What are the global implications of India’s second wave of COVID? | News on the coronavirus pandemic

India has reported 357,229 new cases of coronavirus in the past 24 hours – the 13th consecutive day of more than 300,000 infections – bringing its total to more than 20 million. Deaths increased by 3,449 for a death toll of 222,408, according to data from the Department of Health on Tuesday.

However, medical experts say that real numbers across the country, $ 1.35 billion may be five to ten times the official count.

The sharp rise in infections in the first week of April, when India first exceeded 100,000 cases, was a sign of impending disaster.

Within weeks, India fell into COVID-19 hell as images of corpses lined up outside crematoriums, endless funeral pyres and burials emerged from its main towns and villages.

COVID patient is comforted by his daughter as he receives treatment at a New Delhi hospital [Danish Siddiqui/Reuters]

The current health crisis is moving rapidly to small towns and villages where people are dying from lack of oxygen, hospital beds and life-saving medicines, just like in big cities.

The second wave is largely attributed to a contagious mix of coronavirus variants spreading to different parts. Two variants, the British variant (B1.1.7) and the Indian variant (B.1.617), are largely responsible for the current wave of infections.

As the chaos caused by the British variant in India shows, the emergence of an Indian variant has raised concerns around the world.

The Indian variant, suspected of being highly contagious, could become a global problem – according to the WHO, it has already spread to at least 17 countries.

“No place is really safe and that’s why the world is so concerned,” says India’s leading virologist, Shahid Jameel.

Worrisome variants

The disastrous new chapter of the pandemic in India not only threatens its security, but puts the whole world at risk.

Since December of last year, several variants have spread across the country.

In the northern states, the British variant is considered more dominant according to experts, with nearly 80% of the spread in Punjab and 40-50% of the spread in Haryana and Delhi attributed to it.

It is also present in Uttar Pradesh and Kashmir under Indian administration, in different proportions.

In Maharashtra, however, the Indian variant is more virulent, with parts of the state reporting up to 60 percent of the sample being the Indian variant.

In the east, another story unfolds.

“Our analysis shows that all possible variations are found in West Bengal,” says Jameel.

A long-running assembly election in West Bengal, with mega electoral rallies led by political leaders, including Prime Minister Narendra Modi, is believed to have turned into several “super-propagator” events.

As the state witnesses a spike in cases, the true extent of the spread in West Bengal will be visible in the coming weeks, experts say.

According to Jameel, West Bengal has the UK and Indian strains as well as the South African variant (B.1.351) in small proportions.

“The vaccines have less of an effect on this (South African) variant and how it got to Bengal remains a mystery,” Jameel explains.

The State also discovered another variant, B.1.618, a new line of the Indian variant with a mutation characteristic of the highly transmissible South African and Brazilian variants (P.1).

The WHO lists three variants, first found in the UK, South Africa and Brazil, as ‘variants of concern’, while the Indian variant remains a ‘variant of interest’.

Some, however, caution against blaming only the variants and ignoring the lack of public health measures that lead to the surge.

“India opened up early, believing the virus to be under control, and recent ‘maskless’ political rallies, outdoor religious festivals have also played a major role in increasing transmission and spread. spread, ”said Pooja Gala of the NYU Department of Medicine and Population Department. Health.

Despite a raging pandemic, the Indian government has allowed religious gatherings like the Kumbh Mela (Pitcher Festival) which has seen more than 9 million Hindu pilgrims converge in the state of Uttarakhand in northern India.

A Hindu waves the Indian flag as he dives into the Ganges during the Kumbh Mela in Haridwar, Uttarakhand [File: Anushree Fadnavis/Reuters]

Threat of mutants

In a larger pool of infections, the likelihood of mutations increases.

“Every time a wave or a spread occurs, the main strain that spreads will continue to change,” says T Sundararaman, global coordinator of the People’s Health Movement and former executive director of the National Health Systems Resource Center.

“But so far none of the variants have shown the ability to evade immune,” he says. Immune leakage occurs when a human body does not respond to an infectious agent, in this case a variant.

In a new study, researchers found that the most transmissible Brazilian variant was able to evade the body’s immune response built by a previous infection of a different variant.

The Brazilian variant has spread throughout Latin America, causing deaths and hospitalizations, even in countries with high vaccination rates.

Similarly, in February, South Africa halted deployment of the Oxford-AstraZeneca vaccine (Covishield in India) after a trial showed it offered “minimal protection” against mild and moderate cases of the variant. South African.

Sundararaman told Al Jazeera that if the spread continues in India, “potentially lethal variants that have immune leakage properties” can spread and cause new waves in countries like Chile, despite strong immunization.

“If we don’t eliminate it, the pandemic can be a recurring affair across the world for a long time,” says Sundararaman.

According to Jameel, the incubation period (time between infection and symptoms) of coronavirus is around two to three days, and sometimes even longer.

“The world is really small now because of the speed of international travel. Any virus that is present anywhere can go to another before you even get sick, ”Jameel said.

On April 20, Hong Kong closed all flights from India for two weeks after health officials found 58 passengers on one flight tested positive after arriving. Health officials have found seven of them infected with the Indian variant but with the N501Y mutation.

The N501Y mutation, associated with higher transmissibility and lethality, had been found in three “variants of concern” – the UK, South Africa and Brazil – but was not detected earlier in the variant. Indian.

Many, like US public health researcher Devi Sridhar, advocate border restrictions, managed quarantines and vaccine passports that would allow fully vaccinated individuals to travel without quarantine.

Border restrictions, she wrote in The Guardian, cannot stop new variants but can slow the spread to give scientists time to determine the level of risk posed by the variants to the population of the country.

Border restrictions have worked for several countries, such as New Zealand, Taiwan, South Korea, and Singapore, helping them contain the spread and emergence of any variant.

Vietnam, which closed its borders in March last year, has managed to limit the death toll to 35 and grow its economy.

‘Vaccinate everyone’

A global pandemic is everyone’s problem and requires a global response.

“If we really want the pandemic to be over, we must not only vaccinate at home, but vaccinate everywhere. This is the only way to prevent the emergence of variants that might elude our immunity or affect children more seriously, ”Sridhar wrote.

Unlike the first wave last year, hospitals are seeing more and more young adults and children being brought to the emergency room.

Earlier this month Delhi Chief Minister Arvind Kejriwal revealed that more young people were infected, saying “more than 65 percent of patients are under 45”.

“We saw the same with B1.1.7 in the UK. This may be due to variants that are more easily transmitted and cause more serious illness in all individuals, but we will need more data, ”said Gala.

Police officer asks people who have come to receive a dose of COVID-19 vaccine to leave in a vaccination center closed due to the unavailability of the vaccine, in Mumbai [Francis Mascarenhas/Reuters]

Experts, especially in Western countries, are concerned that such a variant is reaching their shores where, despite strong immunization in older generations, the younger population remains at risk while waiting their turn for vaccines.

India, which was supposed to help vaccinate other countries, is now struggling to vaccinate its own.

Earlier this year, India launched an ambitious vaccination plan starting with inoculating 300 million Indians by the summer. The country has also sent more than 60 million doses of the nationally developed Covishield and Covaxin vaccines to several countries as well.

On May 1, India opened vaccination to all people between the ages of 18 and 45 but is struggling to deliver the doses needed to meet demand. Several states have come out to say that they are forced to postpone the vaccination campaign because they do not have the vaccines.

“India was going to provide 50 percent of the world’s vaccines this summer, and a large portion would go to low- and middle-income countries. From now on, the vaccines will be for household use, ”says Jameel. This raises concerns about the global demand for vaccines, especially in low-income countries, which India was supposed to meet.

As India reaches out to the world, many countries have stepped up to help the crisis-stricken country.

India has received oxygen from Germany, Taiwan, the UK, and several countries in the Middle East, among others. On May 1, it received the first shipment of Russian vaccine Sputnik V, which was granted emergency use authorization by Indian regulators two weeks ago.

The United States, after strong pressure, will ease its embargo on raw materials for vaccines and send test kits, protective equipment, oxygen cylinders and ventilators.

Experts suggest that aid for procurement may not be enough and the situation would necessitate the relinquishment of vaccine patents, technology transfer, technical expertise and manpower on the ground for the mass vaccination.

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