COVID-19 in India: the dangers of false optimism: The Lancet
Despite a strong response at the outset of the pandemic, as of Sept 22, India has the world's fastest growing outbreak of COVID-19 in absolute numbers according to WHO, reporting more than 5·6 million infections. Restrictions began to be lifted in June, and this relaxation has continued in the face of a continuing dramatic increase in case numbers nationally. Beneath these alarming national figures, the pattern of spread in India is nuanced and complex, with marked differences between states, and between rural and urban areas. For example, cities like Kolkata and rural areas in the north of India were relatively spared the outbreak initially, whereas Delhi, with strong international connections, was at the forefront of the first wave. Even so, India is clearly facing a dangerous period.
The country has responded well in many regards, especially
for such a large and diverse nation. India instigated a national lockdown in
March, which was praised by WHO. During the lockdown period, tertiary care
provision was increased, including access to specialist equipment such as
ventilators. Testing numbers also increased quickly, with India being among the
first to roll out innovations like pooled testing. India has also been at the forefront of
efforts to develop and manufacture a vaccine, both through domestic vaccine
candidates and manufacturers such as the Serum Institute of India preparing
production capacity for internationally developed vaccine candidates.
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Difficulties remain. The lockdown created a parallel crisis for many people as income fell dramatically, hunger increased, and many migrant workers walked long distances home. India's GDP was already decreasing before COVID-19 but the contraction of almost 25% year on year in the quarter April to June could make India one of the worst affected countries economically. As the outbreak has spread from its initial foothold in cities to smaller urban areas and villages, pre-existing disparities in health-care provision have become increasingly relevant. Rural health infrastructure in India can be sparse, and some smaller private hospitals have reported equipment shortages, especially oxygen.….
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