The COVID-19 Pandemic Is Not Over-- Far From It

I've spent weeks at a time in Delhi, starting in 1970, but I've never spent months there. I did spend months in Goa though and when I noticed the horrific COVID spike on a NY Times chart today, I was drawn to the article about the pandemic by a quartet of reporters. Goa, a culturally unique former Portuguese enclave that I loved so much in 1970, is having the worst outbreak in the world. "Many wealthy cities are making dramatic progress slowing Covid-19," they wrote. "As they vaccinate more people, cases have started to drop. Tel Aviv, one of the most vaccinated cities in the world, counted just two cases on Wednesday. Los Angeles turned a corner this spring, and is now vaccinating those as young as 12. But outbreaks are devastating India and much of South America, and there aren’t nearly enough vaccines available to stop them."

The Goa I remember 5 decades ago was poor and rural. When I rented a house the landlord told me that the drift of pigs running around the yard came with the property at no extra charge, I told him I didn't need them and that he could take them away. He laughed-- and left them. The next morning when I used the "toilet," I heard them serving their natural function below and realized why they are necessary. Unlike most of India, where Hindus and Muslims would never eat pork, it is a staple in Goa. I was so glad to be a vegetarian!

Today, Goans aren't getting vaccine; they're getting COVID. "Much of the world’s vaccine supply," reported The Times, "continues to be used or stockpiled by countries that have already made steady progress, even as outbreaks in the developing world are raging. With almost half of residents vaccinated, New York City and London are preparing to welcome tourists this summer, while Cape Town waits to administer its first vaccine doses to non-medical workers."

Two countries with surging epidemics have played central roles seeding outbreaks across their regions: India and Brazil. Neither is vaccinating fast enough to keep things under control.

In India, infections have skyrocketed across Delhi and Goa, and outbreaks are spreading quickly to more rural areas, in one of the deadliest waves since the start of the pandemic. Testing is spotty, and the case numbers only hint at the true scale of the problem.

“Every event in India is a super-spreader event,” said Dr. S.V. Subramanian, a professor of population health and geography at Harvard University.

India started vaccinating later than many major Western nations, and just 10 percent of its 1.4 billion people have received at least one dose. And the pace of vaccinations has slowed dramatically in recent weeks, even as the country halted vaccine exports to vaccinate more people at home. Donated vaccines from the United States and other countries are too few to stop the current epidemic.

Now India’s outbreak, along with a potentially more contagious variant of the virus first detected there, appears to be spreading to neighboring countries, which are once again imposing strict national lockdowns.

Yesterday India (under-)reported another 326,123 cases and 3,879 more deaths. India's neighbors are also doing badly, especially poverty-stricken Nepal:

• Nepal- 8,467

• Sri Lanka- 2,386

• Pakistan- 2,517

• Maldives- 1,467

• Bangladesh- 848

• Myanmar- 31 (worthless stats)

• Bhutan- 13

Niha Masih, a Washington Post correspondent based in New Delhi, reported today about how the pandemic is spreading, catastrophically, into rural India, where healthcare is not readily available to tens of millions of people. "Rural areas, where over 65 percent of India’s 1.3 billion people live,"wrote Masih, "had been spared in the first wave of the pandemic but are now facing devastating numbers of infections. Three quarters of all districts in India are reporting a positivity rate of more than 10 percent, a health official said Tuesday, an indication of how widely the virus had spread... Health-care infrastructure in villages-- deficient at best or missing altogether before the pandemic-- is ill-equipped to service the current needs. India’s rural health-care system has far fewer specialist doctors than needed. Low levels of awareness among villagers about coronavirus prevention and a slow rollout of vaccines has added to worries.

At the center of this crisis in the hinterland is the state of Uttar Pradesh-- home to 230 million people, more than the population of Brazil. It is also one of the poorest and least-developed states. In April, local elections were held in villages across the state, which officials say led to the surge in rural areas. According to a teachers’ organization, more than 700 government teachers who were assigned to poll duty died after the elections, many after testing positive for the coronavirus. At the start of the month, the state was recording just over 2,500 cases. By the end of the month, as the elections wrapped up, cases surged to nearly 35,000.

This week, dozens of bodies suspected to be coronavirus patients have been found floating in India’s holy Ganges river in areas of Uttar Pradesh and its adjoining state, raising fears that corpses are being cast into the river because crematoriums are overwhelmed.

"An uncontained outbreak in Brazil," The Times reported, "has helped to spur a new wave throughout Latin America, which was already one of the hardest-hit regions in the world. Vaccines are limited, health care systems are weak, and the political will to keep people home and economies closed has waned." Countries stuck using the Chinese Sinovac vaccine (like Chile) are fining it not very effective.

Some of the world’s slowest vaccine rollouts are in places that have had the most success in controlling the virus. In much of East Asia and Oceania, control measures have kept community transmission almost completely at bay.

Vaccination rates in the region lag behind other wealthy countries, in part because the comparatively low infection rates make the vaccine rollout less urgent. Countries like South Korea and Japan-- where just 7 percent and 3 percent of their populations have received at least one dose-- also rely on vaccines developed and manufactured elsewhere.

Governments that have successfully managed the virus this long may have success maintaining low transmission to accommodate slower vaccination campaigns. But even small outbreaks offer a warning sign that slow vaccination efforts leave them vulnerable.

Bangkok is battling its largest outbreak since the pandemic began, recording nearly half of Thailand’s new cases. Officials said new clusters were detected in some of the city’s most crowded communities, and now the outbreak threatens two major prisons. Schools, cinemas, gyms, pubs and bars in the capital remain closed, and if there are two or more people in cars-- even family-- they must wear masks.

The CDC is wrong about relaxing mask policies. Ignore them. Keep wearing masks unless you are absolutely certain that the only people you will come into contact with are fully vaccinated. And remember, anti-mask and anti-vaxx Trumpists are the most likely people to lie.