India is set to cross one million reported coronavirus cases on Friday, third only to the United States and Brazil.
There are concerns about India’s readiness to confront a surge that could overwhelm hospitals and test the country’s feeble healthcare system.
The milestone will come at a time when several Indian states are imposing focused lockdowns to stem the outbreak amid frantic efforts by local governments who are trying to shield the health system from being overwhelmed.
So far, three states in India — Maharashtra, Delhi and Tamil Nadu — have accounted for more than 50% of India’s total cases.
But in India’s vast countryside, which is much less prepared to handle a crisis and have weaker health care systems and basic sanitation that’s insufficient to prevent contagion, the pandemic is clearly growing.
India’s response to the virus was initially sluggish and then it bought time by locking down its entire population of 1.4 billion people when prime minister Narendra Modi announced a nationwide lockdown on March 24.
“We should have curtailed it earlier or we should have peaked earlier,” said Dr. Ujjwal Parakh, senior consultant in the Department of Respiratory Medicine at New Delhi’s Sir Ganga Ram Hospital.
India’s lockdown came at an enormous economic cost and an unprecedented humanitarian crisis when millions of improvised migrants were forced to return to the countryside due to job losses and hunger.
Aimed at increasing the capacity of the country’s healthcare system, the lockdown slowed down the virus, but it wasn’t enough.
Cases kept increasing while testing still remained abysmally low and the virus rocketed through India’s large landscape.
Namrata Singh, a bank manager in New Delhi says, she believes the true number of infections to be higher as many people may not be getting tested.
“I can afford (getting tested), I went there. But there are people who could not afford tests,” Singh says.
Although the continuing surge has forced authorities to reinstate lockdowns in some cities, the focus is now increasingly on smaller lockdowns that shield the economy from losses.
Nearly a dozen states have imposed restrictions on ‘containment zones’ — areas that can be as small as a few houses on a street — where many virus cases are detected.
India has created hospital beds in some cities, but its health system remains vulnerable.
Dr. Parakh said the guidelines issued by India’s Health Ministry and Indian Council for Medical Research were constantly changing and that confused medical workers in the beginning, leading to greater spread.
Experts say the challenge for India will be the tightrope walk of opening up the economy while trying to restrict the increase in cases to manageable levels that don’t overwhelm hospitals.
But experts say low testing still remains a concern.
India has ramped up its testing capacity, from a single lab in January to over 1,200 right now and over 300,000 samples are being tested every day.
But experts point out that testing criteria remains restrictive and that India had to try and ensure that tests are accessible and affordable.
