India Could Have Up to 500 Million Covid-19 Cases, Experts Believe

India Could Have Up to 500 Million Covid-19 Cases, Experts Believe
A crematorium ground in Allahabad, India, on April 27, 2021. (Photo: Sanjay Kanojia/AFP, Getty Images)

Official Indian government figures, not exactly rosy themselves, appear to be massively understating the scale of the covid-19 pandemic ravaging the country.

Indian health authorities have reported more than 17.6 million cases, but some health researchers suspect the real tally could be dozens of times larger — perhaps even over half a billion, CNN reports. Testing capacity in the country of around 1.4 billion remains grossly insufficient, with close to just 2 million tests being processed per day. World Health Organisation chief scientist Dr. Soumya Swaminathan told the network India’s nationwide positivity rate is around 15% and up to 30% in cities like Delhi, indicating a staggering number of cases left out of the official count — either because the infected individuals in question are asymptomatic, poor, or cannot access testing. Swaminathan added to CNN that prior serology surveys in other countries have indicated infection rates “at least 20 to 30 times higher than what had been reported,” meaning that India could have experienced up to 529 million cases so far.

Ample evidence exists elsewhere that the official government tally, now at 300,000 cases a day, is nowhere close to capturing the full extent of the crisis. Prime Minister Narendra Modi, the leader of the ultra-right Bharatiya Janata Party, has regularly downplayed the virus and has instead seemed more interested in suppressing criticism on social media sites. Meanwhile, the Indian medical system has collapsed, with shortages of personnel and virtually all supplies and equipment. Indian hospitals are reportedly turning away the sick by the hundreds due to lack of beds or oxygen. The sheer number of dead is overwhelming crematories in New Delhi and other cities, where massive funeral pyres have been operating 24 hours a day.

“In Delhi, at least 3,000 people went to funerals in the last week,” Max Rodenbeck, the chief of The Economist’s South Asia bureau, said on Monday, per CNN. “There is one crematorium in Delhi, which is a big land in the park, and (it is) building 100 new funeral pyres… This, is again, in India’s biggest city with the most attention. What happens beyond Delhi is pretty awful.”

Community medicine specialist Dr. Hemant Shewade told CNN that even before the pandemic, just 86% of deaths were estimated to have been officially tallied by the government, while only 22% of the registered ones were given an official cause of death. Many deaths involving the novel coronavirus are likely being recorded as arising from other causes or not being attributed at all. According to the New York Times, officials in the city of Bhopal reported just 41 deaths related to covid-19 in mid-April, but the city’s “main covid-19 cremation and burial grounds” reported 1,000 deaths over the same period. Similar undercounting has been reported in Lucknow, Mirzapur, and Gujarat. Dr. G.C. Gautam, a Bhopal-based cardiologist, told the paper, “Many deaths are not getting recorded and they are increasing every day. … They [government officials] don’t want to create panic.”

“We will know only later how many was really the number of people infected,” Swaminathan told CNN on Monday.

Rupal Thakkar, 48, died in a private hospital in Ahmedabad in mid-April after her oxygen levels plummeted. Her brother, Dipan Thakkar, told the Times her death was recorded as due to “sudden cardiac death” and that “it was a lifetime shock. Why would a private hospital connive with the government in hiding the real death numbers? It was an organised crime. It was an illegal act.”

Much of the tragedy in India is believed to be due to a newer variant of the coronavirus known as B.1.617. It has numerous mutations, some of which may make it more contagious than the original strain. Existing vaccines for covid-19 appear to be effective against it. But despite India’s status as a pharmaceutical powerhouse that makes about 60% of the world’s vaccines, over 90% of the population has yet to get a single shot. President Joe Biden’s administration told Modi’s on Monday that the U.S. will send India “oxygen-related supplies, vaccine materials and therapeutics,” and on Sunday it announced it would share 60 million doses of the AstraZeneca vaccine with the rest of the world (many bound for India). While public health experts attribute part of the botched rollout to complacency after the pandemic in India appeared to be winding down in September 2020, according to PBS, the country is running critically low on supplies to vaccinate its own population after producers signed so many export contracts.

Swaminathan told PBS that India is currently vaccinating about 2 million people per day, but the rate should be at 6 million to 7 million, and India “needs to be increasing manufacturing capacity several fold.” Investment bank UBS estimates that at the current pace just a quarter of India’s population will receive the vaccine by the end of 2021, according to the Wall Street Journal, and some private hospitals may price the vaccine at $US10 ($13)-$US32 ($41) a dose, well outside the resources of many low-income families.

“If we had more accurate data in terms of cases, infections, as well as deaths, then, of course, we’ll be much more prepared and also anticipate the healthcare resource needs,” University of Michigan biostatistics and epidemiology professor Bhramar Mukherjee told CNN. “[Faulty data] does not really change the truth. It only makes it worse for policymakers to anticipate the needs.”

If you have the resources, please consider donating to organisations helping fight the crisis in India. Links to charities and fundraisers are available on The Times of India, GoFundMe, Condé Nast Traveller, and The Cut, as well as this extensive crowdsourced list of individual fundraisers being maintained by volunteers on Google Drive, though be sure to vet any campaign before donating.