As April closed out, India became the holder of a tragic record. It became the first country in the world to record more than 400,000 COVID-19 cases in a 24-hour period.
The epicenter of the COVID-19 pandemic has changed regularly over the past 14 months, shifting from Wuhan, China, to northern Italy to New York before ravaging entire countries and continents. The US and South America have been the worst hit in recent months, but in April the epicenter has shifted once more.
India has seen a dramatic spike in cases and deaths since the beginning of March, but this catastrophic second wave is likely to have global implications.
What are the numbers?
Staggering. The numbers are staggering.
At the height of India's first wave, during August of 2020, the country was recording around 90,000 new cases a day. The world's second most populous country managed to flatten the curve: By February, many days passed in which newly recorded cases were below 10,000. Then in early March, the numbers began to climb. And climb. And climb. And rocket.
India recorded over 200,000 cases on April 15, and the rise since then has yet to be arrested. Over 360,000 cases were recorded on April 27, which at the time was the highest ever recorded in a single day by a single country. On April 30, India became the first country to record over 400,000 positive tests in a 24-hour period. On May 3, the most recent date for which data is available, 355,000 cases were recorded.
The catastrophe of this gargantuan second surge is compounded by the country's limited medical infrastructure. Hospitals throughout India are short on beds and especially oxygen, which is needed to treat severe cases of COVID-19, such that the country's air force is now air transporting oxygen to hospitals. And though India is the world's biggest manufacturer of vaccines, only 1.3% of its population was fully inoculated against COVID-19 by mid-April.
The result is a sharp increase in the official death toll. Reported deaths rarely exceeded 200 a day in February, but have surged to well over 2,000 per day in the last week.
What makes these numbers even scarier is that they're probably inaccurate. The real rise in cases and deaths, some experts worry, is significantly worse.
"Last year we estimated that only one in about 30 infections were being caught by testing," Ramanan Laxminarayan, director of New Delhi's Center for Disease Dynamics, Economics and Policy, told CNN. "This time, the mortality figures are probably serious underestimates, and what we're seeing on the ground is many more deaths than what has been officially reported."
What does this mean for the world?
The impact is threefold. First is the obvious cost in human life. China has the world's largest population, but swift lockdowns and border controls mean it's yet to endure a second wave. With a population of 1.3 billion and an already overwhelmed medical system, the death toll of widespread COVID-19 in India could be monumental tragedy.
Second is coronavirus mutation. As has happened in Brazil, Britain and South Africa, a new variant of COVID-19 has been detected in India: B.1.617. The World Health Organization has dubbed it a "variant of interest," meaning it has potential to be more transmissible or deadly, though its crucially not yet been dubbed a "variant of concern."
The Indian variant of COVID-19, which was first detected last October, has been found in 17 different countries, according to the World Health Organization. That's not an immediate cause of alarm -- B.1.617 appears to be as susceptible to vaccination as other variants, and as yet there's no significant evidence that the Indian variant is more dangerous than others -- though the situation can change.
"The driver for creation of virus variants in simple: the more cases of infection in one place, the more opportunities for the virus to mutate and adapt," explained Nikolai Petrovsky, a professor of medicine at Flinders University and secretary-general of the International Immunomics Society. Virus' adapt, he continued, to become more transmissible or to achieve "immune escape," where previously infected or vaccinated people can be re-infected.
"The more infections, the more variants, the greater the risk of a variant emerging that is even more transmissible and/or harder to control."
The third factor is the distribution of those Indian-made vaccines. India has banned exports of domestically-produced vaccines, reasoning they are most needed within the country. But India is also meant to be the principle supplier for Covax, a global initiative to distribute vaccines to low- and middle-income countries in Africa, Asia and Europe. When India's government banned vaccine exports in late March, the country's manufacturers were responsible for 86% of the initiative's vaccine supply, reports The Economist.
Led by the WHO, the Coalition for Epidemic Preparedness Innovations and Gavi, Covax aimed to deliver 100 million COVID-19 vaccines by the end of March, but by April 11 had reached less than 40 million. Petrovsky said the plan's fatal flaw was centralizing vaccine production in the first place.
Developing countries should "reject the myth that a single country like India can produce enough vaccine to protect the world during a pandemic," he said. "This was never realistic as during a serious pandemic, domestic self-interest will always reign dominant."
How did this happen?
In a January address at the World Economic Forum, Indian Prime Minister Narendra Modi boasted that India had overcome COVID-19. "India took a proactive public participation approach and developed a COVID-specific health infrastructure and trained its resources to fight COVID," he said.
Modi's confidence was premature, and many have heaped much of the blame for the second wave on the prime minister. The surge in cases is being largely blamed on several "super spreader" events, including a religious pilgrimage, which Modi did not discourage, and rallies for upcoming elections, which he actively encouraged
There are many reasons, says including poor dissemination of information by the federal government and sluggish responses in certain state governments.
"The government did not prepare the country for the possibility of COVID-19 returning with a vengeance, as had happened in other parts of the world," wrote Pradeep Taneja and Azad Singh Bali, scholars on politics and public policy respectively, for The Conversation. "Second, even as the virus spread like wildfire, Modi and his cabinet ministers kept campaigning in state elections in five states, addressing massive rallies and praising the crowds for turning out in large numbers."
Adding to the issue is the Kumbh Mela, a religious festival that's considered to be the largest gathering of people in the world. On April 17, around a week into the festivities, Modi said on Twitter that the pilgrimage should only be a "symbolic" one this year, so that India can help fight "the virus." But critics charge that this was too little too late, as an estimated 6 million visited Haridwar in April for a holy dip in the Ganges River.
But the country's leader was not the only one to prematurely declare victory over COVID-19, explained Sujeet Kumar, senior research fellow at Jawaharlal Nehru University. "The Indian media started praising Modi as there were comparatively fewer casualties and infections than other developing and developed countries," he said in an email. "It made people think that the coronavirus was gone, and they returned to their usual life. Given that, all the celebrations and festivals organised here did not follow the COVID protocol."
Addressing his nation in April, Modi's tone had shifted significantly since his January statements at the World Economic Conference.
"Our spirits were high after successfully dealing with the first wave," said Modi in a radio address to the country on April 25, "but this storm has shaken the nation."
How is the world reacting?
With the stakes in human life so high, and with vaccine production being concentrated so heavily in India, countries around the world have sent aid to India.
While it's implemented a travel ban to and from India, the US has committed $100 million in relief shipments to the country. That includes supplies of oxygen, COVID-19 tests and vials of Remdesivir. It's also sending 20 million doses of AstraZeneca, while vaccine-maker Pfizer said it will send $70 million worth of medicines to India.
It's far from just Uncle Sam chipping in, though. The UK has sent ventilators, France has donated oxygen generators and Russia has flown in its Sputnik-V vaccines.
Though India's government has changed its tune, encouraging citizens to take COVID-19 precautions far more seriously, some of its response to the second wave has been criticized. The Indian government sent Twitter and Facebook requests to take down tweets and posts that were critical of the government's handling of the second wave. Some of these tweets and posts were from politicians in opposing parties.
The ruling Bharatiya Janata Party says social media posts could cause panic, or confuse citizens with misleading information and photos. Jawaharlal Nehru University's Kumar sees it differently.
"In many BJP-ruled states like Uttar Pradesh, the government is giving fake data of deaths, but local journalists are posting videos of burning pyres or bodies in queue for cremation," said Kumar. "Social media allows common masses and a few journalists to highlight the issue, which exposes the incompetence of the government."
Correction, May 3: The date of India crossing 400,000 positive tests in 24 hours has been fixed.