Why is India having a Covid-19 surge?
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On the other hand, if we're worried about variants then I hope there are some hard conversations happening about what the strategy here is. Part of what went wrong at the start of COVID around March 2020 was the reactive approach waiting for hard proof that the disease would slip through the borders before cancelling flights. This approach runs a risk that any action will be taken too late.
To be honest, I'm confused by the amount of air travel that is still going on. If locking down large swathes of most countries is on the cards, why is there any air travel happening? Why was there a high profile diplomatic visit to India being planned? Are the benefits from all these plane trips really outweighing the costs? We may as well be trying to evolve COVID to sneak past quarantines.
How is it acceptable to scuttle the economy in response to COVID, why are there still plane flights 12 months in to the pandemic? Someone fill me in on what I've missed; this seems to be not taking the situation seriously. Are these variants not going to be travelling between countries by plane and ship?
Yet, while air travel is down significantly, it's not that far down. Certainly not the 95% decrease it is in my circle.
ADDED: And there are still basically no in-person tech events. Maybe in the fall though I'm skeptical that will happen. And where I work, you basically need high-level exemptions to meet with anyone physically for work purposes.
Among friends I know, that I am the most strictly adhering to lockdown rules, even going beyond what the rules are. I don't visit people, I avoid being visited (even whatever number of people is allowed visiting each other. Just because one can, does not mean it is a great idea.) I try to tell close ones to avoid visits. Many days I don't leave the house or premises, which of course I can only do, because of being able to work from home. Many people at least need to go to work, that much I understand. This goes on for a year or so by now, in which I have once met one friend outside for hiking.
Yet I know people, who I thought were smarter or had more self-control, who travelled. To me this is bafflingly selfish. Is their vacation travelling really more important than people around them, family members included? What if they catch a new variant, perhaps even one which goes undetected? (I don't know if that is biologically possible with the tests we have.) What if they have no symptoms but spread it to others? Are they ready to carry the responsibility for someone suffocating? Why do they need to go on vacation every year, no matter what is happening? What is the reasoning behind their actions?
I guess these thought and questions are not on the menu for many. Too uncomfortable to think about that. I guess I am quite extreme in my isolation. Probably easier for me to do than for others, because of pre-existing social isolation and being used to little social contact. However, what I also think is, that if more people avoided unnecessary contacts, travelling and such, we would be in less trouble than we are now.
The whole thing changed my view of some people I know. Not much to the better, I am afraid. Perhaps I am a person with especially low requirements of my world, as long as I have a computer with Internet access, food and running water. I guess it is hardest for the people, who have a huge contrast to the before pandemic time.
Blaise Pascal, Pensées:
> All of humanity's problems stem from man's inability to sit quietly in a room alone.
I thought this must have been wrong with how distinct of a thing Indian English is but apparently it's true, albeit India still contains the second largest English speaking population at ~10% of 1.37B.
I think essentially all the data we have indicates that there is a surprisingly low rate covid transmission on airplanes and airports. (You can be worried that the data is being provided by airline companies who are biased, but at this point I think you have to postulate a pretty big conspiracy in order to explain the consistent signal.) Assuming that's true, it means:
1. Your concern should be with any method of travel, not air travel per se.
2. Your concern should be with travel between areas with very different rates of covid (or of different variants), not travel in general. If an infected person in country A swaps places (through flight) with an infected person in country B, nothing has changed regarding covid transmission.
The U.S. was extremely slow to restrict travel from India. Are many people traveling to the U.S. from India via car, bus, train, or boat? Flights are the concern because that's how people travel between continents.
> Two more cases of the Variant of Concern VOC-21JAN-02 (P.1) have been identified in England – one in the West Midlands and one in Haringey, London.
When the varient crosses a border, it is highly likely it will cross by plane or boat. The worst case outcome is mass lockdowns. I have some faith that it is easier to detect COVID on sea voyages because it is slower and I assume less volume of people, but air travel is a different story. What are the risk-rewards of this air travel?
In 2020 I faced things like being forbidden from leaving my home & my parents potentially dying (they didn't). These were issues faced on a mass scale. I'd like to know how important all this globetrotting is relative to those pain points.
I suppose I'm open to shutting down passenger travel by boat if the numbers are there.
Because the virus is more than an order of magnitude less dangerous than initial estimates, but we are stuck with the legacy decisions made back then in a political environment where admitting you were wrong is seen as suicide. This is why each successive "lockdown" has basically been "do like last time, but more half assed." The reality of the situation is that the virus has a mortality rate of around 0.3% of which half are over 80. This is just not worth shutting down large swathes of the economy indefinitely for, but, politically, you can't say that. So here we are.
The raw facts are that lockdowns and other COVID restrictions saved millions of lives. I'm open to arguments about other balancing factors but they must come from an underlying view that some restrictions on personal liberty are completely legitimate in emergencies. Skeptics like the signatories of the "Great Barrington Declaration" should learn from India, take the L and have some more humility next time.
...when everyone can receive medical treatment in a roughly modern-ish hospital.
the concern from the start of the "flatten the curve" discussions has been to ensure that the number of simultaneous severe infections does not exceed the number of hospital beds, so that we stay at merely 0.3%.
(and also to keep the rate of transmission low enough that we're not providing ideal conditions for the virus to evolve.)
Humanity has been underestimating and downplaying the disease from the very start. We closed too late, re-opened (multiple times) too early, timidly agonized over every little decision, failed to enforce decisions once made, and then collectively acted shocked, SHOCKED! that it went out of control.
We've had a year to learn what's effective, and have learned a lot. The problem isn't knowledge about the virus, it's lack of political will to actually do anything about it. We know stopping flights and closing borders helps. Why are we so slow to do it?
That is so not true. English is compulsory in Indian schools and has been since partition. There are 125 million English speakers in India, second only to America. You will never find a shortage of people who speak English there, even in remote villages.
I think the main reason is because air travel is heavily used by rich people and the professional managerial class.
If you look at the response, the people who bore the brunt of the pain were working class people and small business owners. The professional managerial class was mostly fine, just slightly inconvenienced.
When a politician is making decisions, they can’t really emphathiz me with your small business or restaurant getting shut down, but they do know from first hand experience, how much of a pain it would be if they were not able to fly, and all their corporate, NGO, and lobbyist buddies also know the pain that they would feel from not being able to fly around to where they wanted.
The reasons behind the lull between the first and the second waves were not entirely clear, and some people assumed that the herd immunity is being reached. Combined with the desire to return to normalcy after a harsh lockdown, it falsely assured people that the worst was behind them. This created the perfect conditions for a bigger second wave.
Finally, the state and every petty official was intoxicated by the powers they weilded during the first lockdown, and they forgot that with great power comes the great responsibility. They unnecessarily focused on tiny things such as fining people Rs. 500 at the traffic lights, while not really understanding the new information on how virus spreads, what are the best ways to tackle transmission and so on. People should have been given the liberty to be outdoors with proper face covering when there was good airflow. They shpuld have known that meeting indoors with poor airflow was the biggest threat. This wasn't communicated properly.
Some government officials did take decisions proactively to save their own district. For example, see here
But unfortunately, this was the exception rather than the norm.
The complete celebratory attitude with a mild (covid) winter made them forget all the planning that they did not even order their vaccines (at least the numbers they needed). Just in case this seems like a critique of the government, let me add both the people and the government were irresponsible, but a cautionary message from top would have helped and that did not happen in time.
The Kumbh Mela is definitely a super-spreader. The increased case numbers in Karnataka can be attributed to the local body elections held there. Moreover, with around 8 months to go for election, UP is actually under-reporting and fudging the figures of its COVID cases.
Do you know how far the province of Quebec is from Europe, Caribbean and Latin America, and US/Florida? Because that's where a few people went and caused an explosion of cases in March 2020:
> The researchers found that as few as 247 spring break travellers were at the root of Quebec’s nearly 70,000 cases. The week off ended March 9th, and those who came back from abroad circulated freely in the community for days.
* https://globalnews.ca/news/7354322/new-study-coronavirus-que...
It is also the state, where the police recently took an oxygen cylinder from a patient for someone who was politically connected [Police wouldn't have done anything this severe, unless they were forced to do the same] (https://www.freepressjournal.in/india/twitter-furious-over-c...)
Anyways these aren't the only blunders the modi government has done, you can find a whole lot of information on the thoroughly incompetent supreme leader and his blunders with a single click quite easily. In case you belong to his fan-club, you would find every other media house(except the ones actually owned by the prominent right wingers) to be sold. (Anyone reading from US- Modi fan club members are very similar to the Trump Fan Club members and behave in the same manner as well)
Cases are exploding in Bangalore, because the city also had taken the restrictions lightly. I live in Bengaluru, and used to see good amount of traffic on the roads till the day lockdown was announced. A number of super spreader events in closed spaces such as colleges, marriages, cinemas where covid protocols weren't followed properly is also the reason mixed with the higher rate of spread of the new strain. This could have also been prevented for Bengaluru as well, if only the central government had taken some preventive action against the new information received. Instead we all know, what it chose to do.
People who got original covid strain may now be getting reinfected again.
Basically no theory about high prevalence of previous infection has survived the test of time, so I think to say something like 'infecting previously recovered people much more vigorously' takes some solid evidence.
But I believe recent immune-escape variants are a much higher risk here. Vaccines generate a much higher antibody titer and a much broader complement of antibody responses than natural infection, and still are noticeably less effective against emerging variants.
Waning immunity also will contribute to this concern: reinfection gets more likely with time even without variants.
I believe that even if one is reinfected, one is still partially protected against severe illness by the remaining antibody complements and other means, e.g. t-cell mediated immunity.
Mind you, I don't think this is a huge absolute risk. I just think it's significant enough to be a significant confound for those of us trying to guess what Rt would be with a return to baseline behavior, and enough for people who've "had it" to be less protected than they might expect.
This is despite people with the vaccine having higher neutralizing antibody titers against B.1.351 than people naturally infected with previous strains.
Therefore it seems very likely to expect that B.1.351 will also cause reinfection at higher rates than we've been used to, since it appears that people with the vaccine are more protected than people naturally infected. This is especially true if people who were infected earliest have their immune responses start to wane.
Again: I don't think this is a huge absolute risk. I just think it's significant enough to be a significant confound for those of us trying to guess what Rt would be with a return to baseline behavior, and enough for people who've "had it" to be less protected than they might expect.
The coercive measures by govs are pushing in the opposite direction.
There is definitely evidence for vitamin D, it's odd this is still not yet widely acknowledged, I can't say I reviewed the research myself but credible people have and have been spreading the information. I've definitely heard of some governments having taken measures for prevention with vitamin D, but there are also some results if administered early enough after infection.
Vitamin D is essential for immune system function, but the wider picture is more complex with high vitamin D levels also correlating with better nutrition (diets higher in cholesterol, which is essential for hormone synthesis - is generally lower in people having severe forms), better immune system function (infections deplete vitamin D), and even activity levels (spending more time outside).
because they thought they had solved the problem, and once they let up - it happened again
Is it just human psychology that is the problem?
1st wave: everybody clamps down. R goes to < 1
2nd wave: people think it's over R goes >1, then clamp down again.
3rd wave: more of no. 2 but with a broader base of carriers across the nation.
3rd wave in India therefore will be really nasty based on other nations 3rd wave, unless their rapid vaccination plan gets a big percentage of the populace vaccinated over the next few months.
The exponential nature of the spread makes it so that things are getting very risky well before the risk is obvious or apparent.
The payoff for avoiding a surge is pretty abstract. For a lot of people it ends up being that people they don't know don't get sick, and things like that.
And then a year is a long time to deal with reduced socialization, we are social animals, "quarantine fatigue" isn't surprising in relation to that.
India’s second wave of covid-19 feels nothing like its first - https://news.ycombinator.com/item?id=27003228 - May 2021 (316 comments)
How India went from a ray of hope to world record for most Covid cases in a day - https://news.ycombinator.com/item?id=26916374 - April 2021 (122 comments)
India's massive COVID surge puzzles scientists - https://news.ycombinator.com/item?id=26898889 - April 2021 (152 comments)
India’s second wave - https://news.ycombinator.com/item?id=26886829 - April 2021 (450 comments)
https://m.economictimes.com/news/politics-and-nation/its-bjp...
Dirty when you politicise people's safety.
Look at the countries in the vicinity of India; they all show similar rise at around the same time.
https://www.worldometers.info/coronavirus/country/pakistan/#...
https://www.worldometers.info/coronavirus/country/bangladesh...
https://www.worldometers.info/coronavirus/country/sri-lanka/...
https://www.worldometers.info/coronavirus/country/maldives/#...
https://www.worldometers.info/coronavirus/country/iran/#grap...
https://www.worldometers.info/coronavirus/country/kazakhstan...
https://www.worldometers.info/coronavirus/country/azerbaijan...
https://www.worldometers.info/coronavirus/country/uzbekistan... ...
COVID is seasonal: https://www.medrxiv.org/content/10.1101/2021.02.28.21252625v...
Mumbai had the peak of its 'first wave' on October 7th. See mobility trends for vehicular and pedestrian traffic at https://covid19.apple.com/mobility. You'll see both monotonically increasing as the peak approaches and then recedes. If this were a simple morality tale of the level of social contact, this wouldn't be the case.
See this paper for a more thorough look at the epidemiological mysteries of an infectious respiratory disease: https://virologyj.biomedcentral.com/articles/10.1186/1743-42...
https://ourworldindata.org/explorers/coronavirus-data-explor...
All of these countries require a recent negative test prior to arrival. The Central Asian countries show inflection at pretty much the same time, barring Uzbekistan which is a week late. However, India has a lot more relative traffic going on with Sri Lanka and they and Maldives, both South of India, inflected a whole month later.
As the Pandemic began in India, most of the experts clearly said that all restrictions, like lockdowns, are just to slow down the spread of the disease temporarily, so that the healthcare infrastructure doesn't get overburdened. It was understood that India needed to upgrade existing hospitals with more ICU beds and hospitals or build temporary shelters that could house and treat the new cases. It was understood that till everyone is vaccinated, the government needs to prepare for "waves" of infected people to manage the pandemic resourcefully.
During the first wave, we had shortages of medical equipments, like ventilators, masks, medicines and PPE kits that needed to be urgently addressed. And it was, to some extent - the government procured these on a war-footing. India had the harshest lockdown in the world. It devastated our economy but on the plus side really reduced the impact of the first wave. Ventilator shortage did result in many death, but this was addressed.
Then, after the first wave subsided, a combination of government hubris and the psychological fatigue of being in lockdown / house arrest led to both the government and the people fooling themselves into believing the worst was over.
Elections were coming up in 5 states, and obviously selfish politicians want people to come to rallies and vote. So huge political rallies were allowed with restrictions (only on paper). The current right-wing power uses religious symbolism for politics, and thus also permitted the largest Hindu religious gathering - the kumbh mela. Again, social distancing and other restrictions were only on paper. Worse, unlike the Saudis who are only allowing vaccinated muslims to attend the religious Haj, there was no similar condition for the kumbh mela in India.
These two events - the huge political rallies and the Hindu religious gathering at the kumbh mela became super-spreader events as millions attended those.
This was one of the major policy failures of the Modi government.
Now, remember, the experts had pointed out that we need to use lockdowns, and lulls between waves, to upgrade our healthcare infrastructure, right? India didn't.
As the second wave rose, our hospitals again became overwhelmed and just couldn't handle the cases coming in. People were denied hospital admission and asked to wait for emergency beds till admitted patients were deemed fit to go home or died. Worse, a huge shortage of Oxygen in hospitals arose and thousands of people died due to lack of Oxygen. So people were not only being denied treatment but also died during treatment.
The depressing irony - India is the largest producer of Oxygen and vaccine in the world!
So how did India get in to such a situation of facing shortage of both!? The reason is the complete apathy of the government in planning and preparation.
While we are the largest producers of Oxygen in the world, we only have 2000 trucks to transport them. Failure to plan and improve the logistics is one of the reason why many of the hospitals are now facing Oxygen scarcity, even though we have a surplus of it! Big Hospitals weren't also upgraded with oxygen plants.
Our vaccination policy also wasn't well thought out. According to an opposition leader, we exported 60 million vaccines between January and March of this year, while we had only vaccinated around 30 to 40 million of our own people! Our vaccine plans also hit a hurdle when a US vaccine by Novavax, that has been licensed for production in India, is facing hurdles of getting the raw material for the vaccine from US (that has obviously prioritized it for its own needs). The government also had thoughtlessly blocked other foreign vaccines from being available in India, for political gains ("India is self-reliant").
We also exported around 1.1 million doses of Remdesivir to other countries. And our media is showing people desperate to buy Remdesivir from anywhere at any price.
Yes, the pandemic is a natural disaster, but the disaster that is unfolding in India is largely man-made and will be a case study in the future in all colleges on what happens when proper planning isn't done and resources aren't utilised properly.
Summary: We had all the resources. But apathy and poor planning screwed up India's fight against COVID.
Is this the same old pattern of infrastructure in colonial economies where all the transportation links are designed to move goods to seaports for export—and not for moving goods inside the country?
That would be a terrible tragedy.
We actually have a very extensive railway network (colonial era yes, but upgraded and expanded to cover the country in the last 70 years) that provides connectivity to most parts of India. And we are now using that to transport the Oxygen and Trucks faster to different states - https://www.livemint.com/news/india/how-indian-railways-plan... .
With vaccine, we are facing issues in keeping up with demand - again a policy failure, because the vaccine makers have been requesting government aid to upgrade and expand their manufacturing facilities since last year. It is only last month that the government has released some funds (as "advance payment") so that the vaccine makers can upgrade their facilities and produce more vaccine faster.
We have to eliminate our socialistic approach to planning. If you lock the private sector out and expect that everything will be handled by the government bureaucracy, then nothing will get done.
There are no right-wing parties in India. Even Modi and the BJP are saffron socialists. They have applied price controls to so many medical items that the demand-supply equilibrium has gone for a toss.
Even today, the vaccines are being produced by two private organizations under a price control regime and all they have to show for it is a stream of abuse from the necrophiles on the left.
If you lock the private sector out and expect that everything will be handled by the government bureaucracy, then nothing will get done.
Well, somebody would have. People are complaining about states being charged $4-5/dose while foreign vaccines are being sold for up to $30/dose.
Also, according to this report,[1] Adar Poonawalla of SII has fled to London with his family because he is being intimidated by prominent people (including many Chief Ministers) and has also been receiving death threats.
This is what happens to the private sector in India.
Adar Poonawalla of SII has fled to London with his family because he is being intimidated by prominent people (including many Chief Ministers)
So far, the central government was directly procuring the vaccine, and distributing it to everyone. Last month, it suddenly changed the policy and told all the states to procure it themselves. This has resulted in differential pricing, and the all the states are now forced to negotiate and procure the vaccines from the manufacturers directly. So all the politicians are now harassing the CEO of the vaccine manufacturers for better deals .. https://www.telegraphindia.com/india/serum-chief-flies-to-uk... ...
Luckily the Supreme Court has stepped in and is now questioning the government on its revised vaccine policy, especially on the pricing mechanism.
Was very predictable. Center was acquiring vaccines and distributing it among states who were then vaccinating vulnerable sections of the population. Politicians started questioning the policy and demanded more control. Once the Center gave them that control, all hell broke loose.
I can guarantee that this abuse will continue and Ella will be next. The media is 100% responsible for targeting these companies over everything from patents to pricing. And while Modi managed to deflect criticism and dump the issue into the hands of clueless state governments, it is going to hurt India very badly.
> Luckily the Supreme Court has stepped in and is now questioning the government on its revised vaccine policy, especially on the pricing mechanism.
Nothing good will come out of it. The SC is not answerable to the people as it is not a democratically elected body. And it does not have executive experience either. I don't know why all these courts keep interfering in every single issue all the time.
Politicians started questioning the policy and demanded more control.
- Vaccine makers were requesting government grants to expand facilities but were provided limited to no resource till last month.
- Exporting vaccines was made a priority over vaccinating indians.
- When indians realised there was a shortage of vaccine and started highlighting these issues, and the government realised that it wouldn't be able to meet the vaccine demands, they suddenly do a complete U-turn of their vaccine policy - the centre backs out completely out of price-fixing and procurement of vaccines without setting any framework in place.
- Thus, completely abdicating their responsibility, they now expect each state government to haggle and negotiate the price directly, draw up individual contracts and get the vaccines.
The opposition did their job in highlighting the deficiencies. Instead of listening and fixing the issues, the government deliberately passed the buck to the state government with a revised policy. It is clear they did it in such a manner (without any framework) so that they could transfer any associated political blame.
The SC is not answerable to the people ... it does not have executive experience either.
That said, some stupid executive decisions can be over ruled with common sense and some have past precedents to follow. For example, it is very stupid to make people register for a vaccine - poor and uneducated people will not be able to do so and will be susceptible to corruption due to this unnecessary step. Common sense. We have one of the largest successful immunisation programs in the world and have successfully vaccinated a large number of people in the past. So we have past precedents on how to vaccinate our people. The vaccines should be free for everyone - common sense and past precedent. And so on.
Someone else in this thread posted that COVID is seasonal and the reason for the current wave is environmental; that post is not getting down voted. Blame has been assigned to a non-Modi entity so I guess all is well.
Hubris was a big part of this. Modi made the statements himself about how well India handled COVID and is now about to help the world. Has egg on his face now but it wont matter. There is enough time to make his own people forget about his mismanagement and lack of empathy before the next election.
https://www.theatlantic.com/international/archive/2021/04/in...
But the vaccines worked, so those rich people got it done. mRNA was a gamble, but it paid off with first trials starting just weeks after the virus was sequenced and first doses entering general patients in nine months instead of the 18 we were originally expecting.
But let's not imagine that the US response wasn't otherwise a disaster, especially when compared to places like Australia and Korea who barely needed to wait for the vaccine at all.
*I know SK isn't technically an island but for all practical purposes it is.
So yes border control helps but you shouldn't also discount policies such as the 'hard lockdowns' https://www.bbc.com/news/world-australia-53289616 where people cannot leave there homes at all for any reason if there's known cases in the immediate area.
All it takes is a critical mass of your own population getting it, followed by wide scale gathering of millions of people with no meaningful mitigations. That's the obvious and simple cause.
This report says that at least one facility has a 10% infection rate.
At the current time, in my opinion, The American border can't keep out any pandemic if our neighbors have it. And vise versa.
Estimates of total unauthorized border crossings run around a few hundred thousand a year. That's what has you so freaked out.
A quick google tells me that the state department issued NINE MILLION visas in 2018 (don't have more recent data, and obviously 2020 is a huge outlier for both legal and illegal border crossings).
You can argue about immigration and labor effects all you want (along with other, less savory cultural/nativist ideas if you swing that way). But as a disease control effect it's complete noise. Legal immigration by world travellers dwarfs it by more than an order of magnitude.
Don't put this on the immigrants. You guys shit on them enough, and this bit just isn't their fault. At all.