During the past few weeks, Indian social media has been inundated with SOS messages: hospitals

tweeting about dwindling oxygen supplies and physicians watching helplessly as patients perish from
preventable deaths. A journalist pleading for but denied a hospital bed took to Twitter to log his
deteriorating condition till he died. Overwhelmed crematoria are working round-the-clock to keep up
with the pace of bodies; furnaces have melted down from overuse and additional funeral platforms are
being built outside. Such are the heartbreaking messages and haunting images that highlight the
formidable second wave of the coronavirus pandemic raging through the country.

India broke the world record for the most new coronavirus cases this week, surpassing 330,000 new
cases on Friday, as deaths in the past 24 hours jumped to a record 2,263, the health ministry said. The
United States held the previous one-day record with 300,669 new cases recorded on January 8, 2021.

New COVID infections in India are reaching record levels, and the health care system is being stretched
to breaking point. Health expert Gautam Menon tells DW what went wrong, and when we can expect
the surge to end.

India recorded the world’s highest-ever daily tally of 314,835 new COVID-19 infections on Thursday.

The South Asian nation’s total cases are now at 15.93 million, while deaths rose by 2,104 over the past
24 hours to reach 184,657, according to the latest Health Ministry data.

The massive surge in infection numbers has put an enormous strain on India’s health system, producing
heart-breaking images of people desperately searching for hospital beds and oxygen tanks to save virus-
infected relatives.

Shortages of medical oxygen, beds and anti-viral drugs in several parts of the country, coupled with an
increasing number of sick people, continue to overwhelm hospitals.

The second wave of COVID-19 in India has been devastating, with a catastrophic rise in the numbers of
new infections in recent weeks. The country has now recorded over 18.7 million cases and over 208,000
deaths. The outbreak of the new coronavirus is overwhelming for all healthcare providers. The situation
is dire, with a lack of medical supplies including oxygen concentrators and ventilators, and limited
human resources. Médecins Sans Frontières (MSF) is currently responding in Mumbai, the capital of
Maharashtra state in western India. Below we outline four questions and answers on the current COVID-
19 crisis in India.
 1. How bad is the COVID-19 situation in India?

India has been experiencing a severe second wave of COVID-19 over recent weeks. The number of
recorded people newly infected with the new coronavirus are reaching new highs; for over a week, the
country has averaged around 350,000 new cases each day. Nearly 390,000 new infections were
recorded yesterday, 29 April – a record.

Healthcare facilities and staff across the country are struggling to cope with the surge in cases. Overall
reports describe hospitals are experiencing a crippling shortage of hospital beds for people with severe
cases, a shortage of oxygen supplies, and shortages of medicines being used to treat mild, moderate and
severe forms of COVID-19.

Overall access to health care is currently compromised. In Mumbai, care for COVID-19 care is organised
in dedicated hospitals, but care for non-COVID-19 care is under stress, as the whole health system is
dealing with this crisis.

2. What explains the sudden increase in cases in India?

There can be several factors to explain the new surge of cases. From October 2020 to mid-February
2021, India witnessed a decline in new confirmed COVID-19 infections. Some public health experts think
that this led people to believe in a false sense of security, dropping measures such as wearing masks and
maintaining a physical distance. Some super-spreader events, like rallies and social events, are also likely
to have played a key role.

In addition, population density is very high, especially in a city like Mumbai, where it becomes difficult to
follow required measures in public places.

There is currently there is not enough evidence to confirm the role that variants of SARS-CoV-2 have
contributed the sudden exponential spread of COVID-19.

At the beginning of February, India appeared to have the virus under control. Daily cases were barely
more than 10,000 a day – considered low for a country of 1.3 billion people.
But since then the number has spiked twentyfold, catching the government off guard and
underprepared. The health minister, Harsh Vardhan, said in March that the country had entered the
“endgame” of the virus but cases were already beginning to take off by that point. Bhramar Mukherjee,
a biostatistician at the University of Michigan who has been tracking India’s pandemic, told the
Associated Press that India had failed to learn from second or third surges in countries including Brazil
and the UK, to ensure it was ready for a similar situation.

‘Double mutant’ variant

The discovery of a new variant of Covid-19 in India has caused widespread concern and has been
blamed as one of the main factors driving the wave of cases. The variant is known as B.1.617 and has
two unusual mutations: E484Q and L425R. This so-called “double mutant” variant is believed to be more
transmissible than previous strains. Although scientists are still not certain exactly how dangerous it is,
the rapid spread of the variant through Maharashtra and then the rest of the country is key reason why
the UK has banned travel from India.

India launched a massive vaccination program but it has not been enough to stem the tide. More than
100m doses have been delivered but the country has been hampered by lack of supply. The government
said last week it had fewer than 27m doses left, enough to last about nine days. India is the world’s
biggest producer of vaccines and is now expected to divert some production to domestic use, causing
alarm over shortages elsewhere in the world.