“The Worst Crisis Ever That I Have Seen”
Conversations with Abhinandan Sekhri, Kavita Sivaramakrishnan, Keshava Guha, and Vikram Patel about the COVID crisis in India. Listen today at 2 pm or anytime at our website.
India’s COVID disaster recalls familiar US horrors: mass death worsened by an unprepared system of privatized healthcare and faulty public health. In the US so far, around 600,000 are dead from COVID; in India, the official toll is near 250,000 and rising, and experts warn the actual numbers exceed that official toll. Abhninandan Sekhri, founder and CEO of the site Newslaundry, tells us from India:
So right now we’re in the worst crisis ever that I have seen in my living memory. And people way older than me, in their 60s and 70s, who have seen a really poor, poverty-stricken India tell me the same thing, that they haven’t seen anything so bad, the way the hospitals are completely overrun. And crematoriums, cremation grounds, because the majority population of India is Hindu and Hindus cremate their dead . . .s So much smoke in one part of Delhi a few days ago because there were like 30 or 40 bodies being burned from morning to evening.
Kavita Sivaramakrishnan, a public health historian at Columbia, explains how privatized healthcare has contributed to this calamity:
So what we see today is a middle class, an elite that thought that this kind of a system—a public health system that is being privatized, where the state has really retrenched its resources from the public—would be the sort of system, if they had the resources, that they would have access to. And what we see in the second wave of the pandemic is really that they’re not able to access the system anymore in Delhi, partly because the system just can’t cope. I think hospitals have become really zones of abandonment . . . The private health are system . . . was never supposed to cope at the time of a crisis, it was basically a system where you would pay your way to get super specialized care, it was not supposed to be meant for a pandemic.
The novelist and journalist Keshava Guha tells us the deeper history behind India’s system:
India’s independence, India’s constitution didn’t come out of nowhere. It was the product of struggles, debates that had lasted several decades. Perhaps you could argue even over a century. And the vast majority of India’s founding fathers believed that political independence was insufficient, that India had to not only be self-governing, but actually be fit for self-government to be a just, fair society.
So many of them were equally, if not more committed to social reform, to the emancipation of women, to fighting the caste system, to eradicating untouchability and actually to achieving material progress. And Gandhi, of course, embodied this in multiple careers as a freedom fighter, but also as a social reformer, as an activist. Gandhi famously said that he hoped that after independence, Congress would cease to be a political party and would actually become a sort of Gandhian style social movement, a social reform organization. That didn’t happen.
But this idea that India needed to not just be a self-governing state, but actually a kind of project of freedom, justice, equality: that was abandoned along the way. And it has to be said that one of the people guilty of that was our (in many ways great) first Prime Minister Jawaharlal Nehru. I think both the public provision of health and the public provision of education were very curiously blind spots for him.
Vikram Patel, a professor of global health at Harvard Medical School, says that much of the care that’s missing in this privatized system isn’t anything high-tech:
People are dying not because the virus is killing them, but because they can’t get good-quality supportive care. You know, Chris, right from the beginning of the pandemic, so much of the emphasis in our conversations in the US and in India have been around high-tech medicine, hospital-based care, intensive care, ventilators, whe in fact the majority of people in India who are dying right now are dying not because they can’t access a ventilator, but because they can’t access low-cost supportive care, which could be delivered by a non-physician. That basically involves oxygen that could be delivered in even a home-based setting. We missed the truth that the overwhelming majority of people who get ill with COVID in fact don’t need a physician or a hospital. They need good-quality nursing care.
Read: The Premonition
On next week’s show, we’ll talk to Michael Lewis about his new book, The Premonition, the story of public health watchers who understood the danger of the pandemic from the start, and whose work was undermined by a broken system, failed leadership, and media’s amplification of uninformed COVID-commentators. Joining us is Marc Lipsitch, the Harvard epidemiologist and early critic of wrong US projections about COVID.
For a film about people finding their way to difficult truths in bad times, look to Kenji Mizoguchi’s Ugestu, streaming over on Criterion. Fantasy, horror, and myth combine with something like stone-cold realism, and the result is a movie of delusions and disillusionment. It’s sad, moody, and strange, training elegantly creeping cinematography on a world of chaos and mist and frenzy.
This week’s ephemeral library:
The workers who sued Uber and won. Christian nationalism in Pennsylvania. Tobi Haslett on the George Floyd rebellion. Why Did it Take so Long to Accept the Facts about Covid? Liz Cheney and the Big Lies. The Allegations Against Blake Bailey and the Shock of the Familiar. The Sage of the Simpsons. The Great New York City Roller Skating Boom.
That’s all for this week, folks. Happy Mothers Day to all the OS Moms out there!