Covid in India and the Indian Variant in the UK

Photograph Source: Javed Anees – CC0

The Covid B.1.617.2 variant (also known as the Indian variant) is one of the factors driving the current pandemic in India.

It has also been linked to recent increases in cases among unvaccinated people in the UK, which now has the highest number of cases of the Indian variant outside India itself. According to The British Medical Journal, cases of the Indian variant in the UK have risen by more than 160% in the week to 20 May. The variant is still predominantly affecting the north west of England and London, but there are clusters across the country.

India’s official death toll from the Covid pandemic is reported to be 295,525, with total infections standing at 26.3 million ((as of last Saturday). However, experts believe the real figure to be up to five times higher. Mortality and morbidity are 75% of those aged 45 or more, and this age-group has been given priority in the face of India’s vaccine shortages.

The virus continues to spread out from India’s big cities into rural areas.

The toll of the pandemic on the rural villages of India, home to 65% of the population and where basic healthcare infrastructure is lacking or absent, will probably never be known. In Uttar Pradesh, where the population of 235 million surpasses that of Brazil, rural villages across UP have reported people dying in their scores within days of getting a cough, a fever or breathlessness, without however getting a Covid test. The government has begun door-to-door testing in villages but has not reached many remote areas.

Meanwhile, these villagers have patchy medical care. Many suspected Covid patients can’t reach hospitals in bigger towns, and die at home. Those who can make it to hospitals are often sent home because hospitals lack oxygen and beds. Many rural hospitals don’t have tests for the Covid virus, so Covid deaths can’t be recorded as such. Some hospitals are so overwhelmed that incoming patients aren’t being registered. In some cases, patients are being treated by first- and second-year medical students. The Guardian says that

“with few doctors and nurses on the ground, many clinics are run by people who don’t have training.

Reuters reports,

The poor health infrastructure and lack of testing means many patients do not know if they are infected with Covid-19 or just have a cold.

In Parsaul village, about 60km (40 miles) from the capital New Delhi, villager Ashok said people in his area were afraid to step out of their houses. He suspects that coronavirus had killed around 15 people nearby in recent days.

Ashok has come with a patient who had fever to the clinic run by a 52-year-old former hospital assistant who moves from one cot to another to check IV levels. Empty intravenous drips lie piled up under a brick-walled staircase.

“Patients with fever and breathing problems have increased in the last two months,” said the former assistant, who said he had been helping patients at his clinic since 1993 but did not wish to be identified as he feared a backlash from authorities.

“The people from nearby six or seven villages know me personally and trust me.” Some patients wore face masks lying on cots, while others had their faces covered with clothing.

Bubli, 30, visited the clinic to get treatment for fever.

“No, she doesn’t have Covid, it’s just a fever,” Bubli’s husband told Reuters. “We are scared of Covid, but going out to a big hospital is more dangerous.”

The cost of firewood for cremations has increased significantly, so poorer families are immersing the shrouded bodies of dead relatives in the Ganges river (regarded as sacred by Hindus), and allowing them to float downstream. Others have buried bodies on the sandy banks of the Ganges.

India’s government has ordered social media platforms to take down content that refers to the “Indian variant” of the coronavirus. The prime minister, Narendra Modi, has been scarcely visible during the current Covid surge. Modi has grown his hair down to his shoulders, with his beard grown to a corresponding length. As a result, he now has the look of a Hindu holy man, who would not look out of place giving his benediction at Woodstock, a la the Maharishi. Whether the new look will arrest Modi’s fall in popularity is another matter.

Kerala state has been a shining exception to India’s chaos. It has more than 250 hospital beds per 100,000 people, about 5 times India’s average, according to data provided by the government and World Health Organization. It also has more doctors per person than most states. Kerala’s share of fully vaccinated people is nearly double the national average of 3 percent.

Kerala’s state government has long been controlled by the Communist Party of India, and has a sustained record of investment in healthcare and education.

Boris “BoJo” Johnson has of course little credibility when it comes to the UK’s response to the pandemic. His response to the surge in cases of the Indian variant is true to form.

Asked why the Indian variant had spread so rapidly in the UK and why India was put on the red list (for quarantining air travellers coming into the UK) two weeks after Pakistan and Bangladesh, which had comparable levels of Covid 19 in early April, BoJo dodged the question by saying, laughingly, that the UK had the strongest borders in the world. The truth is that BoJo is desperate for a post-Brexit trade deal with India, and this appearance of giving Modi’s government the measly vestige of preferential treatment is a not-so-subtle attempt to curry favour with New Delhi.

In addition to being far too slow to put India on the red list, BoJo knows his roadmap for lifting lockdown restrictions is now under threat, and that his guidance for summer travel is a mess.

The Observer has seen documents in which BoJo’s office leaned on Public Health England (PHE) not to publish crucial data on the spread of the Indian variant in schools.

This attempt at concealment was said by scientists, union leaders and teachers to be “deeply worrying”.

The focus of their concern is the pre-print of a PHE report that included a page of data on the spread of the Indian variant in schools. But when the report was published on May 13, the page was not included—it was the only one that had been expunged from the pre-print. Shortly afterwards, the government proceeded with its decision to remove the mandate on face coverings in English schools.

This week BoJo’s erstwhile Rasputin-like adviser Dominic Cummings is scheduled to give evidence to the House of Commons health and science committees as part of a joint investigation into what can be learned from the handling of Covid in the UK.

Cummings, who was given the boot by BoJo in November last year, has turned against his former boss, and his testimony is much anticipated.

In a series of tweets, Cummings has already mentioned government graphs from the pandemic’s initial stages showing projections for a single, protracted but flattened wave of contagions and deaths, with herd immunity cited as “the optimal single-peak strategy”.

The government has denied that herd immunity (which would have resulted in tens of thousands of excess deaths) had ever been on its agenda, and this adds spice to the parliamentary appearance of the proverbial loose cannon Cummings.

Kenneth Surin teaches at Duke University, North Carolina.  He lives in Blacksburg, Virginia.