India’s excess deaths during the pandemic could be a staggering 10 times the official COVID-19 toll, likely making it modern India’s worst human tragedy, according to the most comprehensive research yet on the ravages of the virus in the south Asian country. Most experts believe India’s official toll of more than 414,000 dead is a vast undercount, but the government has dismissed those concerns as exaggerated and misleading. Read: Covid-19: Bangladesh behind India, Pakistan in recovery rate The report released Tuesday estimated excess deaths — the gap between those recorded and those that would have been expected — to be between 3 million to 4.7 million between January 2020 and June 2021. It said an accurate figure may “prove elusive” but the true death toll “is likely to be an order of magnitude greater than the official count.” The report, published by Arvind Subramanian, the Indian government’s former chief economic adviser, and two other researchers at the Center for Global Development and Harvard University, said the count could have missed deaths occurring in overwhelmed hospitals or while health care was delayed or disrupted, especially during the devastating peak surge earlier this year. “True deaths are likely to be in the several millions not hundreds of thousands, making this arguably India’s worst human tragedy since Partition and independence,” the report said.     The Partition of the British-ruled Indian subcontinent into independent India and Pakistan in 1947 led to the killing of up to 1 million people as gangs of Hindus and Muslims slaughtered each other. Read: India's COVID-19 death toll crosses 350,000 The report on India’s virus toll used three calculation methods: data from the civil registration system that records births and deaths across seven states, blood tests showing the prevalence of the virus in India alongside global COVID-19 fatality rates, and an economic survey of nearly 900,000 people done thrice a year. Researchers cautioned that each method had weaknesses, such as the economic survey omitting the causes of death. Instead, researchers looked at deaths from all causes and compared that data to mortality in previous years — a method widely considered an accurate metric. Researchers also cautioned that virus prevalence and COVID-19 deaths in the seven states they studied may not translate to all of India, since the virus could have spread worse in urban versus rural states and since health care quality varies greatly around India. And while other nations are believed to have undercounted deaths in the pandemic, India is believed to have a greater gap due to it having the world’s second highest population of 1.4 billion and its situation is complicated because not all deaths were recorded even before the pandemic. Dr. Jacob John, who studies viruses at the Christian Medical College at Vellore in southern India, reviewed the report for The Associated Press and said it underscores the devastating impact COVID-19 had on the country’s under-prepared health system. “This analysis reiterates the observations of other fearless investigative journalists that have highlighted the massive undercounting of deaths,” Jacob said. The report also estimated that nearly 2 million Indians died during the first surge in infections last year and said not “grasping the scale of the tragedy in real time” may have “bred collective complacency that led to the horrors” of the surge earlier this year. Over the last few months, some Indian states have increased their COVID-19 death toll after finding thousands of previously unreported cases, raising concerns that many more fatalities were not officially recorded. Several Indian journalists have also published higher numbers from some states using government data. Scientists say this new information is helping them better understand how COVID-19 spread in India. Murad Banaji, who studies mathematics at Middlesex University and has been looking at India’s COVID-19 mortality figures, said the recent data has confirmed some of the suspicions about undercounting. Banaji said the new data also shows the virus wasn’t restricted to urban centers, as contemporary reports had indicated, but that India’s villages were also badly impacted.  

India's federal health ministry said on Saturday there was not enough scientific evidence to link COVID-19 with increase in Tuberculosis (TB) in the country. "Due to the impact of COVID-19 related restrictions, case notifications for TB had decreased by about 25 percent in 2020 but special efforts are being made to mitigate this impact through intensified case finding in OPD settings as well as through active case finding campaigns in the community by all states," the ministry said. Read: Indian COVID variant: Why is it more deadly? "Moreover, there is not enough evidence currently to suggest that there has been an increase in TB cases due to COVID-19 or due to increased case finding efforts." The ministry refuted local media reports alleging that a sudden rise in cases of TB has been noticed among patients who were infected with COVID-19 recently. "It is clarified that TB screening for all COVID-19 positive patients and COVID-19 screening for all diagnosed TB patients has been recommended by the ministry of health and family welfare. States have been asked for convergence in efforts for better surveillance and case finding of TB and COVID-19, as early as August 2020," the ministry said. According to the ministry, the dual morbidity of TB and COVID-19 can be further highlighted through the facts that both the diseases are known to be infectious and primarily attack the lungs, presenting similar symptoms of cough, fever and difficulty in breathing, although TB has a longer incubation period and a slower onset of disease. Read: 17 India returnees test positive for Covid-19 "SARS-CoV-2 infection can make an individual more susceptible to developing active TB disease, as TB is an opportunistic infection like black fungus," the ministry said.

The office of the Principal Scientific Adviser of Indian Government on Sunday said ''Project O2 for India'' has been initiated to ensure supply of critical raw materials such as zeolites, setting up of small oxygen plants, and manufacturing of compressors. according to a report of NDTV. The second wave of COVID-19 saw an increase in demand for medical oxygen in different parts of the country, it said in a statement. Read: Supreme Court steps in to resolve India's oxygen crisis While meeting the current demand, manufacturing medical oxygen also became important to ensure the country has adequate supply in the future. "Project O2 for India" of the Office of Principal Scientific Adviser is to enable stakeholders working to augment the country's ability to meet this rise in demand for medical oxygen. "Under Project O2 for India, a National Consortium of Oxygen is enabling the national level supply of critical raw materials such as zeolites, setting up of small oxygen plants, manufacturing compressors, final products, i.e.,oxygen plants, concentrators, and ventilators," according to the statement. Read: 24 die in southern India hospital due to oxygen shortage The consortium is not only looking forward to providing immediate to short-term relief but also working to strengthen the manufacturing ecosystem for long-term preparedness. A committee of experts has been evaluating critical equipment such as oxygen plants, concentrators, and ventilators from a pool of India-based manufacturers, start-ups, and Micro, Small and Medium Enterprises (MSMEs). The manufacturing and supply consortium includes Bharat Electronics Limited (BEL); Tata Consulting Engineers (TCE); C-CAMP, Bengaluru; IIT Kanpur; IIT Delhi; IIT Bombay, IIT Hyderabad; IISER, Bhopal; Venture Center, Pune; and more than 40 MSMEs, it said. Read Why Shouldn’t You Store Oxygen Cylinder at Home During COVID-19 Pandemic? The consortium has started to secure CSR/philanthropic grants from organisations like USAID, Edwards Life sciences Foundation, Climate Works Foundation, etc, it said. Hope Foundation, American Indian Foundation, Walmart, Hitachi, BNP Paribas, and eInfoChips are procuring oxygen concentrators and VPSA/PSA plants as part of their CSR efforts to aid the consortium's work. NMDC Ltd has agreed to fund the procurement of raw materials like zeolite for the manufacturers in the consortium, it added. Read Oxygen plant to be set up at Osmani Medical College Hospital Source: NDTV

Bangladesh’s Deputy High Commissioner in Kolkata Toufique Hasan on Thursday handed over 10,000 vials of Remdisivir, an antiviral injection, to the representative of the Indian government at the Indian border port of Petrapole.    These 10,000 injections manufactured by Beximco Pharmaceuticals were sent as medical assistance on behalf of the people of Bangladeshi at the instruction of Prime Minister Sheikh Hasina for the Covid-affected people of India.    This was the first consignment of medical assistance, including medicines and health protection items, Bangladesh offered to India as support to the Indian people during this deteriorating Covid situation in India.   Earlier, the government of Bangladesh offered to dispatch on an emergency basis medicines and medical equipment for the people of India who are fighting the pandemic across the country.    These include approximately 10,000 vials of injectable anti-viral, oral antiviral, 30,000 PPE kits, and several thousand zinc, calcium, vitamin C and other necessary tablets, said the Ministry of Foreign Affairs.    Also Read: Bangladesh offers emergency medical supplies to India The government of Bangladesh expressed deep sorrow and condolences at the loss of lives in India due to the spread of the Covid pandemic.    Bangladesh said it stands in solidarity with close neighbour India at this critical moment and is ready to provide and mobilise support in every possible way to save lives.   The thoughts and prayers of the people of Bangladesh are with the people of India for alleviating their sufferings, the Ministry of Foreign Affairs said.   Bangladesh is interested to provide further support to India, if needed, it said.  The Indian government thanked Bangladesh for its gesture and support after receiving the consignment of essential medicines that entered West Bengal via land border at Petrapole.   "Thank our neighbour and close friend Bangladesh for this gesture and support. Taking forward our unique relationship," Arindam Bagchi, Spokesperson at Indian Ministry of External Affairs (MEA), tweeted on Thursday.

In hopes of taming a monstrous spike in COVID-19 infections, India opened vaccinations to all adults Saturday, launching a huge inoculation effort that was sure to tax the limits of the federal government, the country’s vaccine factories and the patience of its 1.4 billion people. The world’s largest maker of vaccines was still short of critical supplies — the result of lagging manufacturing and raw material shortages that delayed the rollout in several states. And even in places where the shots were in stock, the country’s wide economic disparities made access to the vaccine inconsistent. Also Read: India: 18 die in fire at Covid hospital Only a fraction of India’s population will be able to afford the prices charged by private hospitals for the shot, experts said, meaning that states will be saddled with immunizing the 600 million Indian adults younger than 45, while the federal government gives shots to 300 million health care and front-line workers and people older than 45. Also Read: India grieves 200000 dead with many more probably uncounted So far, government vaccines have been free, and private hospitals have been permitted to sell shots at a price capped at 250 rupees, or around $3. That practice will now change: Prices for state governments and private hospitals will be determined by vaccine companies. Some states might not be able to provide vaccines for free since they are paying twice as much as the federal government for the same shot, and prices at private hospitals could rise. Since state governments and private players compete for shots in the same marketplace, and states pay less for the doses, vaccine makers can reap more profit by selling to the private sector, said Chandrakant Lahariya, a health policy expert. That cost can then be passed on to people receiving the shots, increasing inequity. “There is no logic that two different governments should be paying two prices,” he said. Concerns that pricing issues could deepen inequities are only the most recent hitch in India’s sluggish immunization efforts. Less than 2% of the population has been fully immunized against COVID-19 and around 10% has received a single dose. Immunization rates have also fallen. The average number of shots per day dipped from over 3.6 million in early April to less than 2.5 million right now. In the worst-hit state of Maharashtra, the health minister promised free vaccines for those ages 18 to 44, but he also acknowledged that the shortage of doses meant immunization would not start as planned on Saturday. States say the paucity of shots is one reason why immunizations have declined. India thought the worst was over when cases ebbed in September. But mass gatherings such as political rallies and religious events were allowed to continue, and relaxed attitudes on the risks fueled a major humanitarian crisis, according to health experts. New variants of the coronavirus have partly led the surge. Deaths officially surpassed 200,000 this week, and the true death toll is believed to be far higher. The country’s shortage of shots has global implications because, in addition to its own inoculation efforts, India has promised to ship vaccines abroad as part of a United Nations vaccine-sharing program that is dependent on its supply. Indian vaccine makers produce an estimated 70 million doses each month of the two approved shots — the AstraZeneca vaccine made by the Serum Institute of India and another one made by Bharat Biotech. The federal government is buying half of those vaccines to give to states. The remaining half can then be bought by states and private hospitals to be given to anyone over 18, but at prices set by the companies. The federal government is buying shots at 150 rupees each, or $2. The Serum Institute will sell the shots to states at 300 rupees each, or $4, and to private players at 600 rupees each, or $8. Bharat Biotech said it will charge states 400 rupees, or less than $5.50 for a shot, and private players 1,200 rupees, or more than $16. By comparison, the European Union paid $2.15 per dose for the AstraZeneca vaccine. The company says that price is discounted because the EU contributed to the vaccine’s development. The strain is mounting on the Serum Institute, which in addition to being India’s main supplier is also a critical supplier of the U.N.-backed initiative known as COVAX, which more than 90 countries are depending on. The institute paused exports in March. “The urgent demand for vaccines in India is bad for the rest of the world,” said Ravi Gupta, a professor of clinical microbiology at Cambridge University. Some experts warned that conducting a massive inoculation effort now could worsen the surge in a country that is second only to the United States in its number of infections — more than 19.1 million  “There’s ample evidence that having people wait in a long, crowded, disorderly queue could itself be a source of infection,” said Dr. Bharat Pankhania, a senior clinical lecturer specializing in infectious diseases at Britain’s University of Exeter. He urged India to first stop the circulation of the virus by imposing “a long, sustained, strictly enforced lockdown.” Pankhania cautioned that immunization efforts alone would not help immediately stem the current spike of COVID-19, since shots “only start to bear fruit in about three months’ time.” Vaccination would help prevent future waves of infection, he said. India is also importing shots from the Russian makers of Sputnik V. The first batch was due to arrive Saturday. Another 125 million doses of Sputnik V will be distributed by an Indian pharmaceutical company later this year. Given the urgent need for vaccines, some experts said rationing available doses is critical. “Vaccines need to be delivered to the areas with the most intense transmission,” Gupta said, explaining that vaccines should be used as “emergency control measures” in specific regions of India rather than offering doses to all adults across the subcontinent. Pankhania said the widely seen images of Indian virus patients gasping for air and smoke billowing from makeshift funeral pyres should spur rich countries to share their vaccines more freely. He criticized the approach taken by many Western countries that are attempting to vaccinate all citizens, including younger people at low risk, before sharing any doses. “It is better globally to immunize all the (vulnerable) people that need to be protected rather than to immunize entire populations in only some countries,” Pankhania said.

Amid the rapidly deteriorating Corona situation in India, the government of Bangladesh has offered to dispatch medicines and medical equipment on an emergency basis as the pandemic overwhelmed India’s health system. The emergency supplies include approximately 10,000 vials of injectable anti-viral, oral anti-viral, 30,000 PPE kits, and several thousand zinc, calcium, vitamin C and other necessary tablets, said the Ministry of Foreign Affairs (MoFA) on Thursday. The government of Bangladesh expressed deep sorrow and condolences at the loss of lives in India due to the spread of the coronavirus. Bangladesh said it stands in solidarity with close neighbour India at this critical moment and is ready to provide and mobilise support in every possible way to save lives. The thoughts and prayers of the people of Bangladesh are with the people of India for alleviating their sufferings, MoFA said. Also Read: Liquid oxygen import from India suspended at Benapole Bangladesh is ready to provide further support to India if needed, it said. India’s Covid cases cross 18m India has reported a record rise in coronavirus cases and deaths over the last 24 hours, pushing its overall caseload above 18 million. Also Read: Border with India to remain shut for 14 days: FM With 379,257 new cases and 3,645 new deaths on Thursday, India’s total number of cases and deaths are now at 18.38 million and 204,832 respectively, according to health ministry data.

The world’s fastest pace of spreading infections and the highest daily increase in coronavirus cases are pushing India further into a deepening and deadly health care crisis. India is massive — it’s the world’s second-most populous country with nearly 1.4 billion people — and its size presents extraordinary challenges to fighting COVID-19. Some 2.7 million vaccine doses are given daily, but that’s still less than 10% of its people who’ve gotten their first shot. Overall, India has confirmed 15.9 million cases of infection, the second highest after the United States, and 184,657 deaths. Also Read: India records world's highest single-day spike in Covid cases The latest surge has driven India’s fragile health systems to the breaking point : Understaffed hospitals are overflowing with patients. Medical oxygen is in short supply. Intensive care units are full. Nearly all ventilators are in use, and the dead are piling up at crematoriums and graveyards. HOW DID WE GET HERE? Authorities were lulled into believing the worst was behind them when cases started to recede in September. Cases dipped for 30 consecutive weeks before starting to rise in mid-February, and experts say the country failed to seize the opportunity to augment healthcare infrastructure and aggressively vaccinate. “We were so close to success,” said Bhramar Mukherjee, a biostatistician at the University of Michigan who has been tracking India’s pandemic. Despite warnings and advice that precautions were needed, authorities were unprepared for the magnitude of the surge, said K Srinath Reddy, president of the Public Health Foundation of India. Critics have pointed to the government deciding to not pause Hindu religious festivals or elections, and experts say that these may have exacerbated the surge. “Authorities across India, without exception, put public health priorities on the back burner,” Reddy said. Consequently, India’s 7-day rolling average of confirmed daily new cases has risen over the past two weeks from 6.75 new cases per 100,000 people on April 6 to 18.04 new cases per 100,000 people on April 20, possibly driven by new variants of the virus, including one that was first detected in India, experts say. Also Read: Indian capital gasps for oxygen India’s top health official Rajesh Bhushan would not speculate Wednesday why authorities could have been better prepared, saying: “Today is not the time to go into why did we miss, or did we miss, did we prepare?” WHY IS INDIA’S HEALTH SYSTEM COLLAPSING? India only spends a fraction of its gross domestic product on its health system, lower than most major economies. As the virus took hold last year, India imposed a harsh, nationwide lockdown for months to prevent hospitals from being overwhelmed. This brought terrible hardship to millions, but also bought time to implement measures to plug critical gaps, like hiring additional health care workers on short-term contracts, establishing field hospitals and installing hospital beds in banquet halls. But authorities didn’t take a long-term view of the pandemic, said Dr. Vineeta Bal, who studies immune systems at the Indian Institute of Science Education and Research in Pune city. Suggestions for permanent improvements like adding capacity to existing hospitals or hiring more epidemiologists to help track the virus were widely ignored, she said. Now authorities are scrambling to resuscitate many emergency measures that had been ended once the numbers fell. A year ago, India was able to avoid the shortages of medical oxygen tthat plagued Latin Americ and Africa after it converted industrial oxygen manufacturing systems into a medical-grade network. But many facilities went back to supplying oxygen to industries and now several Indian states face such shortages that the Health Ministry has urged hospitals to implement rationing. The government in October began building new plants to produce medical oxygen, but now, some six months later, it remains unclear whether any have come on line, with the Health Ministry saying they were being “closely reviewed for early completion.” Tanks of oxygen are being shuttled across the country to hotspots to keep up with the demand, and several state governments have alleged that many have been intercepted by other states en route to be used to meet local needs. WHAT COMES NEXT? India is faced with the massive challenge of trying to prevent its health care system from further collapse until enough people can be vaccinated to significantly reduce the flow of patients. The good news is that India is a major vaccine producer, but even after halting large exports of vaccines in March to divert them to domestic use, there are still questions of whether manufactures can produce enough fast enough. “Vaccination is one way to slow down the spread — but this really depends on the speed and availability of the shots,” said Reddy of the Public Health Foundation. Already several states have said they have shortages in vaccines — although the federal government denies it. India said last week it would allow the use of all COVID-19 shots that have been greenlit by the World Health Organization or regulators in the United States, Europe, Britain or Japan. On Monday, it said it would soon expand its vaccination program from people aged 45 to include all adults, some 900 million people — well more than the entire population of the entire European Union and United States combined. Meanwhile, Reddy said some states have had to implement new lockdowns but long-term, it was up to individuals as well to do their part. “As a society, it’s crucial that we maintain public health measures like masking, physical distancing and avoiding crowds,” he said.  

New Delhi was being put under a weeklong lockdown Monday night as an explosive surge in coronavirus cases pushed the India’s capital’s health system to its limit. Chief Minister Arvind Kejriwal said in a news conference the national capital was facing shortages of oxygen and some medicine. Also Read: Night curfew in Indian capital till April 30 “I do not say that the system has collapsed, but it has reached its limits,” Kejriwal said, adding that harsh measures were necessary to “prevent a collapse of the health system.” According to India’s health ministry on Monday, Delhi reported 25,462 cases and 161 deaths in the past 24 hours. India overall reported 273,810 new infections on Monday, its highest daily rise since the start of the pandemic and now has reported more than 15 million infections, a total second only to the United States. The Health Ministry also reported 1,619 deaths from COVID-19 in the past 24 hours, pushing the toll over 178,769. India has the fourth highest number of deaths after the U.S., Brazil and Mexico — though, with nearly 1.4 billion people, it has a much larger population than any of those countries. The soaring cases and deaths come just months after India thought it had seen the worst of the pandemic, but experts say even these figures are likely an undercount. Similar virus curbs already have been imposed in the worst-hit state of Maharashtra, home to India’s financial capital, Mumbai. The closure of most industries, businesses and public places Wednesday night is to last 15 days.