India on 22nd April, Thursday broke the global record of most Covid infections in a single day after recording a massive increase of nearly 3.15 lakh new cases along with 2,102 deaths in the past 24 hours. The torrent of infections has led to a severe health crisis in the country with PM Modi saying lately that the second wave has hit India “like a storm”. What has been chiefly upsetting during the ongoing Covid surge is the rapid speed at which India is accumulating new infections.

It has taken just 17 days for the daily case tally to rise from 1 lakh on April 4 to over 3 lakh on Wednesday. During this period, cases have risen at 6.76% daily, more than four times quicker than a similar progression in daily numbers in the US — the only other country that has registered more than 1 lakh cases in a day.

The Destabilization of Healthcare:

Healthcare and other indispensable services across India are close to breakdown as a second coronavirus upsurge that started in mid-March rips apart the country with overwhelming speed.

Graveyards are running out of space, hospitals are refusing patients, and distressed families are begging for help on social media for beds and medicine.

At least 22 Covid-19 patients who were on ventilator sustenance died 21st April Wednesday, waiting for oxygen supplies that were lost in an accident, a senior official from the Nashik district in Maharashtra said.

Prime Minister Narendra Modi talked to the nation on Tuesday 20th April, recognizing the country’s “very big battle” against Covid-19. He reached out and appealed to states to “use a lockdown as their last option,” even as the capital New Delhi came into its first full day of a week-long lockdown.

On Monday 19th April, Delhi Chief Minister Arvind Kejriwal warned that failing to stop movement in the city could lead to “disaster.” On Tuesday, he cautioned that some Delhi hospitals were “left with just a few hours of oxygen,” as authorities scurried to transform sports complexes, banquet halls, hotels and schools into much-needed treatment centers, with the objective to add 6,000 extra beds within days.

With scarcities being reported across the country, local and state leaders appealed to the federal government for more oxygen and medicine. Modi appeared to answer those calls on Tuesday, declaring plans for the delivery of 100,000 cylinders of oxygen countrywide, new oxygen production plants, and hospitals devoted to Covid patients.

But experts fear it’s too little, too late, as positive patients scramble for limited resources and mass assemblies threaten to spread the virus even more.

In Maharashtra there is currently a day-to-day requirement for 1,550 metric tons of oxygen for Covid-19 patients but the state produces 1,250 metric tons of oxygen which is being used completely for medical purposes. The outstanding 300 metric tons are being provided by other states, Tope told reporters on 21st April Wednesday. Maharashtra has 3,343,359 cases of coronavirus including 685,552 active cases and 61,343 deaths according to the Indian Ministry of Health on Wednesday.

With few official opportunities available, families are turning to social media for help.

Demand for the drug Remdesivir and its active pharmaceutical ingredients has risen during the second wave, instigating the government to temporarily ban the export of the medication to increase its supply in the domestic market. The Indian government has authorised the drug for emergency use within hospitals, though the World Health Organization (WHO) says evidence does not suggest the drug reduces the risk of dying from Covid-19 or requiring mechanical ventilation. Seven major manufacturers of Remdesivir have cut prices to between 899 rupees and 3,490 rupees (about $12-47) due to “the intermediation of the government,” according to a government memo on April 17. But several states have recognised that high demand and low supply has created a black market for Remdesivir and analogous medications.

Potential Causes:

After the first wave concluded in the winter, the government and public relaxed too much, due to a mixture of Covid fatigue and a incorrect sense of security, experts say. In early March, weeks before cases began hiking again, the federal health minister stated that India was “in the endgame” of the pandemic. This kind of exultant rhetoric meant citizens relaxed their Covid-safe behaviour, such as social distancing or wearing face masks. And, despite forewarnings of Covid risks, large congregations continued to take place — sports matches recommenced, extravagant weddings went ahead, and movie cinemas reopened.

The biggest crowd by far is the Kumbh Mela, one of the biggest pilgrimages on Earth. Millions of Indians are traveling from across the country to Haridwar, an ancient city in Uttarakhand state, to join ceremonials and observances and take holy dips in the Ganges River. The festival publicly began on April 1 and ends later this month. There are Covid-safe recommendations in place — visitors must register online and provide a negative Covid-19 test to partake in the holy baths, and thousands of officers are directing surveillance — but experts worry it won’t be enough to minimize the risk, given the sheer number of devotees. Several million are likely to visit on “auspicious” days.

In West Bengal state, a major election ground, tens of thousands were part of assemblies by Modi’s Bhartiya Janta Party (BJP) and the reigning Trinamool Congress Party. Videos from Modi’s rallies, including one in Tamulpur in Assam state on April 3, show him orating before massive crowds, packed tightly together and cheering. Modi’s rallies have come in for severe criticism from several other political stalwarts, including a former finance minister who called the mass rallies “completely insensitive” given the Covid emergency. In the face of rising cases, the Indian National Congress, India’s main opposition party, has deferred all public rallies in West Bengal.

Meanwhile, the Kumbh Mela hasn’t been stopped, nor have any new rules been enforced to curb the surge. Numerous religious sub-groups, including Juna Akhara and Niranjani Akhara, have since requested their followers from out of state to return home and follow recommendations. Some states and cities are necessitating festival returnees to be tested for the virus and isolated. But medical personnel fear it’s too late.

New Infectious variants:

Some experts said it is likely that the surge could be driven by the existence of more contagious variants, which weren’t present during the first wave. Late last year, scientists had identified a new variant, called B.1.617, with two mutations – the E484Q and L452R. This double mutant strain was first noticed in Maharashtra. Now, India has also discovered a “triple mutated” variant of the virus, which has been found in samples taken from Maharashtra, Delhi, West Bengal and Chhattisgarh.

In fact, the Covid-19 virus that is doing the rounds in Bengal is progressively being found to be an indigenous triple-mutation (B.1.618). “Bengal strain”, as a scientist has named it, might be more virulent, and — something that experts find principally disturbing — may be capable of escaping a person’s immune surveillance, even if that person was previously exposed to a virus without this mutation, and even if vaccinated.

Potential End of 2nd Wave:

It’s hard to say but specialists believe that India will hit its highest case load between May 11 and May 15. Researchers working on a mathematical model to work out the development of the pandemic say there is a likelihood of a peak rise between the dates of May 11 to May 15 with 33-35 lakh total ‘active’ infections. This means the number of ‘active’ cases in India will keep snowballing roughly for another three weeks before a drop.

If the current model shows the trend accurately, the mid-May peak would be three times greater than the first peak of over 10 lakh ‘active’ cases observed on September 17 last year. The present model shows that Delhi, Haryana, Rajasthan and Telangana may see a peak of ‘new’ cases during April 25-30; Odisha, Karnataka and West Bengal during May 1-5 while Tamil Nadu and Andhra Pradesh during May 6-10. It shows Maharashtra and Chhattisgarh might already have touched its peak phase now while Bihar will see it around April 25.

India is faced with the colossal challenge of trying to prevent its health care system from further failure until enough people can be vaccinated to considerably reduce the stream of patients. The overflow of new infections has already stunned the healthcare system, with various hospitals as well as states facing shortage of oxygen, ICU beds, ventilators and key drugs.

The positive news is that India is a major vaccine manufacturer, but even after stopping large exports of vaccines in March to focus them to domestic use, there are still problems of whether manufactures can produce enough fast enough. Vaccination is one way to slow down the onslaught – but this really rests upon the rapidity and availability of the shots.

India has so far administered jabs to over 13.23 crore of its population, which includes over 1.9 crore people who have been fully vaccinated.