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Resurgence of COVID-19 in India: time for introspection
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  1. Rimesh Pal1,
  2. Urmila Yadav2
  1. 1Endocrinology, PGIMER, Chandigarh, India
  2. 2Pediatrics, PGIMER, Chandigarh, India
  1. Correspondence to Dr Rimesh Pal, Endocrinology, PGIMER, Chandigarh 160012, India; rimesh.ben{at}gmail.com

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The second wave of the COVID-19 pandemic has hit India hard. The number of new cases per day has gone up from 11 794 in the first week of February 2021 to over 414 000 as of 6 May 2021. The number of new deaths per day has shot up from 116 in the first week of February 2021 to more than 4500 as of 18 May 2021. Test positivity rates rose nationwide from 2.8% in the first week of April 2021 to 22% in the first week of May.

The second wave is different from the first wave that occurred in September 2020 in a few ways. First, the rate of increase in new cases is significantly higher. Second, a marginal rise has been recorded in the number of young people testing positive for the virus than the first wave. Third, compared with the first wave, there has been a substantial increase in the proportion of patients presenting with shortness of breath and those requiring oxygen supplementation and mechanical ventilation during the ongoing second wave. The sudden avalanche of severe COVID-19 cases has expectedly led to an acute shortage of hospital beds, oxygen and medications. Finally, unlike the first wave, a significant proportion of the cases in the second wave are being caused by SARS-CoV-2 variants, which are believed to be more contagious than the wild-type virus.1

The devastating second wave of COVID-19 has ushered in a barrage of questions against the Government of India, with national and international media criticising the leaders at the country’s helm. Indeed, the Government had behaved recklessly by allowing massive religious gatherings and election rallies. There is no going back from the fact that our political leaders have faltered; however, a moment of self-realisation and introspection is urgently needed before we go to sleep peacefully after shifting the blame to our leaders. We all need to pause for a moment and interrogate ourselves, ‘Am I not responsible for the present scenario?

Indeed, the ongoing resurgence of COVID-19 in India is largely a result of the complacency of its citizens. The levels of public awareness about COVID-19 had already been poor among the Indian population during the first wave of the pandemic.2 While the first wave of COVID-19 was reaching a nadir in the country, COVID-19-appropriate behaviours had further started taking a back seat, as if the virus had completely been exterminated. A recent nationwide survey conducted in over 25 cities of India showed that nearly 50% of the respondents were not wearing masks, and 64% are not doing it properly. Another survey conducted in 2021 by a community social media platform across 319 districts from India found that only 29% of respondents reported ‘good mask compliance’ in their area. Surprising it may seem, even till the present date, as the pandemic is at its full swing, masks are off the face of the majority of the Indian citizens.

To complicate the scenario, ever since COVID-19 cases began to dwindle, the citizens started gleefully indulging in loud parties and large social gatherings. People began flocking to shopping malls, restaurants, pubs, theatres and discotheques, flouting well-established norms. The Indian wedding industry was already slated to be back to the pre-COVID level by the end of 2020. Needless to say, it was we Indians who decided to throw caution to the wind and let our desires rule our lives. We must remember that governments can only issue guidelines, but we need to follow them when we are not under active vigilance.

Another matter of grave concern is the defiant attitude of the masses towards COVID-19 vaccines. A survey had revealed that 60% of polled Indians were hesitant to get vaccinated against COVID-19. Moreover, even a significant proportion of healthcare workers in India are unwilling to accept vaccinations.3 The possible reasons for the hesitancy could be a false sense of ‘strong inbuilt immunity’, apprehensions about the adverse effects and, above all, the very denial that a novel coronavirus disease does exist. In this regard, it is worth mentioning that during the first wave of the pandemic, it was hypothesised that as Indians are exposed to a host of endemic infections, they tend to develop a trained innate immune system that subsequently protects them from a new but related pathogen like SARS-CoV-2. Furthermore, universal BCG vaccination and malarial endemicity in India were assumed to be protective against COVID-19.4 Besides, India’s soaring high summer temperatures and humidity were also contemplated to might have helped in slowing down the spread of the virus.5 All these might have instilled a sense of false security in the minds of the citizens, although the second wave of the pandemic has blatantly disproved all such hypotheses.

To make things worse, the attitude of some of the citizens infected with SARS-CoV-2 is appalling. Patients are shamelessly violating home isolation norms, and to escape being caught by the authorities, people have even taken resort to spurious reverse transcription PCR (RT-PCR) reports. Such acts are uncalled-for and highlight the sheer irresponsible and careless frame of mind of the citizens.

As responsible and unbiased citizens of the nation, the authors feel that we are all responsible for the resurgence of COVID-19 in India in some way or another. We all have flouted COVID-19-appropriate norms now and then, especially at a time when we should have strengthened our guards rather than letting them down. Blaming the whole fiasco on national political leaders is just a means to hide our mistakes. Unless we realise and own up to our wrong deeds, it is not long before we witness another COVID-19 surge. We need to remember that our actions during the relatively quiet period will decide how long the infection stays quiescent. The change seems insignificant if we realise that we only need to give up the luxury of gatherings, meetings and loud marriages for a while to live life to the fullest in the near future. The destiny of COVID-19 and the fate of the nation rest in our hands.

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  • Contributors RP and UY contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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