India is currently the world’s hardest-hit country by COVID-19, with 273,810 new cases in one day. With a lack of widespread testing in the nation, the case numbers could be much higher. Across the country, hospitals are struggling with a shortage of oxygen supplies and hospital beds. Yahoo News Medical Contributor Dr. Kavita Patel explains what could be behind the recent surge and why the United States should care what’s happening in the second most populated country in the world.

Video Transcript


KAVITA PATEL: India is now experiencing a surge that’s on a level that we have not seen before. Certainly, even in India over the last year, they were relatively luckier than most countries of their size. There are a lot of theories behind that.

However, in the last 24 hours alone, they’ve had 300,000 cases. And that’s most certainly an undercount, because there is not widespread testing. So the fact that we’re seeing, in some parts of India, like Bombay or Mumbai and New Delhi, as high as 1 in 3 or 1 in 4 people testing positive is actually, again, an underestimate.

There is very little public health infrastructure in India. And certainly, in most of the country, you see incredibly crowded and cramped environments. It is virtually impossible to exhibit social distance. And because of the lack of public health infrastructure, really very little testing and tracing.

In the beginning of the pandemic, there was a conscious effort to try to have contact tracing and people going door to door and doing tests. But that was when the country was under a lockdown. Even a lockdown was really difficult to enforce in India. When you’re dealing with a country of a billion people, it just becomes logistically impossible.

MARIA VAN KERKHOVE: This virus variant, it’s a variant of interest, the B1617 lineage. This was first detected and reported by India having two mutations, the E484Q and the L452R. Those are specific mutations within the genome. This was reported by scientists out of India.

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KAVITA PATEL: So in particular, the World Health Organization has flagged– and so have other health authorities– the B1617 variant, a variant of concern, which means that it does have significant clinical risk and that it could be not just more infectious, but potentially more deadly. And it’s of real concern because it has something called the double-mutant virus, or double-mutation virus, and that it has a series of mutations in two parts of the spike protein that make it easier to attach, infect, and replicate. It is the newest iteration of the virus’s mutations that could potentially put even vaccinated populations at risk.

The fact that we have very, very smart variants with mutations that are incredibly infectious in a country where you cannot keep people isolated, quarantined, or 6 feet apart, reasonably, and on top of that, a nonexistent kind of health or public health infrastructure, that is why we’re seeing cases skyrocket.

Why now as compared to before? Lots of hypotheses. Lots of theories. But at a minimum, this tells us that this was an opportunity for the virus, which in other parts of the world does not have a host because people are getting vaccinated, has turned to places like Brazil and India, where there are not as many vaccinated people.

And as a result, India’s hospitals are completely full. There is now rationing of everything, including doctors, nurses, oxygen, beds supplies. And in fact, many Indian Health officials are telling people, especially in New Delhi and other places, that if you can get resources in your own home, you’ll be better off than trying to come into a hospital where you will likely not be able to receive oxygen or attention.

That’s translated, of course, to tens of thousands of deaths over the last several weeks. And that number is certain to climb over the next weeks. Because India had had a lockdown previously. There is no desire, politically, from a country, or even at a state level, to lockdown.

India had rebuffed deals with kind of the leading vaccine manufacturers, such as Pfizer, but instead now, in light of its cases, is importing vaccines, such as the Sputnik V vaccine from Russia, as well as the CanSino vaccine from China. And it’s posing a risk now, because there’s just not enough vaccine supply for not only India’s population, but even in the hot spots, to kind of deal with the cases that are rising.

Ironically, in every aspect, including vaccines, India is one of the largest exporter of vaccines, because it is a large manufacturing source for drugs and vaccines in general. So this is posing risk at a time when India thought it had escaped the worst by not experiencing the surges over the last year. But in the last several weeks is now facing its own internal crisis with a lack of vaccine supply.

So all in all, it creates a recipe for disaster. Where it impacts the United States is that we have seen that this pandemic is truly global. So even if the United States is vaccinated, if there is a ready pool of people who are unvaccinated and can get infected, it offers the chances for the virus to mutate in a way that could potentially pose a risk for immune escape in countries like the United States.

So we have to watch Brazil, India, and countries who are experiencing incredible surges with a lot of caution for how it affects the world and those countries, but also how it could affect the US.

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