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India is preparing for another COVID surge but low vaccine coverage leaves it vulnerable

People stand in a queue to receive a COVID-19 vaccine in Bengaluru, India. Jagadeesh NV/EPA-EFE

India is preparing for another COVID surge but low vaccine coverage leaves it vulnerable

People stand in a queue to receive a COVID-19 vaccine in Bengaluru, India. Jagadeesh NV/EPA-EFE

India is preparing for another COVID surge but low vaccine coverage leaves it vulnerable

People stand in a queue to receive a COVID-19 vaccine in Bengaluru, India. Jagadeesh NV/EPA-EFE

India is preparing for another COVID surge but low vaccine coverage leaves it vulnerable

People stand in a queue to receive a COVID-19 vaccine in Bengaluru, India. Jagadeesh NV/EPA-EFE

The Indian healthcare system’s capacity to respond to the second wave was insufficient, as its preparedness – fearfully arranged during the first wave – had been rolled back.

Ankur Mutreja, University of Cambridge and Vignesh Shetty, University of Cambridge

The first wave of COVID-19 in India – in the summer of 2020 – was efficiently flattened by a rapid country-wide lockdown. A consistent drop in case numbers from September 2020 to February 2021 allowed a cautious but smooth return to what was almost normal life.

But the ensuing second wave – starting in March 2021 – proved catastrophic, with over 400,000 cases reported each day during its peak. The virus spiralled out of control, mainly because of behavioural and political complacency. Large religious gatherings, election rallies and recreational socialising allowed the virus to take hold in a huge population pool.

This helped give rise to the now dominant and highly transmissible delta variant, with huge consequences for the world. Delta is more capable of causing illness in people who have been vaccinated or previously infected than most other forms of the virus. Emerging evidence (some still awaiting review) also suggests that the variant increases the risk of hospitalisation across all age groups.

A graph showing India's COVID cases since the start of the pandemic

The Indian healthcare system’s capacity to respond to the second wave was insufficient, as its preparedness – fearfully arranged during the first wave – had been rolled back. Levels of beds in intensive care and equipped with oxygen supplies were reduced after the first wave was suppressed. As a result, the country’s health system was overwhelmed.

With the worst of India’s second wave is behind it, work is now underway to try and avoid the same things happening again in the future.

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