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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning, again everyone. Now we turn to India where the coronavirus crisis continues to surge as both new COVID-19 cases and deaths keep breaking previous records. On Wednesday morning, India reported nearly 400,000 new cases in one day and a further 3,200 deaths, the deadliest day so far, bringing the death toll to over 200,000 people, though the actual account is thought to be much higher than what the government is reporting. Remember, the United States still holds the record for most total deaths by Coronavirus with way over 500,000.

The story of India's new deadly wave though is particularly striking as many people living there thought the worst was over as recently as a few months ago. After a strict lockdown last year, life went largely back to normal by summer. People returned to work and the government sanctioned large events like religious pilgrimages and political rallies to resume. There may be a lesson here for us and other places. Public confidence was so great that even when vaccines became available, the demand was low despite India manufacturing doses for the rest of the vaccine-hungry world.

How did India go from leading the world and beating back the virus to leading the world in new cases and can the United States and other countries, A, learn from this and B, step in to help supply crucial resources? Here with me now is Rohan Venkat, Associate Editor at Scroll.in, that's an award-winning independent news organization in India and S. Mitra Kalita, Co-founder of URL Media and CEO and publisher of Epicenter-NYC, which has been helping connect harder to reach new Yorkers with vaccine shots. Mitra, welcome back and Rohan welcome to WNYC. Hello, from New York.

1. Mitra Kalita: Thank you, Brian.

Rohan Venkat: Thanks, Brian.

Brian: Rohan, just set the scene for people who may not be familiar with what's happening there. Where are you and how are things?

Rohan: I'm in Delhi at the moment. As you mentioned, we had a strict lockdown last year. We had a peak in cases in about September and without lockdowns, without seeing the several waves that Europe and parts of the US saw over 2020, it seemed as if India had got a handle on the virus. By January, Delhi, a city of 22 million people was showing around 100 new cases a day. Everyone seemed to think that things had gotten back to normal. Seroprevalence seemed to suggest that nearly half of the city had been infected giving a fair bit of confidence to folks that things had gotten fine, good enough for us to go back to normal. Then, suddenly in late March, early April, the new numbers started turning up.

Now if you look at the graph, it looks almost vertical. We've had more than 300,000 cases a day for the last eight days in a row, added more than a million cases over just the last three days and the deaths are surging as well. It's extremely grim out here that the health care system has collapsed. It's extremely hard for most folks looking for hospital beds, patients are having to find oxygen cylinders themselves, to get medicines. It's not just the case in Delhi, it's around the country. We're hearing stories of this including in bits of rural India which seemed to have been protected from the earlier wave in 2020.

Brian: What happened? Why do you think if people were protected from the earlier wave or if I heard you right, you said there was 50% zero positivity. In other words, half the people had already been infected, which means there should have been some herd immunity or something close to it to make it hard for this surge to take place. What happened?

Rohan: It's a good question and something that has kept some of our folks who are studying this-- They're looking into it and there's no clear answers. One obvious one is complacency and triumphalism. Indians did assume that this thing was over and started to gather in large numbers. We had elections in four states and the union territory, the government allowed a large Hindu festival on the Banks of the Ganges to go ahead where millions of people gathered. There was the general belief that based on the numbers going down in December, in January, that India was over the worst of it. Some of it is undoubtedly just complacency, people gathering again not masking.

The sort of things we already know about the virus. On the other side of it, there is the concern about variants. There is an Indian variant. India has not committed the kinds of resources that Europe and America has to studying variants. We don't know how exactly it acts, but certainly, there is the sense that this wave has been powered by the virus circulating for longer than we expected and potentially variants that have changed the way it behaved possibly reinfecting people, possibly leading to some immune escape even from vaccines. We don't know yet, but it's evident that it's a combination of complacency and bad COVID protocol as well as potentially the virus just changing shape.

Brian: Let me follow up on that and then we'll open up the phones for anybody with connections to India and we'll bring in Mitra. These are scary anecdotes and they're just anecdotes at this point. I'm not sure the science is there but you tell me that people who've been fully vaccinated were infected. I know there's always breakthrough cases after vaccination, but has anyone gotten seriously sick, or are these just the breakthrough infections we've come to expect?

Rohan: Folks have definitely been seriously infected after one shot. India has done a tremendous number of vaccines relative to many other developing countries. About 10% of the country has one shot so far, although it's been slowing. After two shots, there's very little evidence of anyone getting severe cases. We don't know yet and so at least on that front, it isn't as scary as it potentially could be. The data is quite limited and India is really just struggling to keep a handle on things at the moment. We don't know yet. What is evident is that people who were infected last year, say early last year are getting infected again.

Again, we don't have strong enough numbers. India's data collection is not as good as some other more developed countries. Also, the government in many places has been suppressing data or choosing not to test further, but they have been a spate of reinfection and there is the belief that immunity from being infected does die down after a while.

Brian: Listeners, we want to open up the phones to you. If you have family or other connections to India, what are you hearing, and how your loved ones doing? 646-435-7280. Do you know people who've gotten sick in this new wave? Do they have thoughts on why there is a new wave? Have people been getting the vaccine or if not, why not? What do they want from the government right now? Anyone with connections to India? 646-435-7280, 646-435-7280. You can tell us what you've been hearing or you can ask a question of our guests, Rohan Venkat, the Associate Editor at Scroll.in, the award-winning independent news organization in India.

He's in New Delhi today and S. Mitra Kalita, co-founder of URL Media and CEO and publisher of Epicenter-NYC here in New York. Mitra, I know from reading your Twitter, that you have family in India and some have been affected by the virus. To the extent you want to talk about it, how are they doing and what are you hearing bigger picture from family and friends over there?

Mitra: Sure. It's been as Rohan characterized as indeed a very grim period not just for the country, but for those of us-- There are millions and millions of what we call the Indian diaspora around the world. My assumption is that my text messages from my mother, from my family, my WhatsApp from my extended family, and my feeds on Facebook and Twitter are being repeated millions of times over. Just to give you a taste of that, in the last 48 hours, I learned that one of my best friends in New Delhi's sister died. I checked in with my husband's sister-in-law just to check because she has COVID right outside of New Delhi.

At the State of Assam where I'm from, imposed a curfew because Assam was doing okay, but it's definitely closing in. My mother texted me three times in the last 24 hours, one saying a friend of ours' father had passed away in Pune, another state, then she messaged me saying that my sister-in-law her sister, their mother, and the maid all have COVID. These are three different families spread across India. Then we discovered that my husband's cousin has COVID. Then we just learned that a family friend of ours in a village in Assam has passed away.

I don't want to characterize this as normal, but we're just at a stage where my phone is punctuated with these pings or the dings of the text message and I think a lot of the pressure you're seeing on the world to act is because many of us have a personal connection to India, and realize that it's not possible for this to just stay within India. It affects the rest of the world, whether it's immigrants and families like mine, but also that India is one of the world's largest pharmacies to the developing world and if we can't solve for the vaccine distribution in India, there is a ripple effect for the rest of the world.

Brian: We've all been hearing reports in this country of the oxygen shortages over there and Rohan referenced it too is there any relief on that front? Currently, I know President Biden said earlier this week that America would step in with supplies, but I'm not sure on the scope of that or the timeline. Do you have any information on that Mitra or do you urge any policy on that or size of the effort that you think they're not up to yet?

Mitra: Sure. Rohan will probably have some more information on the ground, but there are certainly a number of Indian American groups that are organizing both-- The oxygen needs are great, this is another thing we're certainly seeing on social media with addresses, names, phone numbers of people in desperate need of oxygen. There are services on the ground in India to try to link them to that, but of course, much of India's population is not on Twitter or Facebook so we have a similar kind of COVID disconnect that we've seen here in the US among certain populations.

I do know of some private-sector efforts and certainly, my Twitter feed, I've been trying to share some vetted organizations that folks can donate to. Then I think the political pressure that you mentioned is really important. We are in a stage where it's a very complex confusing issue with this issue of sharing patents, and the know-how of the mRNA vaccines that would be Pfizer, COVID, I’m sorry, Pfizer and Moderna and exactly how to make those vaccines with the developing world.

We're increasingly seeing pharmaceutical companies and governments themselves having to respond to the desire to share this technology and then you're also seeing another bucket which is donations of the vaccines and President Biden has pledged certainly unused doses of AstraZeneca going overseas, the World Health Organization has a program called COVAX that people can donate to individually.

The challenge with this is that it's still going to leave up to 70% of the developing countries unvaccinated. Really I think we need to operate on two tracks. One, yes, get as many unused doses from every country, get the donations, get the oxygen, get the medical expertise that's like the urgency, but there needs to be a parallel track of allowing these countries to manufacture the vaccines on their own, and roll out that distribution within months as opposed to waiting for years.

Brian: Let's take a phone call. Here is Pallavi in Manhattan. You’re on WNYC. Thank you so much for calling in.

Pallavi: Hi, Brian. Thanks for taking my call. My name is Pallavi, and I work as a research scientist in medicine at Columbia University, and I'm currently doing research on COVID. As a scientist who studied COVID, this catastrophe in India is a perfect example of perfect storm. The vaccine misinformation and hesitancy, the public becoming complacent and the total ineptness of the central government is just at a different level and I mostly blame the government.

If this would have happened last year, I could have understood as the whole world was caught unprepared including the US. They did a decent job with the first wave, although there is something to be said of how harsh the lockdown was during the first wave, which affected mostly the poorest people in India. Now, India has had eight to nine months to prepare for this, and the government did nothing. Not only they did nothing to control the second wave, but just--

Rohan mentioned, they acted in a completely harmful manner like holding political rallies of tens of thousands of people in the most populous state of West Bengal, and religious gathering of millions of people at Kumbh Mela, and also promoting the so-called homemade vaccine before any data was published or even phase three trials were completed. Many people lose confidence in vaccines together. It's absolutely heartbreaking to see what's going on in India. I lost my aunt last year to the first wave so my heart goes out to these people who are suffering now.

I have worked in India like 12 years ago, in Indian hospitals, and I know how badly prepared Indian healthcare system is. I think the government just totally dropped the ball on this and they wasted all these months doing nothing. I also want to appreciate the foreign media like BBC, New York Times, WNYC, Guardian, The Australian for their relentless coverage because the Indian media is so afraid of the government.

90% of the cable news channels are just like the Fox News here and just afraid to go after the government and show the entire scope of tragedy. At least because of this media coverage here I’m hearing India is getting some foreign aid, I don't know how long it's going to take for us to reach the peak and break this wave, but I think it's going to be a very hard road ahead.

Brian: Pallavi, thank you for so much information and context. I can hardly imagine what it's like for you and Mitra and so many other people who are experiencing so many losses in your extended networks, as well as some close people to be just constantly hearing these things. Pallavi that was such clear information on the context. Thank you very much for calling in. I'm going to go to another caller. Shelly in the Bronx you're on WNYC. Hello, Shelly.

Shelly: Hi, how are you? My husband is from India and my in-laws live there. My mother-in-law actually just managed to get her second vaccine shot this morning which we were so grateful for and she's in Delhi, but we were very worried about her leaving her apartment. We're hearing just constant devastation. My husband's been on the phone, it feels like two weeks just non-stop calling people, texting people, our good friend who lives here in Long Island, she lost her father over the weekend, and her family's in Delhi.

It's very hard to see people who have sick family members, but they're so far away. There's this feeling of helplessness. There's not much you can do when you're so many miles away. That's been very hard to see.

Brian: Shelly, I'm so sorry that you're going through that and your husband and his family are going through that. Mitra, what can you say to Shelly? There's that helplessness that she describes that maybe with all the people you listed in your earlier answer you’re feeling too.

Mitra: I think the helplessness is twofold. One is just in the moment of hearing about these deaths and people who are sick. The second piece which I think many of us have been going through for the whole year is when are we going to see our families again? Because of the variants that Rohan mentioned, I think many of us who have been vaccinated who are in the US are realizing that the connectivity between the two countries is very real. On the other hand, if you've been vaccinated, "When am I going to see my family again if these vaccines are not even effective against the variants?"

Which is not what I'm saying, but that's being researched. I do think one area that we've been throwing ourselves into both my own family as well as Epicenter is this stress of, "We are one world and we really need to act like it." Epicenter, Brian, I've been on every week, we really focus on Queens, but you can't focus on Queens without focusing on the rest of the world and so to the extent that we can help our Indian neighbors spread the word about vaccines. On Friday, we did a table in Diversity Plaza here in Jackson Heights and we had volunteers ducking in and out of Indian restaurants, booking people for their vaccines, there's a mobile vaccination pop-up right now here in Jackson Heights.

We've just heard from volunteers there yesterday that it's been very, very effective, Tibetans and Nepalis, especially Nepal is another country that's also seeing a surge, Bangladesh as well, these are, of course, India's neighbors. I do think to the extent we can get the word out. When I say domestically, nothing is really domestic. I hope we understand that our American neighbors have families overseas. By helping them, we might be spreading information about vaccines and about COVID safety to an extended network.

Brian: I saw that you wrote a piece for Epicenter called," Vaccine apartheid is literally going to kill us." How are you defining that term "vaccine apartheid"?

Mitra: Sure. The term "vaccine apartheid," I believe came from Kenyan officials who were basically decrying the Western world and the system where rich countries have access to the vaccines and pretty plentiful at that, whereas poor countries are fighting for the system I described of donations and so forth. I do think that vaccine apartheid is indeed upon us. We are already at Epicenter getting emails from around the world saying if I arrived in New York next week, "Do you think you can help me find a vaccine?" We did a live stream earlier in the week, Rohan was also on it. We had representatives from Peru and Brazil as well.

The woman from Peru had just landed in Miami to get her vaccine. I think we've been framing this as vaccine tourism, which makes it sound like it's elite people from the developing world coming to the US to get their vaccines. There's perhaps a little bit of that, but there's also a desperation for those of us who are here to ensure that our families live. This is not each country to its own, but it really is a matter of taking care of humanity right now. I can't stress that enough.

Brian: Rohan and my other guest is Rohan Venkat, associate editor at the news organization, scroll.in. He's in Mew Delhi. India is the largest vaccine manufacturing country in the world, according to what I've read. It would be surprising for some people that a major vaccine manufacturing country can be short on vaccines. Can you describe how that works?

Rohan: It is true India is the world's largest manufacturer of vaccines, although in normal times, the bulk of those are children's vaccines. Certainly, the largest COVID manufacturer is here as well it's the Serum Institute of India, which is making the AstraZeneca vaccine or a version of it. The simple fact is that India is also 1.3 billion people. No matter how large the manufacturers are, how many supplies they can give us, it was never going to be immediately enough for the Indian population.

India also, or the Serum Institute, in particular, is making the vaccines for COVAX, which Mitra mentioned earlier, the global effort to give vaccines to developing nations. India, exported many, many vaccines, some of them as donations to neighboring countries and other poorer countries, some of them as part of the COVAX effort, and some even to developed nations early on as part of this complacency when people expected that the virus was dying out in the country.

For the last couple of months, India has not exported vaccines, and doesn't expect to simply because this wave has been so harsh. That puts the rest of the developing world at risk because they're not going to get the supplies they were expecting from India. The simple answer really is that we have a giant population. We have manufacturers with limited space at the end of the day.

India decided to focus on two Made in India vaccines, which have done brilliantly, but they're limited in supplies. India is opening up to imports of vaccines now despite its giant manufacturing base. As Mitra said, not only licenses are shared more liberally, but if intellectual property rights are waived and know-how is shared with the developing world that we'll be able to scale up to the extent that the rest of the world can also hope to open up like New York seems to plan.

Brian: How can people not do that under these circumstances? Who should we hold accountable for doing that?

Rohan: It is the developed countries that are standing in the way. India and South Africa co-sponsored a push at the World Trade Organization starting last November to have a global waiver. Since then about 100 other countries have come on board, but it's the large western nations that have said no, that are standing in the way. I believe in the last week there's been some talk in the US, the president spoke with the manufacturers in the US about this, and there's been some move on it considering the recent wave in India.

It's western nations that really-- Something for the American population to be aware of. It is the fact that as the US starts to open up the rest of the world is still quite under the brunt of this pandemic and part of it is because we are still not allowing everyone to have vaccines.

Brian: Mitra to finish up. I wonder if I can a quick thought from you on the local news here in New York, that Rohan has just referred to. Mayor de Blasio announced this morning that the city will fully reopen on July 1st. You cover and work with communities that have been among the hardest hit by the virus in New York City, do you think that's smart? Do you think that's premature? Are you good with it? What's your reaction to that announcement?

Mitra: I'm hoping that the buildings have ventilation. I will say that at the outset, that I still feel like there are many factors of fighting COVID beyond vaccines that we want to make sure that our infrastructure is ready for. I think that's just one hope for the city, a plea for the city to make sure that come July we have social distancing and that the windows can open. I'm seeing mixed reactions to the mayor, partly because the state has still not weighed in on what's going to be fully open and what's not.

Yet, again, we have this schism between New York City and the rest of the state. We know that they, of course, influence each other. I have to say based on the trend lines we're seeing from just going into retail and restaurants and saying, "Does anyone need a vaccine? There's a mobile van unit outside, you can get it right now." On Friday when we were trying to book people, we didn't have the mobile van there. Up to 70% of workers had not yet gotten their vaccines. That is very worrisome. Meaning city workers are about to be out and about, but a population that they interact with will still largely not be vaccinated.

I think that is something for us to continue to solve for. The second, the good news, I'll end on a good news note. The mobile van that has been here giving vaccines in Jackson Heights got rid of all of its doses yesterday. The lesson I think is the more we go out into communities and make it easy for people, hopefully, by July we will make a significant dent. When I walk into retail outlets and restaurants and say, "Has everyone gotten their vaccine?" They'll all say, "Of course we have". That's my hope. That is how New York City will spend the next few weeks.

Brian: Let's hope. Ending on hope with S. Mitra Kalita, Co-founder of URL media and CEO and publisher of Epicenter NYC, and Rohan Venkat associate editor at the Indian News Organization Scroll. He joined us from New Delhi. Thank you both so much for coming on.

Mitra: Thank you, Brian.

Rohan: Thanks, Brian.

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