Familiares de pessoa que morreu de Covid-19 durante cremação em Bengaluru, na Índia 13/05/2021 REUTERS/Samuel Rajkumar

A scandal emerged first when a local newspaper in Gujarat reported that the true death toll in the state was being hidden and that it was probably many times more than the official numbers. Many Indians had suspected that the true scale of the pandemic was being hidden from view, as hospitals and doctors, and front-line healthcare workers (ASHA workers) were beginning to get overwhelmed in the face of mounting numbers. This was followed up by certain health experts suspecting higher mortality than the official reports, namely Dr Jha, who had estimated a daily death toll of up to 25,000. Now, even the New York Times is reporting the possibility of a much higher death toll.

By Adhiraj Bose – Mazdoor Inquilab  from Kolkata India

In their paper dated 25th May, the New York Times created a stir, when they reported the actual fatalities from the pandemic in India might be over 4.2 million! That would be more than the entire global total of the pandemic so far. The government, of course, denied it, but without any substantial proof to back up their claims, nor any real refutation of the Sero survey data that the statisticians cited by the New York Times referred to. This data was from the government’s own survey. 

If there is any truth to this, and in all likelihood, there is, then this would be the worst, most fatal episode in South Asian history, since the Bangladesh liberation war, where at least 300,000 Bengalis were killed by the Pakistani army (and possibly up to 3 million). The responsibility for this disaster lies squarely at the feet of the government in charge. Modi led the ‘pharmacy’ of the world, with the largest capacity for vaccine production and research, a large army of committed healthcare workers, and an annual budget of over 300 billion dollars, and led it to the ground, to a humanitarian disaster. 

The government must be blamed for its callousness, incompetence, and arrogance, with the way it treated the people of India. While the second wave has started to subside, with reported cases falling to levels of the first wave (62,226 new cases on 15th June, 1,470 deaths, official figures), the damage done over the course of the first and second wave of the pandemic is yet to be undone. Unfortunately, the BJP led government has already started tooting its own horn and making manoeuvres to take credit for the success, which is owed entirely to the brave healthcare workers and doctors of India, not to the bungling and arrogant government.

Even by official figures, 380,000 deaths have occurred in India, with more than 200,000 in the brief second wave alone. The lock-downs caused economic chaos and plunged the country into the first recession in 40 years, and caused job losses in the tens of millions. This disaster was not a day in the making, if we recall, the government’s bungling began with the first wave itself. 

The first wave and the lockdowns

The first wave was handled disastrously. As we had written about previously, despite knowing about the virus since December, and being warned of its potential to spread, the government took the threat lightly and did not impose curbs on foreign travel till it was too late. There was no preparation for a possible outbreak in India, on the contrary, the government was organizing mega-events like the “Hello Trump” event in Gujarat. It was to no one’s surprise that Gujarat eventually became one of the most affected states in India.

When the government did take action, their lack of preparedness showed as the government hastily imposed a nationwide lock-down. Millions were put out of work and displaced as migrant workers and daily wage earners were left without any means of earning a living. There was no contingency plan for them, no measure to ensure their hardships could be minimized. Instead, a callous and heartless suspension of economic life throughout the country crippled India for many months to come. The lockdown was released when it became too much to bear, seeing workers crawl on streets and lick spilt milk to satisfy their hunger. It was not until workers went on a riot in Gujarat and Maharashtra that the government started allowing trains to operate, so they could return home. The lock-down was ended soon thereafter, and the first wave showed its second more deadly face, as new cases ballooned into the tens of thousands, and daily deaths touched 1,000 and above.

The first wave was a disaster, but it was nothing compared with the government’s mishandling of the second wave of the pandemic, the one we are still going through. After a great effort, the first wave subsided, new cases went from nearly 100,000 a day to less than 9,000 a day. However, this is where everything started to go haywire. The pandemic had subsided, but it was not out, testing had declined precipitously, and nothing had been done to augment India’s notoriously fragile healthcare infrastructure. The government was not lacking in funds, it could afford to build the new parliament building, and green-lit the Central Vista project which costs 20,000 crores. This was a shameless vanity project that everyone in the opposition was vocal against, but the government was committed to seeing through with it. However, the greatest priority for the government was winning the elections in West Bengal, Assam, Tamil Nadu, Kerala and Pondicherry. 

Prelude to the second wave

The BJP has two concerns over all others, taking power and keeping it, through any means possible, and using that power to push forward a reactionary neo-liberal agenda, which legitimizes Hindutva, and destroys India’s public sector. They do not care if the working class lives or dies, they hate India’s minorities, and they hate India’s Dalits, they care only for the upper caste, and have been becoming more brazen in this bias. Yogi Adityanath, the Chief Minister of Uttar Pradesh most reflects this transformation. Unsurprisingly, during the pandemic, his state, along with Gujarat, Bihar and Madhya Pradesh, were at the forefront of censoring Covid mortality data. It was even less surprising then, that the BJP used the resources and institutions of the government to win in the five poll-bound states, the most important of these being West Bengal, which had been a traditional bastion of opposition against the Central government. The election campaigning saw large scale rallies, propaganda efforts, no social distancing was maintained, and no heed was paid to the possible spread of the virus. In order to boost up the party’s ‘Hindutva’ credentials, they removed the sitting Chief Minister of Uttarakhand, a state under the party’s rule, and replaced it with a more pliant hardliner. The reason for this? The outgoing chief minister wished to impose restrictions on the Kumbh Mela festival, where millions gathered to take the holy dip in the Ganges.

The Kumbh festival is an annual festival of great importance for Hindus and the BJP, of course, had to keep it ongoing, lest its core support base in the five poll-bound states, went against them. The consequence of this move was the creation of the world’s largest super spreader event, where millions amassed to take the holy dip in the waters of the Ganga and exposed themselves to the possibility of being infected. Elections were first and foremost in the mind of the government, so when the second wave was showing signs of emerging around the end of February, the government paid no heed to it, campaigning continued, the Kumbh Mela festival continued, while the government pretended everything was alright. India hadn’t even recovered from the disastrous lock-down of the first wave, and the mammoth job losses which came with it when the second wave hit.

It did not take long for the pandemic to get out of control, cases ballooned from 9000 a day to 400,000 a day in a span of a month, the death toll crossed 1,000 in a few weeks, and touched 4,000 in May. These were of course official numbers, and India’s notoriously bad record-keeping, and municipal systems, ensured that the reality would be clouded by red tape or inefficient recording. The Sero survey data, along with fatalities reported from overburdened crematoriums, suggested a much more dire picture than what was reported. It was common to find crematoriums and crematorium workers being overburdened with the new arrivals every day. In one case, ad-hoc crematoriums were set up in a parking lot. The most macabre visuals came from Uttar Pradesh where bodies flowed down the Ganges in the dozens, some were simply dumped there, perhaps to hide the true scale of the tragedy? The Uttar Pradesh government had restricted photography at crematoriums for a time, a clear effort at censorship.

India’s healthcare collapsed

Over the course of this horror show, critical medical supplies were found missing, especially oxygen. The government had let off the reins by now, and Modi even came on television essentially leaving the citizens to fend for themselves. During this time, many youths across the country formed help committees using social media, while youth workers of the communist party helped people find beds in hospitals. Social media played a critical role in helping patients find beds, as well as reporting on shortages in hospitals. In some cases the government censored such tweets and resorted to harassing helpers, using the state police. The BJP was more worried about their image being tarnished than in saving lives. This attitude was also reflected in the government’s confused vaccine policy.

India was known and is still known, as the pharmacy of the world, in part because of the prolific manufacture of generic drugs which are exported across the world. Africa in particular is dependent on Indian exports of medicines. India’s high vaccine capacity helped the country overcome polio and eradicate it. As the first wave of the pandemic subsided, the government got cocky, and decided it was a good time for India to increase its influence in the world, and engage in what the media has coined ‘vaccine diplomacy’, where major economies compete to sell their vaccines to various countries of the world and increase their ‘goodwill’ and influence. China and Russia have done it with Sinovac and Sputnik, the west did the same with the Pfizer vaccine, and India decided to get in on the game. Unfortunately, they did not count on the second wave hitting as hard as it did, perhaps because the government was too blinded by its hubris, and claimed to have prematurely ‘won’ over the virus. The government exported 66 million doses of the vaccine as part of a UN programme, those 66 million doses could have been used to save the lives of Indians at home, but instead, we ended up with critical vaccine shortages. 

The BJP answered this by practising its own version of vaccine discrimination: states under the party’s rule received far more doses than states ruled by the opposition. This was brought out by the state of Maharashtra and exposed the government’s double-dealings and single-minded determination to keep power. The situation was never truly remedied, and it has created an uneven situation between states with higher vaccination rates and states with lower vaccination rates. The problem was further compounded by a confusing three-tier price for vaccines, where most nations are implementing a free universal vaccination programme, India under the BJP went backwards and implemented a tiered price system for vaccine distribution! Many in the middle class who had already been pushed to the brink of poverty, would not be able to afford the price, and critical shortages of vaccines have ensured that many who would avail free vaccination could not get the jab. 

The result of all this is probably the highest death toll in the world or, at least, close to the levels of the USA, at a minimum of 600,000 deaths (the same figure cited by the NY Times article).

Conclusions

The pandemic in India is a humanitarian disaster of epic proportions. Since the Spanish flu outbreak that killed over 17 million, India hadn’t faced a health crisis like this. India’s capitalist rulers, could not set up a health infrastructure that could adequately care for its 1.3 billion citizens, even as it showed potential to do so. The ‘pharmacy of the world’ does not have enough doctors per million, or beds per million, to treat their patients and that is under normal conditions. The pandemic exposed just how ramshackle the state of healthcare is, and this is one of the most privatized health systems in the world. 

Public hospitals are treated with disdain, and anyone who can afford a private hospital does so, at great cost to themselves. The government barely funds these institutions, as a result, not only is critical healthcare infrastructure missing, but front-line healthcare workers, the nurses, junior doctors, and even senior practitioners, are left overwhelmed, overworked, and underpaid. It is not for no reason that junior doctors and nurses often go out in protests against the government. 

Over the course of the pandemic, about 1,000 doctors have given their lives to treat the sick, doing 24-hour shifts in overwhelmed hospitals, working in an environment where there are actual threats to their lives from impassioned family members of patients. Attacks on doctors are a common occurrence in India, but the government takes no steps to remedy the situation because healthcare is not a priority. It was not a priority for Congress nor is it for the BJP. In this critical junction, we must raise important questions. Now is the time to talk about a nationalised healthcare, with an adequate budget and funding, which can ensure medical treatment for all. There is no dearth of committed healthcare workers in India, India already has one of the world’s most prolific pharma sectors, and has the resources to build it up. What is lacking, is the political will to do so. It is here that the struggles of junior doctors and healthcare workers, must rise above their immediate local perspective and evolve as a movement for socialized healthcare. 

The United Kingdom, where capitalism was born and developed to the greatest extent, could build a world-class national health service. This same National Health Service saved Britain from what could have been a much worse pandemic, thanks to a great deal to Boris Johnson’s leadership. Despite all the attacks on it in the past several years, from Thatcher to Johnson, it has survived, because the working class of the UK have fought to defend it. If the British could build a National Health Service, then so can we! And we must strive for it! 

NATIONAL HEALTH SYSTEM! 

SUPPORT THE ASHA WORKERS!

SUPPORT THE JUNIOR DOCTORS! 

DOWN WITH MODI! 

DOWN WITH CAPITALIST HEALTHCARE!