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COVID crisis: Why India’s health system is on the ‘brink of collapsing’

India continues to break daily COVID-19 infection records, reporting more than 350,000 new cases and more than 2,800 deaths. While the Biden administration pledged to share vaccines with India and other countries, they will not arrive in India for some time. John Ray of Independent Television News breaks down the latest, and William Brangham speaks to experts about what it means for the country.

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  • Judy Woodruff:

    India is in a dire COVID crisis.

    While the Biden administration pledged to share tens of millions of doses of the AstraZeneca vaccine with India and other countries, that vaccine still must be approved by the U.S. Food and Drug Administration, and those doses will not arrive in India for some time.

    The country is breaking new records daily. Today, India reported more than 350,000 new cases and 2,800-plus deaths. Many experts believe those numbers substantially undercount the true impact.

    In a moment, William Brangham talks with one of those experts.

    But let's begin with a report John Ray of Independent Television News.

  • John Ray:

    Death and grief, in India, both are now on heartbreaking public display, where a son begs for his father's body to be taken to the crematorium for his last rites, where the virus has returned at such speed, it has far outpaced this country's ability to cope.

    Sonita (ph) mourns for her brother, just 45 years old. COVID is claiming ever younger victims. He was a hospital worker in Patna, where patients lie in makeshift wards, where every life hangs by the slender thread of an oxygen tube, in a land where oxygen is just one more fatal shortage.

    It brings panic and fuels soaring black market prices. We met the family of Sanjit Kumar (ph). He is struggling to breathe in the back of this car. They finally secured oxygen for him, but it proves to be too late.

    "We have driven here and there and everywhere to find help," said his brother," Rajiv. Their mother cannot be consoled. "If we had oxygen in time, he would have survived," he says. "But the hospital couldn't give him any."

  • Dr. Murtuza Bagwala:

    Indian health care system is in crisis. I will say that. We are short of oxygen. We are short of normal beds, ventilators, thoracic medicine.

    So, there is an overall deterioration in all sectors.

  • John Ray:

    And in the country that is home to the world's biggest manufacturer of vaccine, too often, there is none. In Mumbai today, crowds queued for precious doses, with little regard to safe social distance.

    Aid from overseas, ventilators and machines to make oxygen, will arrive tomorrow. It can't come too soon for this young woman, denied a bed at a hospital in Delhi and left instead to the care of her family on the pavement outside.

    This is a nation in shock, crying out for help.

  • William Brangham:

    That report was from John Ray of Independent Television News.

    Let's talk a little bit more about India's crisis and what the U.S. might do to help.

    I'm joined again by Dr. Ashish Jha. He is the dean of Brown University School of Public Health.

    Dr. Jha, always great to have you back on the "NewsHour."

    We heard a young doctor in that report describe how the system — the overall deterioration in every sector of India's public health system. You have just — you have said that the medical system there is on the brink of collapse.

    What might that look like, if that were to happen?

  • Dr. Ashish Jha:

    Yes, William, this is a very difficult situation that India finds itself in.

    There has been chronic underinvestment both in the health care and public health system of India. It was not ready to cope with a crisis of this size. And what that means is that hospital beds are running out. Doctors and nurses are getting infected at alarming rates. And, obviously, that means that, for people who have COVID, there is no place to get care.

    But it is also a tragedy for everybody else who needs health care, if you have a heart attack or a stroke or get into a car accident. There really isn't a recourse. It is a system that is on the brink of collapsing. And it is going to have huge health affects and other types of effects for a long period of time.

  • William Brangham:

    And if, as you and others have argued, that India's already astronomically high number of infections is an undercount, those stressed-out hospitals haven't even seen the worst of it yet.

  • Dr. Ashish Jha:

    That's what I am worried about.

    I think that there is not yet a realization, certainly among Indian policy-makers, that this is now turning around quickly. One of the things we learned from all the surges in the United States is, you see infections rise and hospitalizations follow seven to 10 days later, and deaths follow a couple of weeks after that.

    India is still seeing increasing numbers of infections. Hospitalizations are going to continue rising. And the problem, of course, is, there are no hospital beds. And the wave of patients will continue. And unless we expand capacity substantially, those patients will have no place to go.

  • William Brangham:

    We have spent a long time dissecting what went wrong with the U.S.' response and what cost so many lives here.

    Do you have a good sense of how India got to today, meaning, could this have been prevented?

  • Dr. Ashish Jha:

    It absolutely could have been prevented.

    And it's frustrating to watch what happened, because, in so many ways, the government of India made exactly the same mistakes that other countries, including ours, made last year. You know, numbers of infections had come way down by January or early February, and there was a sense that India had somehow beaten COVID.

    But when the infections started raising again, partly because things opened up, the government had large political rallies, there were — there was the Kumbh Mela, which is a major religious festival, where millions of people came together in one city. And infection numbers were rising and there was denial.

    And it was only when it was no longer possible to deny the flood of very, very sick patients, that the government has come to acknowledge that this really is a crisis. But many of us have been watching this for months, for the last two months, and trying to sound the alarm. But, unfortunately, it has not been met with an effective response.

  • William Brangham:

    So, the U.S. in the last two days have announced it is going to try to help out in some ways. It is going to release some of its AstraZeneca vaccine that we have been sitting on, although that may take months to get to India.

    It's going to help them with oxygen supplies, some therapeutics, some personal protective gear. These are all things that you argued that the U.S. should have been doing. Do you think those steps will help in a substantial way?

  • Dr. Ashish Jha:

    I do. I do.

    I mean, of course, the size of the problem is enormous. And no one country, not even the United States, alone can do it. But the United Kingdom, Germany, the Saudis, others have also stepped up to offer help.

    India has a lot of internal capacity that it can also start mobilizing. All of this put together I really do think can make a substantial difference. But everybody needs to be pitching in right now. The size of India's problem is really astronomical. And no one person, no one country alone is going to be able to solve this.

  • William Brangham:

    I mean, there's obviously a moral case to be made for why we should help a country in such dire straits, but there is also, from a — given the way that these variants are spreading, there is also a public health case to be made that we need to help everyone get a handle on this.

  • Dr. Ashish Jha:

    Yes, absolutely.

    I mean, one of the things that is always worth remembering is, this is a global pandemic. And things that happen in one place spread quickly. If you just think about the variants that have arisen out of South Africa, or Brazil, or the U.K., they're all here in the United States.

    And then we have seen new variants out of India. They're also in the United States. And this is the reality of a globalized world. So, there are many, many key reasons to help India, certainly a moral one, certainly a geopolitical one, but also the simple fact that you have got a lot of opportunities for infections in India, a lot of potential for more mutations, more variants.

    And that makes the world less safe. So, whatever your reason for engaging, I think the key here is, we all have to engage and bring the infection numbers way down.

  • William Brangham:

    Lastly, Ashish, 10 Democratic senators have urged the Biden administration to waive temporarily the intellectual property rights for certain vaccines.

    We know that Prime Minister Modi mentioned this to President Biden today. Do you think that would help, if we loosened those restrictions to allow other people to make more vaccine? Would that help India today?

  • Dr. Ashish Jha:

    You know, I think the intellectual property issue is important. It certainly is part of it.

    But I worry, William, that we're getting distracted by this. This is not the biggest constraint. If we relax all I.P. rights right now, I don't think it would add much in the way of vaccines to the global supply. What we really need is technology transfer. What we need is to build out capacity. Vaccines are hard things to make.

    And the intellectual property is not the biggest thing holding us back. There's a lot of other work that I think the Biden administration should absolutely be taking on and expanding capacity. So, I want to relax those I.P. standards. But I don't want to think that that somehow is going to solve these issues.

  • William Brangham:

    All right, Dr. Ashish Jha, dean of the Brown University School of Public Health, always good to see you. Thank you.

  • Dr. Ashish Jha:

    Thank you.

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