The world finally woke up to India’s virus nightmare

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India’s surging coronavirus cases should have been a loud wake-up call. Sure, the enormous spike in cases this spring came as a surprise. Just months before, an earlier rise in daily cases had dropped mysteriously, and India, home to some of the world’s biggest vaccine manufacturers, seemed well primed for mass immunization.

But that changed weeks ago, in mid-March, when cases ticked up but vaccinations did not. By April, daily cases had topped 100,000, higher than they had ever reached in 2020. Soon, they were more than triple that, setting a record for any nation on Earth and accounting for more than 39 percent of all new cases globally. India’s death toll is nearing 200,000, even with serious allegations of undercounting.

The rapid rise of infections seems to have come from the perfect storm of fast-spreading variants, slow vaccination and relaxed restrictions that public health experts had warned about. And yet for what seemed like an agonizingly long time, it appeared that much of the world was sleeping on it.

As countries like the United States began to see the positive results of mass vaccination programs, Indians took to social media to detail shortages of supplies needed to make vaccines and lifesaving supplies like oxygen. Alarming stories of a new, potentially more infectious virus strain called B. 1.617 flooded global headlines.

Only last week did the world take serious action, with countries from Britain to the United Arab Emirates promising oxygen generators or ventilators.

Even China, in the midst of a border dispute with India, offered to send vaccine doses to its neighbor, without offering clear specifics. Most closely watched was the United States. On Monday, President Joe Biden told Prime Minister Narendra Modi that the United States would provide “oxygen-related supplies, vaccine materials and therapeutics” and said that the U.S. supply of Oxford-AstraZeneca coronavirus vaccine doses would be shared with other nations.

Already, many are asking if this is too little, too late. In particular, there is anger that the United States did not move faster to help India just months after the country was identified as a key democratic ally in Asia.

Even officials who are grateful for U.S. help have expressed shock at its pace. “What took us by surprise was the slow response by the U.S. It created some misgivings in the public opinion, and that sometimes creates complications,” an unnamed Indian official told the Wall Street Journal, suggesting someone had “dropped the ball.”

From the vantage of Washington, many get the same sense. Thomas Wright, senior fellow at the Brookings Institution, tweeted on Monday that sharing AstraZeneca doses was the right call but that “the administration will receive a lot less credit for doing this now under massive pressure than a week ago.”

The situation has renewed questions about U.S. vaccine policy, which has focused on domestic supply and largely neglected broader problems of global vaccine supply, apart from pledging up to $4 million for Covax, a WHO-backed vaccine distribution effort. Critics, such as British lawmaker Claudia Webbe, have pointed out that the United States and other wealthy countries have not backed calls to waive intellectual property rights for coronavirus vaccines.

Then there is the thorny, complicated issue of U.S. export controls. Adar Poonawalla, the chief executive of Indian vaccine manufacturer Serum Institute, has said that his own supply problems are due to the U.S. use of the Defense Production Act, which limits the exports of critical materials needed to make vaccine doses.

U.S. officials have pushed back against some of the framing, denying in a White House briefing on Tuesday that invoking the Defense Production Act had restricted the export of U.S. materials. But they also refused to answer questions about intellectual property waivers and admitted that exports of an initial 10 million AstraZeneca doses could take “weeks” to reach countries in need.

The United States was hardly the only one slow to act on India’s surge. While many Indians are angry at the pace of international support, others are directing their anger at those closer to home. Modi and his Hindu-nationalist governing party have been criticized for lifting virus restrictions and allowing huge events, including political rallies and religious festivals.

To many, it looks like Modi declared victory before the battle was over. In a column for the Financial Times, Gideon Rachman writes that India and Modi had fallen prey to “Covid hubris.” While that malady is not unique, Modi, Rachman writes, made some “distinctive and disastrous errors,” including a failure “to use the decline in infection after the first wave to prepare properly for a second wave.”

Part of it was pride. India reveled in its status as one of the world’s major manufacturing centers for vaccines. But with few imports and much of its supplies being exported, the country was forced to climb back last month and impose its own restrictions on exports, many of which were going to poor nations – a move that undermines later Indian criticism of the U.S. Defense Production Act.

Rather than face these failures, the Indian government has attempted to gloss over them, even using local laws to block criticism of Modi on Twitter. However, even fierce critics of Modi say he can’t shoulder all the blame.

Writer Vidya Krishnan argues the pandemic has shown the failures of India’s health-care system, increasingly stratified since the economic liberalization of the 1990s. “The Indians who bought their way to a healthier life did not, or chose not to, see the widening gulf,” Krishnan writes in the Atlantic. “Today, they are clutching their pearls as their loved ones fail to get ambulances, doctors, medicine, and oxygen.”

For a disaster the size of India’s surge, there is more than enough blame to go around. Alarm bells should have been ringing at least a month ago. Instead, they were ignored for far too long on both a national and international level.

That alarms are now blaring is in large part the result of India’s important place on the world stage, including its enormous population and well-connected diaspora – as well as the sheer scale of its current outbreak. But other smaller nations, poorer and less connected, are facing their own worrying waves, too.

“We’re also seeing a surge in other parts of the rest of the world – Nepal, Colombia, Malaysia could be next,” Georgetown University’s Matthew Kavanagh, one of several academics who have called on the United States to share vaccine technology, said this week. “Brazil is still surging. We’re seeing a worrying uptick in Namibia and Botswana. It’s very scary.”

The world slept through the alarm in India and is now frantically dealing with the nightmare. The task now is to not miss the next wake-up call, if we haven’t done so already.