NEW DELHI — India hit a milestone on Friday morning that it had made great sacrifices to avoid: recording more than one million coronavirus infections.
The virus has been gnawing its way across this country of 1.3 billion people and gaining speed, fueled by high population density, an already beleaguered health care system and a calculation by the central government to lift a nationwide lockdown in hopes of getting the economy up and running, come what may.
But as India’s number of confirmed new infections keeps hitting record highs, many states and cities have been locking down again. In some areas, long lines of bodies snake out of cremation grounds. India is now racking up about 30,000 new reported infections each day — more than any other country except the United States and Brazil, and it is catching up to Brazil.
India now has the third-highest total cases — 1,003,832 cases and 25,602 deaths — after the United States and Brazil. Researchers at the Massachusetts Institute of Technology estimate that by the end of next year, India will be the worst-hit country in the world.
“We have paid a price for laxity,” said K. Srinath Reddy, president of the Public Health Foundation of India, a nonprofit organization of public health experts and academics.
About 25,000 deaths have been officially attributed to Covid-19, but testing remains sparse, so the real figure could be significantly higher.
Schools and universities have been shut since March with no clear plans to reopen, leaving nearly 278 million students without much to do.
More than 100 million Indians have lost their jobs. The economy, which already had been showing deep cracks before the pandemic, is now forecast to contract by as much as 9.5 percent in the year that began on April 1, a stunning reversal from the last decade, when India was one of the most promising business environments on earth.
In the early days of the pandemic, Prime Minister Narendra Modi took swift action. He advised masks and social distancing. At a time when India had fewer than 1,000 known infections — though the true figure was certainly higher — he imposed a severe nationwide lockdown that would last nearly three months.
Millions of migrant laborers, who over the years had gravitated to jobs in the cities, suddenly found themselves with little or no work. They poured out of the cities and back into the countryside, hoping to rely on relatives in their home villages to survive. In the process, they spread coronavirus infections into nearly every corner of India.
As the economic pain really began to bite, Mr. Modi changed course. Last month he urged the leaders of India’s 28 states and 8 territories to “unlock, unlock, unlock.”
Public health experts say Mr. Modi got it backward and should have waited until the crisis was further along, and then imposed a strict lockdown.
The early lockdown was “premature and it did nothing” because the virus hadn’t spread at the time, said Dr. Anand Krishnan, a professor of epidemiology at the New Delhi-based All India Institute of Medical Sciences. “Now is the time to impose such drastic public health measures.”
The worst hit areas are India’s biggest cities, like Mumbai, New Delhi, Chennai, Ahmedabad and the tech hub of Bengaluru. The crowded urban areas, where many families live eight or even ten people per room, make social distancing nearly impossible, hastening the spread of the highly contagious coronavirus.
Officials in India’s northeastern state of Bihar imposed a two-week lockdown beginning Thursday after a sudden spike in cases — more than 20,000 in 24 hours. Bihar is a source of migrant labor across India; the surge in Bihar’s cases correlates with the return of workers from distant cities.
A sharp rise in cases has also forced a new lockdown in Goa, a state on India’s western coast that is famed for its beaches, just a few weeks after it reopened to tourists, a lifeline to the state economy.
The southern state of Kerala, which had been largely successful in controlling the spread of the virus, also extended lockdown restrictions by a week in its biggest city, Thiruvananthapuram, after cases nearly doubled in just a few days.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 16, 2020
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Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
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What are the symptoms of coronavirus?
- Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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What’s the best material for a mask?
- Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
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Is it harder to exercise while wearing a mask?
- A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
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What is pandemic paid leave?
- The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
“We need more focus on the new COVID-19 hot spot in South Asia,” said a statement from John Fleming, an official with the International Federation of Red Cross and Red Crescent Societies. “Lives of people in India are no less valuable than people in other parts of the world.”
Mr. Modi and top government officials have repeatedly said in televised speeches that India is doing better than richer countries, especially when it comes to the death rate. India has reported about 20 coronavirus-related deaths per million people, while many other nations, including the United States, Brazil, Spain, Italy have all lost hundreds per million.
“I don’t think it has anything to do with how the government has handled the pandemic,” Dr. Krishnan said. Instead, he said, it’s because India’s average age is younger than that of other countries, and obesity and diabetes, which increase people’s vulnerability to the virus, are less prevalent here.
The Indian Medical Association, said that Covid-19 has killed 99 doctors.
“If Covid mortality has to be lessened, it has to start with doctors,” the organization said in a news release Wednesday.
Public health experts say India still lacks a transparent and robust mechanism to respond to a crisis of this magnitude. And what’s needed, they say, is a vigorous and energetic response from both the government and citizens.
“Opening malls and allowing large religious gatherings is not the way,” said Mr. Reddy. “You can’t give the virus a highway to travel.”
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