An October 2021 serosurvey revealed that 97% of the residents of India’s national capital city of Delhi had developed antibodies against the Covid-19 virus. Delhi’s Health Minister Satyendra Jain thought it fit to describe this as “very positive”.
With evident satisfaction, he said, “Earlier, researchers had said that herd immunity could be reached at 70% to 80%, then they said 90%, but in Delhi it is 97% now.” This was a leap of 41 percentage points from the last survey that had been done before the April-May second wave.
An earlier serological survey conducted by the Indian Council of Medical Research in June and July, after the devastating second wave had subsided, found that 67.6% of Indians showed the presence of antibodies specific to the SARS-CoV2 virus. These levels were similar for rural and urban areas.
The jump was huge – in the first such survey done in May and June 2020, only 0.7% had antibodies. In the serosurvey of December 2020-January 2021, the number had risen to nearly 25%.
Herd immunity is when the population develops antibodies against a virus in numbers that are large enough to prevent the further spread of the virus to those who are not infected. This immunity in individuals can develop in two ways: either from infections, or vaccination.
But the finding that 80% of the children surveyed in Delhi also had antibodies (none of whom, of course, had been vaccinated) confirmed that this outcome was not primarily, or even substantially the result of (until then still low levels of) vaccination.
It revealed instead that staggering levels of infection had ravaged the country’s capital and a great part of this was unrecorded and untreated. There is irony that the capital city (and probably many parts of the country) had by the end of the year accomplished or swung close to the touted goal of “herd immunity” not because of skilful management by the government but by its spectacular failure, leading to such large numbers of infections and deaths that a kind of Malthusian outcome of a new balance with the virus was reached.
Prime Minister Narendra Modi and his promoters sought to celebrate the high vaccination count on his birthday – on September 17, 2021 – of 25.1 million doses as a shining accomplishment surpassing that of any other country in the world.
A closer look at the numbers, in India and the world, told a different and far less edifying story. For one, the very next day after his birthday, on September 18, the numbers slumped to 88.37 lakh, and the day after that to 40.4 lakh.
Both China and India alone have populations higher than a billion, therefore it is not surprising that India, according to data published by the Indian government, had administered five times more doses than Japan, nine times more than Germany and ten times more than France.
But upon computing the percentage of the population covered, India’s accomplishment lags far behind many other countries, including much poorer countries even in the neighbourhood.
By September 2021, the United Arab Emirates led the world with 87.26% of their population fully vaccinated, followed close on its heels by other countries such as Portugal, Malta, Singapore and Spain, which had fully vaccinated more than 80% of their population, according to The Indian Express.
China was in the 13th place, with 74.97% of its population fully vaccinated – numbering more than a billion people. By contrast, only 20.55% of the population was fully vaccinated in India. Even Nepal, Sri Lanka and Bhutan had overtaken India.
Still, characteristically never acknowledging the mistakes that led to the horrors of the summer of 2021, a spectacle of gratitude to the Great Leader was organised. Fifty million “Thank You Modi” postcards were sent to the Prime Minister’s Office.
Bharatiya Janata Party-ruled state governments spent large amounts of official money to deluge newspapers with full-page “Thank you Modi” advertisements. State governments distributed 140 million bags of cheap food rations in bags with his picture prominently displayed on each.
Videos in various languages thanking him for the “successful” vaccination and hailing Modi as the “garibon ka masiha”, or the messiah of the poor, jammed millions of WhatsApp phones. Even the Army’s 15 Corps, stationed in the Kashmir Valley, felicitated Modi on its official Twitter handle @ChinarCorpsIA, reported The Wire.
It would be natural to be led into believing after all this drum-beating that Modi had indeed led India into a final and decisive defeat over the virus. This was not the first time that the prime minister, his ministers, officials and the cravenly obedient media had made such a claim.
Announcing the first lockdown in March 2020, Modi had compared – with his penchant in multi-religious India for drawing on Hindu symbolism – India’s “war” against Covid-19 with the Kurukshetra war in the epic Mahabharata.
It had taken 18 days for the armies of the Pandava princes to defeat their enemies – their cousins, the Kauravas – in that legendary war. Modi asked for 21 days to vanquish the enemy of Covid-19.
Of course, this did not happen. First, the lockdown was extended over and over again, well beyond the initial 21 days, and after it was finally lifted, infections and deaths rose alarmingly.
Once more, when in the winter of 2020 – for reasons that scientists are not able to fully explain – the infection and mortality graph slumped in the country, Modi in January 2021 claimed victory over the virus, declaring that India had trounced the virus ahead of all other countries of the world. The deadly summer that followed proved how wildly misplaced and discordant were his bugles of victory.
Harvard professor Vikram Patel, writing in The Indian Express, recounts many of these recent milestones of failed “victories” of the ruling establishment: First, “we were told that the pandemic would end in May 2020 thanks to the country’s dramatic and brutal lockdown. Then, when the first wave appeared soon after the lockdown relaxed, that universal masking would help beat the pandemic. Then, when this first wave mysteriously petered out despite low levels of masking, we were told this was because a very high proportion of people had experienced asymptomatic infections”.
This implied, Patel says, that the virus had swept the land, but most people did not even realise that they were infected, so we had miraculously attained that fabled goal of “herd immunity”. “By Diwali 2020, we thought the nightmare was behind us and bars, wedding venues and holiday destinations began heaving with people, celebrating that the virus had been beaten and that we were well on our way back to normal. Only we were not,” he wrote.
Refusing once more to learn from science and India’s dizzying surges and grisly toll of runaway deaths in the summer of 2021, the celebration of a billion vaccinations sounded again like an exultant call of victory.
However, the counsel of scientists at the time I write this is sobering: they are telling us that the world is likely to perhaps never defeat the virus into extinction. China, Israel and Singapore had in the past touted, like India, a zero-Covid strategy.
But both scientists and leaders in many countries are admitting today that this is a war that no country is likely to win. K Srinath Reddy, President, Public Health Foundation of India, writes in The Indian Express that many countries are gearing themselves to confront the sombre truth that well into the foreseeable future, humankind will have to live with the virus.
Israel, celebrated by many for an early success in the “war”, is “beginning to acknowledge that its much-acclaimed war to crush the virus is ending in a stalemate”.
Chris Hipkins, the Covid-19 response minister of another shining success, New Zealand, said the highly infectious nature of the Delta variant had raised “pretty big questions” about the possibility of “eliminat(ing) the disease”. From his neighbourhood, Australian Prime Minister Scott Morrison was even more blunt in his assessment: he said that it was highly unlikely that his country would ever return to zero-Covid cases.
A Tsunami of Suffering
How the second wave of Covid-19 devastated India.
Vaccination, we can hope, will be a shield against severe disease and death, but it will not decimate the virus. Srinath points out that only two microbes that have been completely eradicated from earth so far by science: smallpox in humans and rinderpest in cattle. Even polio still survives, surfacing from time to time in Afghanistan and Pakistan.
We must recognise that to eliminate the coronavirus completely is an unrealistic ambition, partly because as a respiratory virus, it spreads more rapidly and further than many other microbes. Once we recognise that we have to learn to live with this virus, this means that at least in the near future we will need to continue using measures such as masks and refraining from large crowds in closed rooms until enough of the world’s population is vaccinated.
Even vaccination will not eliminate the virus from the world, but we should aspire that it would make the virus progressively milder, until hopefully we reach a stage in the future – how far into the future, scientists do not agree on – when it will not be more dangerous than the common flu virus.
Srinath explains the reason for this: that there is no survival advantage for the microbe if the human species is eliminated, because it needs to lodge in living breathing human bodies to survive, multiply and spread. Wiping out our species would also result in wiping out the microbe.
We still cannot be sanguine, because scientists have found another further danger that “minks, cats, dogs, lions, tigers, gorillas and white-tailed deer” are also being infected with the virus and therefore are also potential reservoirs.
But “the vastly numerous and highly mobile human population will remain the favourite vehicle for the virus to hitchhike its way across the world”. The virus can and will slip through lockdowns. In the words of Srinath Reddy, “Like love, as Shakespeare declares in Venus and Adonis, the virus too laughs at locksmiths”.
Srinath Reddy and Vikram Patel agree, therefore, that we need to abandon war-like slogans of eradicating the virus because the reality is that this is just not going to happen. The only hope for eliminating this virus, Patel explains, would be the discovery of a vaccine that effectively blocks the entry of the virus into the body, or else a highly effective antiviral medication. “But history,” Patel says, “makes me somewhat pessimistic given the failure of decades of efforts to conjure similar magical potions” for any coronavirus infection.
If we are not going to be able to eliminate the virus from the planet, humankind needs to rapidly learn how to live as safely as possible with the virus without periodically and permanently damaging the economy and livelihoods, the education of children, travel, celebrations, mass entertainment and everyday social interactions with friends, extended family and co-workers.
Leading Indian scientists, like Soumya Swaminathan, Chief Scientist of WHO, and Vikram Patel believed that by the autumn of 2021, the virus had shifted in India from stirring an epidemic to becoming endemic.
Living with the virus
It is clear, then, that the virus will continue long into the foreseeable future to occupy our world, infecting some, killing some. The world will never be the same after this, the greatest health and humanitarian crisis of a century.
The question that looms uneasily over all of us is – how do we move in a world when the epidemic ends but the virus remains part of our lives? How should we craft our lives in this new world, on the other side of the pandemic?
I worry at the time I write this first about what the transformations will be in our lives until we reach the stage, maybe years later, when as scientists predict (and hope), the virus is no more dangerous than the common flu.
Will we continue to wear masks in public, in schools, theatres, buses and metros, trains and airplanes? Will we continue to shut schools, and exclude a full generation from the only opportunity that they had to escape the oppressive hard lives of their parents? Will we continue to avoid, even legally prohibit, large gatherings in closed spaces? Will the working poor continue to have to endure the merciless realities of mass hunger, joblessness and uncertainty? And for how long?
As Patel asks, can we countenance continuously being “trapped in a seemingly never-ending cycle of lockdowns, uncertainty, vaccination drives, restrictions on travel and in-person interactions, the evisceration of occupations that require in-person interactions, the loss of learning for children shut out of schools, wearing masks in indoor spaces. …not to mention the shattering of the most vulnerable livelihoods”.
And if we resolve to abjure these ways of protection, are we fated to just live with successive waves of the epidemic sickening and killing many people each time?
There has to be another, more hopeful, path for the years that immediately lie ahead that we must find. Patel indeed pulls back from this grim prognosis of the future suggesting that we must all learn to cohabit with the virus with no restrictions on travel, work or mingling.
We must learn to pursue normal living, but remain mindful of the altered reality that some of us will continue to fall ill and a small fraction will die. The numbers who will die can be restricted by greater investments in public health, particularly at the primary level. We must also prioritise public resources for regular booster vaccines for only the vulnerable, such as the elderly, persons with disability and people with co-morbidities.
The much greater question in the minds of people across the planet is: what is life going to be like on the other side of the pandemic, when indeed Covid-19 cohabits with humankind in the way that does the common flu? What will be our individual and collective futures? Will the future be safer, more humane for all peoples? Or will things remain unchanged?
What we remember, and how we remember, the rampage of the pandemic, will determine how we will build our futures.
A helping hand, and more
Harrowed, even overwhelmed frequently with grief and with rage, I have struggled to remember, to piece together in this series fragments of this history of the tumultuous summer of the Covid-19 second wave in 2021.
But even amidst my darkest grief, my most searing rage, I also always remembered with hope.
Even as the Indian state abandoned its people during what was probably the gravest humanitarian crisis to savage the country in 75 years since freedom; even as people from the richest vaccine producers, to corporate hospitals, to pharmacists, to ambulance drivers, to sellers of firewood for funeral pyres were pitiless in their extortion; ordinary people across the length and breadth of this ancient land rose tall in kindness and solidarity, to assuage the suffering of others in distress.
Many organised oxygen supplies, others cooked meals, some ran errands for older and sick people confined to their homes, yet others ferried corpses or performed the last rites for strangers whose families could not leave their homes because they too were infected or because they had no money left.
One of these was Vidit Singh Bhadauria, a Class 12 student in Kanpur. The day after he lost his father to Covid-19, Vidit was on the phone, sometimes fighting back his tears, helping others find oxygen cylinders or refills in his city. “Every day I get over 300-400 calls and I try to help each and every one,” he said. He succeeded in assisting 60-80 people in Kanpur each day of the pandemic.
Sikh gurudwaras, beginning with those in the national capital, took leadership in kindness. The proudest legacy of the Sikhs through recent centuries is the langar, which is not just a food charity to which every household in the community contributes whatever it can – food, or money, or labour – but to ensure that no one sleeps hungry.
What is essential to this solidarity food provisioning is the moral imperative that those who are hungry must be treated with dignity, like honoured guests. And that the rich and poor, people of every caste, class, faith and gender, must sit together and eat, as markers of the equality of all and to protect the self-respect of those who depend on the langar to survive.
Even during the first lockdown, Sikhs indefatigably organised millions of meals for the city poor who had been thrust overnight into hunger, including in Delhi for people who had been ravaged by the fires of communal violence just a month earlier.
But during the second wave, they realised that people were dying because they were denied something even more compellingly and urgently life-saving than food, and this was oxygen to breathe. They decided to establish what they called an oxygen langar to combat this devastating oxygen famine.
Initially, gurudwaras organised hundreds of oxygen cylinders. For those whose loved ones could not find oxygen-linked hospital beds, the gurudwaras supplied oxygen. Some patients were brought gasping for breath in cars, some in autorickshaws, some in cycle-rickshaws and for each of the choking patients, volunteers would connect them to oxygen supplies, tirelessly doing all they could to keep them alive for the interlude until their families could organise for them hospital beds.
For patients who were sick at their homes, some gurudwaras made arrangements to supply and refill their cylinders in their houses. In time, when they found that patients died even after they supplied emergency oxygen because there were no hospital beds, some gurudwaras created community-based hospitals with beds, oxygen and trained health staff.
Inspired by them, news came in of many similar efforts, for instance, by Muslim volunteers in Mumbai. Several mosques in the metropolis organised free oxygen cylinders for patients who were being treated in their homes because hospital beds were unavailable. Oxygen was “provided for free to people, irrespective of religion, caste or creed. This is our united fight against the pandemic and we thought of doing our bit to help the needy,” Arshad Siddiqui, chairman, Red Crescent Society of India, told the Times of India. The non-profit Red Crescent Society supplied more than 1,000 oxygen cylinders.
The life of Gaurav Rai, 52 years old, changed course completely one day. Less than a year earlier, before the pandemic, his vocal cords had been damaged. Depressed, he had walked to the Ganga, thinking of taking his life. Fortunately, he turned back to give life another chance, according to a News18.com report.
During the second wave of Covid-19, he found himself slouched under the staircase of Patna Medical College Hospital, gasping for breath. But there was no hospital bed for him, and no oxygen supplies. He was convinced that he was going to die. But his life was ultimately spared once again: his wife took five hours to manage to buy an oxygen cylinder from the private black market.
Once recovered, Rai found a purpose to live. He resolved to ensure that he would help as many patients who needed oxygen, like he had. He and his wife invested their savings to create, initially, a small oxygen bank of 10 cylinders in the basement of their Patna apartment. Word of his mission spread through social media and contributions poured in, helping the bank expand to 200 oxygen cylinders.
Rai, now popularly known as “Oxygen Man”, would rise every day at 5 am, respond to calls for oxygen and set out in his small hatchback to save as many lives as he could. He did not take a single day’s rest through the second wave and saved at least 950 lives with the oxygen cylinders that he installed in their homes, never charging money.
He was not by any means alone.
A disabled beedi worker Janardhanan, from Kannur district in Kerala, was so distressed by the suffering he witnessed around him that he chose to donate all of his life savings, adding up to Rs 2 lakh, to the Chief Minister’s Distress Relief Fund. He was left with just Rs 850, but he was content.
A 19-year-old golfer Krishiv KL Tekchandani, who had been playing at tournaments since he was seven, donated the prize money accumulated over these years to fund the vaccination drive at his local Golf Club in Mumbai.
Many started helplines to assist others with information and support as they desperately searched for oxygen, beds and medicine. Just one of these “Covid-19 Helpdesks” started by the Presidency University Students Council, was joined by over 1,000 students. They formed a network on Facebook where they shared real-time updates on where those in need could find hospital beds, oxygen cylinders, refills, ambulances, plasma banks/donors, medicine, food, quarantine centres, safe homes and more.
Businessman and philanthropist Azam Khan led a team of volunteers in Telangana, who created an application for those searching for oxygen refills, and the team would lead them to the nearest source.
Gopi, an e-rickshaw driver in Lucknow, helped those in quarantine with supplies such as milk, vegetables and newspapers, and even medicines and medical reports from hospitals. Raja and Shakeel, who ran a cycle shop in Lucknow, were inspired to do the same. They even helped people withdraw money from their bank accounts, according to a Financial Express report.
In Kolkata, mountaineer Satyarup Siddhanta and model Madhabilata Mitra were part of a network of 400 others, including doctors, who offered treatment and advice. They also ran a free ambulance service. Many groups from around the country ran free quarantine centres for those who did not have homes in which they could be isolated. My colleagues who work with homeless people tied up with the Archbishop of Delhi and the Green Crescent in Darya Ganj to create two 50-bed facilities to provide Covid-19 care to the poorest homeless residents of the city.
Saddam Qurashi and Danish Siddiqui are two trained firemen employed by the municipal corporation in Bhopal. Since the pandemic began, the corporation had requisitioned their services as ambulance drivers. In the course of their work, they often encountered families too frightened to even touch the bodies of their loved ones who had died from Covid-19.
The two men took upon themselves the task of giving these bodies a dignified burial and cremated at least 60 bodies of Hindus who had succumbed to the dreaded virus with Hindu rites. “Dharm se uper insaniyat aur desh hai (humanity and one’s country are higher than religion),” they said.
One Kiran Verma posted on Twitter that he would be happy to transport people free in his car who needed to travel for treatment or food, and promised that he would do so “with a smiling face”!
It is because of people like these that amidst the deluge of grief and rage, I always, always encountered hope.
Read the other parts of the “Tsunami of suffering” series here.
Harsh Mander is a Richard von Weizsacker Fellow, Chairperson of the Centre for Equity Studies and convenes the Karwan e Mohabbat, a people’s campaign to fight hate crime with solidarity and atonement.