The continuing staff crunch and lack of infrastructure in the health sector are the main hurdles in COVID management in India.

The crowds at testing centers across the country and the delay in reporting of positive cases has become a major cause of concern.

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"I went for the COVID test a few days ago as the negative test report was mandatory for attending a meeting in some other state. When I saw the crowd for the COVID test outside the center, I was fearful that I would catch the virus," local citizen Venod Kumar said. Many people are actually not opting for tests at centers because of such fears.

More so, people in the country are so apprehensive that they have suddenly taken to panic buying of oxygen canisters and cylinders to have at home to meet any crisis, creating unwanted scarcity in the market for those requiring this equipment the most.

Visibly, the social workers and the health teams have provided relief in identification and drug distribution to COVID patients at home and the Indian government is constantly updating the facilities. Still, there is a glaring mismatch in the burden of cases and the existing facilities at COVID care centers, which has compounded the crisis in India, leading to very high casualty in the second wave.

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Shimla, INDIA

The COVID-19 pandemic has crippled the whole world. India is no exception and is currently grappling with a crisis to save lives in the midst of the second wave, which is far more devastating.

The latest official reports show that India recorded over 352,000 new cases between Monday and Sunday with total infections rising to around 17.3 million.

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The active cases in the country are over 2.8 million, while 14.3 million patients have recovered after testing positive. The total death toll in India is now over 195,000 with a record 2,812 new fatalities in the last 24 hours.

India was seemingly quick to respond when the pandemic broke out last year and imposed nationwide lockdown beginning March 24, 2020, continuing for a few months. It followed strict restrictions on movement within the country and with the central government taking the lead in monitoring the states, things remained under control. The country got the time to prepare to handle the cases in the meantime.

All this did shatter the country's economy with everything coming to standstill then, but fewer lives were lost in the pandemic in 2020.

However, after witnessing low mortality figures in the first wave in India compared to the developed nations last year, everyone, in this country of around 1.4 billion, took things lightly and could not anticipate that the impending second wave (that was already ravaging other countries) in 2021 could be so devastating. This affected the overall preparedness.

There was general slackness in restrictions across the states in India. The mass gatherings – events like Mahakumbh Mela (biggest religious congregation) at Haridwar in Uttarakhand (a Northern state) and the election rallies in certain states – were allowed even as the second surge was underway.

Though the political leadership in India did a commendable job in supporting the manufacturing of the vaccines for COVID-19 and around 141 million people have already got the shot. There have been gaps in timely planning on the ground to control and treat the cases in the last few months. The hospitals in many cities, including the national capital Delhi, have run out of beds and oxygen, leaving the people to gasp for breaths outside, resulting in many deaths.

"I think the Indian government should give thrust on COVID management at home also. People are unaware and all of them rush to hospitals. They should be told about the symptoms and tools to check at home," said renowned public health expert in Delhi, Dr. Denny John.

"What has compounded the problem is that people are not being admitted to hospitals without a COVID diagnosis and are made to wait and wait. The reports are taking time. The government must order that staff at hospitals use a triage system in hospitals as advocated in disaster management to prioritize most serious patients," he said.

Dr. John said many private hospitals are not honoring the health insurance in this crisis and making the people pay upfront because of the stress on the system.

"The central and state governments could not envision that the second wave was going to be so bad. Otherwise, things would have been better," said a disability rights activist, Ajay Srivastava from Shimla in Himachal Pradesh (a north Indian state). Srivastava, who got a positive diagnosis a few days ago, said he and his wife had self-isolated themselves at home after coming back after attending a relative's death in Delhi. "I am surprised nobody checked us on the state border. The government should have some restrictions on borders to check spread," he said. The couple later preferred to move out of state, looking for better treatment facilities.

Realizing the gravity of the situation, however, the Indian government has now taken many steps to fill the gaps, by increasing the supply of oxygen, provision of extra beds and availability of drugs. It has allowed states to decide and take stringent measures to check the spread of infection.

Efforts for international imports of essential drugs and oxygen have also been geared up. The results are yet to be seen.

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