“I’ve been … trying to say to them, ‘If everything goes very well, things will be horrible for the next several weeks. And it may be much longer,’” he said.
Jha said the focus needs to be on core public health measures: targeted shutdowns, more testing, universal mask-wearing and avoiding large gatherings.
“That is what’s going to break the back of this surge,” he said.
The death and infection figures are considered unreliable because testing is patchy and reporting incomplete. For example, government guidelines ask Indian states to include suspected COVID-19 cases when recording deaths from the outbreak, but many do not do so.
Municipal records for this past Sunday show 1680 dead in the Indian capital were treated according to the procedures for handing the bodies of those infected with COVID-19. But in the same 24-hour period, only 407 deaths were added to the official toll from New Delhi.
The New Delhi High Court announced it will start punishing government officials if supplies of oxygen allocated to hospitals are not delivered. “Enough is enough,” it said.
The deaths reflect the fragility of India’s health system. Prime Minister Narendra Modi’s party has countered criticism by pointing out that the underfunding of healthcare has been chronic.
But this was all the more reason for authorities to use the several months when cases in India declined to shore up the system, said Dr Vineeta Bal of the Indian Institute of Science Education and Research.
“Only a patchwork improvement would’ve been possible,” she said. But the country “didn’t even do that.”
Now authorities are scrambling to make up for lost time. Beds are being added in hospitals, more tests are being done, oxygen is being sent from one corner of the country to another, and manufacturing of the few drugs effective against COVID-19 is being scaled up.
The challenges are steep in states where elections have been held and unmasked crowds likely worsened the spread of the virus. The average number of daily infections in West Bengal state has increased by a multiple of 32 to over 17,000 since the balloting began.
“It’s a terrifying crisis,” said Dr Punyabrata Goon, convener of the West Bengal Doctors’ Forum.
Goon added that the state also needs to hasten immunisations, but vaccines are in short supply, the result of lagging manufacturing and raw material shortages.
Experts are also worried the prices being charged for shots will make it harder for the poor to get vaccinated. On Monday, opposition parties urged the government make vaccinations free to all Indians.
India is currently vaccinating about 2.1 million people daily, or around 0.15 per cent of its population.
“This is not going to end very soon,” said Dr Ravi Gupta, a virus expert at the University of Cambridge in England. “And really … the soul of the country is at risk in a way.”