Tens of millions at risk as new COVID-19 cases explode in India

Shattering the lies promulgated by Prime Minister Narendra Modi’s far-right BJP government that the pandemic in India has been “successfully controlled,” new COVID infections have been accelerating across the country with daily cases consistently exceeding 10,000 all last week.

Healthcare workers treating a patient amid a surge of COVID-19 cases in Mumbai, India, Monday, April 10, 2023. [AP Photo/Rafiq Maqbool]

On April 20, India recorded 12,580 new COVID cases, the highest figure in over eight months. With this, the total official number of COVID cases has reached 44.85 million. Currently, there are 65,286 active cases being followed. 

These figures represent a colossal under-reporting of the actual toll of the virus, given that the entire surveillance apparatus for tracking and reporting on the pandemic has been dismantled. Even during previous waves of COVID-19, when there was some testing infrastructure, subsequent serological surveys revealed that the vast majority of cases were never officially detected.

The present increase in the number of COVID-19 cases is directly bound up with the rapidly proliferating lineage of the Omicron virus labeled XBB.1.16. This sub-variant first drew international attention in India earlier this year. It was placed on the WHO’s list of variants “to watch” on March 22. Along with India, it has been detected in over 33 countries. 

Last week, the World Health Organization (WHO) upgraded the new variant to the status of a “variant of interest,” given both its more infectious nature compared to other Omicron subvariants and its highly immune-evading characteristics. 

The international health agency noted, “At present, there is no early signal of an increase in severity. The initial risk assessment is ongoing and is expected to be published in the coming days.” 

Data on the XBB.1.6 from Seito Labs did indicate a higher rate of death and serious illness with this variant. However, due to the high vaccination rates and previous infections, the impact of the virus is blunted for much of the population.

But it leaves those unvaccinated, those in poor health, and the elderly at high risk of severe disease. For India, those endangered number hundreds of millions of people—most desperately poor, living in isolated rural areas or urban slums, and with little or no access to even barebones health care services.

The rising infection numbers in India threaten not only the people of the subcontinent, but the entire world. Hundreds of millions of new cases mean hundreds of millions of new opportunities for SARS-CoV-2 to mutate into new, more infectious and more deadly forms.

The Delta variant developed in India in 2021 at the very point where the Modi goverment was proclaiming victory over the virus. A similar danger now exists with XBB.1.16. The large number of subvariants of the coronavirus shows that it retains its ability to mutate rapidly, with natural evolutionary pressures giving the advantage to mutations that are more vaccine-evading.

As in other countries, the Indian corporate media have latched on to comments from official government sources downplaying the significance of the XBB.1.16 upsurge to inure the population to accept as benign continued infection with a deadly and harmful virus.

For instance, India Today reports health ministry sources as telling it that XBB is not a “dangerous variant.” Other media outlets are repeating this claim, advising people not to “panic.”  

The Indian ruling elites have a notorious history of ignoring prior warnings of onrushing disasters, as seen in the pandemic’s devastating second wave in spring 2021, which was driven by the highly pathogenic Delta variant of SARS-CoV-2. 

Starting from early April 2021, to the peak of the second wave about April 30, India reported over 400,000 new daily cases and over 4,000 daily deaths. Scenes of masses of bodies piled onto funeral pyres shocked the world and demonstrated that the death toll was far higher than officially acknowledged.

Figures on excess deaths, subsequently, showed that the 2021 COVID wave was one of the deadliest public health disasters in the country’s history. At the time, Reuters reported that warnings had been made by a forum of scientific advisers to Indian officials in early March of a new and more contagious variant of the coronavirus taking hold in the country. But these warnings were totally ignored by the Modi government. Indeed, as the Delta variant surged across the country in mid-April, and at a time when shortages of ICU beds, critical drugs, oxygen, and medical personnel were already being widely reported, Modi took to the airwaves to vow that he would “save” the country from lockdown—not the deadly virus.

A similar refusal to admit plain facts, in order to avoid spreading “alarm,” characterizes the government’s response to the current COVID crisis. Currently, India’s daily positivity rate stands at 5.46 percent while the weekly positivity rate is 5.32 percent. Both numbers indicate the infection is spreading once again, but greatly underestimate its impact.

The rates in India’s national capital Delhi and Maharashtra, where Mumbai, the financial capital, is located, are far higher. Both areas were centers of the 2021 Delta outbreak as well.

Last Tuesday, Delhi reported 1,537 fresh infections, up a staggering 430 percent in only three weeks. The positivity rate of 26.54 percent implies that there is a high number of undetected transmissions taking place, which means that without rapidly re-initiating mitigation measures, a significant proportion of the population stands to become infected again. Maharashtra recorded 1,100 new coronavirus infections last Wednesday and 1,113 on Thursday.

The number of new COVID-19 deaths last Thursday was said to be 29, which is understood to be a mere fraction of the actual figures. Without proper testing and the confirming of previous COVID infections that will have left patients’ health compromised, deaths from respiratory and cardiovascular collapse will be palmed off as solely due to the prior medical conditions of those who perished. The contribution to those deaths from the government’s grossly negligent response to the pandemic will be erased. 

Overall, the official COVID-19 death toll in India since 2020 stands at an astronomical figure of over half a million preventable deaths. Yet, according to a July 2021 report by the US-based Center for Global Development, the real death toll of COVID-19 pandemic in India was already between three and five million, or ten times the official figure. 

Neither Prime Minister Modi nor any other Indian political leader has ever expressed an iota of concern over the massive death toll, revealing their indifference to the fate of millions of Indian toilers. They only display publicly the real attitude of capitalist governments all over the world, which have declared the pandemic officially over to ensure the working class is producing profits at full capacity regardless of the real conditions on the ground.

India long ago abandoned even limited measures to curb the virus spreading, while rhetorically attempting to keep face with the concerns of the population. 

On March 22, chairing a “high-level review meeting,” Modi remarked that the COVID-19 pandemic “is far from over”, and directed officials to increase whole genome sequencing of COVID positive samples. He also stressed the need to “ensure the availability of the required drugs and logistics for influenza and COVID-19 cases across health facilities.” For this he asked authorities to carry out “mock drills” in hospitals to “ensure that our hospitals are ready.”  

However, he failed to announce any enhanced funding for these healthcare facilities. In reality, the Modi government has taken pains to reduce the national healthcare budget, which is among lowest across the world, while continuing to rapidly expand India’s military spending. In 2022, India’s military spending was the world’s third largest  

According to the National Council of Applied Economic Research (NCAER), India’s oldest and largest, non-profit, economic policy research think tank, the share of health in the aggregate federal and state budgets in 2022-23 stood at 2.4 percent of the GDP. This is a sharp reduction from 3.6 percent in 2021-22. India’s healthcare spending as a percentage of GDP is well below the average for the world, and for other developing countries. 

And despite the recent rise in COVID infections and concerns raised by the WHO on the nature of XBB.1.16, the government is not implementing universal mask mandates, school closures, or providing free mass testing to track and trace these new infections. Health Minister Mansukh Mandaviya adopted the usual delaying tactics by asking states to identify hotspots and ramp up testing in those places, allowing the wave to get ahead of public health efforts. With a fast-moving virus, immediate and broad-based response is essential.

In defiance of the government’s “don’t panic” injunctions, Dr. Randeep Guleria, the former director of Delhi’s All India Institute of Medical Science (AIIMS), speaking to India Today TV on April 17, advised people to mask up in indoor spaces with poor ventilation and indoor crowded public areas. 

Endorsing remarks made by the TV presenter, Sneha Mordani, who suggested that the current daily cases around 10,000 is a “gross underestimation,” Dr. Guleria said: “We are really underestimating [the] number of cases… It could be many times more [than] what we are currently testing because many people are not getting tested. We really don’t know how many people [are] actually positive.” He proposed to increase testing to know the “actual situation.” As media reports show, India, a country with 1.4 billion people, tests only a minute fraction of its population, with around 200,000 COVID tests administered every day. 

Dr. Guleria also countered the claims made by some people that “if there are mild cases, we need not to bother too much.” He said, “As the cases are increasing, the chances for the virus to mutate are higher [which could lead] to a new variant.” 

He added that the virus’ rapid mutations mean that the potential for a new mutation to emerge with increased lethality is possible and even probable. “I don’t think we can really predict how this virus will behave in the future.”

The Modi government’s indifference to the impact of COVID-19 on India’s population over the last three years should come as a stark warning to the working class that they cannot rely on the ruling elites to protect them and their families from any future threat posed by COVID or other public health catastrophes.