Dr. Sanjay Gupta on India’s COVID-19 Crisis

India covid crisis

CNN’s chief medical correspondent speaks with Katie about the recent outbreak of COVID-19 in India.

On Tuesday, Katie talked with Dr. Sanjay Gupta, CNN’s chief medical correspondent, about the recent outbreak of COVID-19 in India, which has led to skyrocketing cases and deaths and oxygen shortages around the country. Read on for a few takeaways from the conversation.

“I think that people are scared, which I know maybe sounds obvious, but a month ago they were not at all scared. I think they really thought that this was over, and I’m talking about not just the average citizen; I’m talking about the doctors, the public health community.” Dr. Gupta said he remembers thinking, That sounds premature when family members told him the pandemic was over in India last month.”

“It pains me to say this, but the problem is going to get a lot worse before it gets better.” Dr. Gupta said the positivity rates in New Delhi are currently 20%-25%, and that the real number of infections is likely three to four times higher than what is being reported. Additionally, he said, the current number of hospitalizations and deaths is reflective of new cases a few weeks ago, when the numbers were lower than they are currently. “There’s no doubt that for the next four to six weeks at least, you’re going to continue to see these tremendous, tremendous demands on the hospital system, a staggering number of deaths.”

“I think the problem over there is much worse than we even realize right now. Right now, there’s 3,000 to 4,000 people who are dying a day from COVID in India that are counted. The public health system there is pretty fragmented. You have many parts of the country where we’re probably not getting any kind of reliable counts at all…if a million people are infected a day and we roughly think that the mortality rate across the board is close to 0.5%, then we’re talking about 5,000 people at least a day that will be dying of this disease.”

“What is happening now is basically several months of that sort of thinking: Hey, we dodged the bullet here, we’re not going to get hit that hard.” Dr. Gupta reflected on the early months of the pandemic when India, despite its dense population and poor public health system, managed to keep its case count low. Avoiding heavy caseloads for much of the past year, he said, lent India a false sense of security. A combination of religious festivals, political rallies, and vaccination rates around 2% likely allowed the virus to spread so quickly, he said. “They were giving away more vaccine than they reasonably should have before taking care of their own people.”

“We’re now seeing just how inadequate [the basic investment in public health] was.” Dr. Gupta pointed out that while every country in the world could invest more in public health, India was in particularly poor shape. One lesson the world may take from the pandemic, he said, is the importance of investing in public health. “The idea of saying, ‘Hey look, we’re going to ask politicians to spend a lot of money on things and prepare for something that may never happen’ – it’s a tough sell,” Dr. Gupta said.

“They’ve got to try and extinguish some of these flames right now because the vaccine, as important as it is, can’t possibly happen fast enough to deal with the crisis on the ground right now.” Dr. Gupta said it would take months, if not years to get any reasonable percentage of the Indian population of 1.4 billion people vaccinated. Instead, India has to reimpose lockdowns in order to slow the spread of the disease.

“I’m hearing all these stories about people who would otherwise be saved by simply having a higher concentration of oxygen in what they’re breathing, and they can’t get it in many places.” Young, otherwise healthy people are dying due to a lack of oxygen, Dr. Gupta said, and a lot of oxygen is currently being sold on the black market.

“You can go into exponential growth very easily with a virus that’s this contagious, even leaving aside the variants.” Dr. Gupta reiterated how easy it is for cases to multiply in a short period of time. Lockdowns are effective, he said, but it is difficult to lock down cities that are already in crisis. While New Delhi is in lockdown, Dr. Gupta said, “there’s still a lot of movement and motion around the city” due to people seeking out medical care.

“We’re increasingly learning that you don’t want this virus.” While the kind of rapid spread we’re seeing in India will eventually lead to a level of herd immunity, it comes at the expense of many lives and could leave millions of people with long-term symptoms, Dr. Gupta said. “There will be hospitals dedicated to long-hauling COVID in the future because of the numbers that we’re talking about here.”

“I feel helpless.” Dr. Gupta said he’s telling his family what he thinks is the best course of action every day, but that mask-wearing and staying home sounds “a little bit too simplistic” in the face of the enormous problem. “They’re seeing people dying and they smell smoke from those cremations that are happening in parking lots in Delhi…The smoke, the smells, the feel of the city — that’s what they described to me. It’s really heartbreaking.”