India finds itself in the throes of a humanitarian disaster. Until March 2021, case numbers were low in most parts of the country, leading many to think that the worst was over. Much like in Brazil though, jingoism, overconfidence and false reassurance from the political elite negated hard-won progress.

Mass gatherings have acted as state-sanctioned super-spreader events. More infectious variants and a sluggish uptake of vaccines are also fuelling the current surge. These are the triggers, but there are more deep-rooted issues at the heart of the current crisis.

India is an inherently high-risk country for an epidemic. The country holds 1.4 billion people, living in crowded areas with extensive community networks and limited facilities for sanitation, isolation and healthcare.

Most do not have the luxury of isolating at home for prolonged periods. Over 90% of workers are self-employed with no social safety net. The vast majority rely on daily earnings to put food on the table. Many predicted that because of all of this, the initial wave of COVID in 2020 would have a devastating impact.

The fact that it did not led some to believe that the Indian population was innately less vulnerable to COVID. An old theory, the hygiene hypothesis, was dusted off in an attempt to explain the low number of cases. The idea is that poor hygiene trains people’s immune defences, so when people are exposed to the coronavirus, their bodies are well-equiped to deal with it.

But this theory largely relied on population studies that failed to account for various factors involved in disease severity at an individual level. Even with higher quality research, correlation does not imply causation, especially with the threat of new variants on the horizon. And yet this theory settled comfortably into the national psyche of a traditionally patriotic country.

Complacency gave the coronavirus an opportunity to spread. Unlike in the first wave though, proportionally more cases have progressed into deaths this time around because the health system was overwhelmed. Supplies of oxygen, ventilators, health workers and beds are critically low in hotspots like Delhi.

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https://theconversation.com/covid-in-india-the-deep-rooted-issues-behind-the-current-crisis-159854