the listed states contributing to the raise ? No. Let's put today's status, is that state even in the top: 10 [5]

6. And do you know you need a permit and negative covid test report to participate in this religious event ? [6]

7. They also talk about Narendra modi rallies. Seriously ? He took rallies in the states where elections being conducted by Indian election commission, like all all other political parties he has to support his party. This is saying like Biden cannot take election rally while Trump goes on giving daily speeches. Importantly, do you see the state of Westbengal where election allies happened in the top ?

8. As Maharastra went into curfew, poor migrant labor mainly from Bihar and UP and people from other states rushed back home and there is no data how this might have affected

9. Did BJP declare victory over virus ? Yes. But there is no scientific or data based attribution of spike Or the some commenters indirect attribution of peoples laxity and not wearing masks to victory declaration is misguiding

[0] https://www.scientificamerican.com/article/indias-massive-co...

[1] https://www.thehindu.com/news/national/coronavirus-updates-f...

[2] https://www.hindustantimes.com/india-news/6-states-contribut...

[3] https://indianexpress.com/article/explained/explained-why-is...

[4] https://timesofindia.indiatimes.com/india/maharashtra-hits-1...

[5] https://www.business-standard.com/article/current-affairs/ne...

[6] https://www.covid19india.org/

[7] https://www.ndtv.com/india-news/kumbh-2021-limited-to-30-day...

>a few commenters here for sure knows the causes conclusively

The hubris has been around here for as long as you have.

So you mean to say just because other parties are having elections, PM can dump his responsibilities as a PM and run without a mask into the rallies and have thousands of gatherings? Afaik Biden was against rallies and was quite vocal of that. Modi didn't even had a problem, he went smiling. When you talk about Khumb, you talk of it as it is a local event. The visitors to Kumbh are from nation wide. One person can easily infect 30 people and which can spread exponentially there. Yeah right they have a permit, but how strictly was it enforced, was the authenticity of reports validated? There were images of people in it without wearing masks. The truth is they let their guard down for elections and the style of current govt is PMO centric decision making, so it made matters worse in no time. I have yet to see a person like "Dr Fauci" in US appointed with sole responsibility to tackle the situation, and take the spotlight of decisions, questions and instructions rather than a person who "talks" one way thru a radio show and asks to bang plates and light candles to scare the virus away.

Absolute clusterfuck it is right now in India. And thank you international media for bringing this to light.

This could've been averted if the government wasn't busy promoting quackery [1], pandering to astrologers and hardliners by organizing a massive religious festival in the middle of pandemic [2]. And they did fuck all to improve the medical/oxygen infrastructure for the past one year and are promoting fake news that puts the blame squarely on provincial governments. [6]

Our supreme leader Modi was busy canvassing and praising crowds attending his rallies as recently as 17th April while the country was burning. [3]

Modi's heir in the making who has the potential to make him look like a saint has recently threatened to file cases against people and seize their properties if they take their grievances to social media.[4]

And even now, the government is more concerned about their image than controlling the situation. And the establishment's toadies are busy online(I see a lot of them here too) defending their dear leader even now with the same enthusiasm they show to credit him for anything positive.

The people are to blame too ofcourse for relaxing but what can we expect when the leaders at helm proclaimed the pandemic is over.

PS: I had to post this from a newly created account cuz I wouldn't want this to weigh against me when I apply for a passport. [5]

[1] https://www.bbc.com/news/56172784 [2] https://science.thewire.in/health/leaders-listened-to-astrol... [3] https://www.ndtv.com/india-news/west-bengal-assembly-electio... [4] https://thelogicalindian.com/trending/yogi-adityanth-oxygen-... [5] https://thenextweb.com/news/this-indian-states-police-force-... [6] https://www.thequint.com/news/webqoof/no-centre-did-not-allo...

Is there a paywall bypass for this? I wish HN would ban links that require payment/registration.

No JS, no cookies works for the Economist, or you can use an extension for paywall bypass:

https://github.com/iamadamdev/bypass-paywalls-chrome

https://archive.is/2021.05.01-051853/https://www.economist.c...

For this and many sites that rely on JS for their paywall try putting remove-js.com/ in front of the URL like this:

https://remove-js.com/https://www.economist.com/diary/2021/0...

wow this is such a cool hack

Doesn't work for me, I get an Access Denied page served by Cloudflare.

Do you also work for free?

If you cannot pay, just dont read the article or use some workarounds.

If there's a workaround, it's allowed. Users usually post workarounds in the thread.

This is in the FAQ at https://news.ycombinator.com/newsfaq.html and there's more explanation here:

https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...

https://news.ycombinator.com/item?id=10178989

God save Indians from Modi regime; He is charging 28% TAX on vaccine;

"He who will not reason is a bigot; he who cannot is a fool; and he who dares not is a slave" --Sir William Drummond https://en.wikipedia.org/wiki/Public_image_of_Narendra_Modi

Are we going to have a India second wave discussion every single day?

How is this "hacker" "news" @dang .. it's only unnecessary political bickering about how bad the government is from a bunch of India haters. Same talking points imported from Twitter everyday.

You're downvoted so much that I can't even read the text anymore. Lol. Good luck trying to defend your country against Westerns who denied sharing their vaccine formulas with India and left it to rot.

We've banned this account for using HN primarily for political and nationalistic flamewar. That's not allowed here, regardless of which politics or nation you're battling for. It destroys this site for its intended purpose.

https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...

https://news.ycombinator.com/newsguidelines.html

That's not an accurate description of the thread, except in patches where people have been starting and fighting political flamewars. You're right that that's not ok here. Your account shouldn't be doing it either. We ban accounts that use HN primarily for such things, regardless of which side of whatever flamewar they're on. We don't care what color the flames burn—we care about not burning.

https://news.ycombinator.com/newsguidelines.html

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