India’s true COVID-19 death toll could be 5 to 7 times more than the official figures suggest, according to The Economist.
Earlier this year, the country was ravaged by a disastrous second wave of COVID-19, with widespread reports of hospitals overflowing and oxygen shortages.
The Indian health ministry claims that since the start of the pandemic, a little over 411,000 people have lost their lives to the virus. Experts now believe that the official figure is a fraction of the true death toll.
A recent paper by Christopher Leffler of Virginia Commonwealth University in America, cited by The Economist, estimates that between 1.8 million and 2.4 million people have died from COVID-19 since the start of the pandemic.
If true, that would mean India has by far the highest COVID-19 mortalities worldwide. Currently, the US has the highest official death toll, with over 6o0,000 recorded deaths, according to the John Hopkins University.
Another study cited by The Economist, based on insurance claims in the Indian state of Telangana, suggests that the virus death toll could be six times more than the official figures suggest.
The Indian government has rejected these reports, claiming that they are not based on scientific evidence.
Yashwant Deshmukh, chairperson of CVoter polling group, told The Economist that the misleading official figures were “not about capacity, but intent.”
“And it’s not about the central government or a particular party. It is about data suppression at every level, no matter who is in charge.”
According to Foreign Policy, the way the Indian government records COVID-19 fatalities has obscured the true death toll.
The first problem, according to the magazine, is that India’s death registration system already under-reported deaths before the pandemic. This is partly because many Indians do not receive medical treatment before passing and many deaths are not medically certified.
But some problems in registering deaths are specific to the pandemic. India’s official guidance states that if a person dies without being tested for the virus or had tested negative but displayed symptoms, their death should be classified as a “suspected or probable COVID-19”.
But officials from several Indian states told Foreign Policy that only people who had tested positive for the virus and then died soon after in hospital, with a clear disease progression, were counted as official COVID-19 deaths.
The magazine added that most states in India had established “death audit committees,” which examine death certificates to determine what should be classed as a COVID-19 death. In some cases, the deaths of people with comorbidities were attributed to those conditions rather than to COVID-19.
India has now mostly overcome its second wave, reporting roughly 40,000 new cases a day, according to John Hopkins University. At its peak, India accounted for roughly half of the world’s COVID-19 cases, according to the World Health Organization.
With remote work becoming more normal than ever during coronavirus lockdowns, there are more so-called “digital nomads” than ever before – professionals who moved at least three times in the last year – according to MBO Partners.
So, where are these digital nomads going?
Tulum, Mexico, is a popular destination, but there’s somewhere far more remote for the most dedicated remote workers: the Himalayas. That’s where WorkationX is located, overlooking the mountains of the Kangra District at Rajgundha, India.
The only way to reach the WorkationX compound is a four-hour hike, but visitors who make the trek will be greeted by multiple homages to the closest thing the tech world has to a religious prophet: Tesla CEO Elon Musk.
Musk, next to Iron Man for good measure, is featured with his hands clasped in a prayer position. In this shared working space, a smattering of bean bag chairs have been arranged for improvised seating.
In another spot in the building, over a stairway, Musk is featured as Uncle Sam:
WorkationX is a co-working space intended for guests to, “work, live and engage with the local community of the Himalayas,” according to the company’s website. “It is a workspace dedicated to the modern day visionary, Elon Musk.”
Got a tip? Contact Insider senior correspondent Ben Gilbert via email (email@example.com), or Twitter DM (@realbengilbert). We can keep sources anonymous. Use a non-work device to reach out. PR pitches by email only, please.
Coinbase plans to hire hundreds of engineers and other staff for its tech hub in India, who will each be given $1,000 in cryptocurrency when they start, the crypto exchange company said in a blog post Friday.
A “boom in cryptonative talent” prompted the recruitment spree, Pankaj Gupta, Coinbase’s site lead in India wrote in the post.
The Indian hub, announced in March, will house engineering, software development, IT services and customer support. Employees will work remotely, at first, given pandemic concerns, but Coinbase expects to open its first physical office of many in Hyderabad.
“We have ambitious plans for this hub in the near future – we want to hire hundreds of world class engineers in the near term,” Gupta wrote.
The $1,000 in crypto handed to new employees under the CIkka program – short for “Coinbase India Sikka” – is meant to inspire them to come up with ideas to develop the crypto exchange’s range of services.
“Our expectation is that they’ll leverage this offering to learn about crypto, and will use this knowledge to help us build the next generation of products,” Gupta said.
Coinbase plans to set up locally-led teams in India across all the major areas it works in, from crypto to cloud, to machine learning to platform. While, they will be involved in both global and local projects, crypto investing in India also grew from $923 million until April 2020 to nearly $6.6 billion in May, Bloomberg reported.
“There’s never been a more exciting time for builders working in crypto,” Gupta said.
As part of the expansion in India, Coinbase is looking into possible start-up acquisitions and “acquihires” – where a company is bought to secure its talent – Gupta said.
Crypto adoption has grown worldwide, driven by increased popularity for decentralized finance, smart contracts and non-fungible tokens, which like bitcoin and ether are built on blockchains.
The hiring spree covers senior and junior roles across product management, user experience, design and program management. There will also be a HR and recruitment team.
India marked the next step in the company’s global mission as it has already opened hubs in the US, the UK, Ireland, Japan, Singapore, Canada and the Philippines.
Doctors in Oman, a small nation on the Arabian Peninsula, have encountered at least three COVID-19 patients with “black fungus,” the Associated Press reported Tuesday.
The fungal infection, known as mucorymycosis, can be fatal. The news comes as Oman faces a surge in coronavirus cases brought about, in part, by the fact that more than 90% of its population has not yet been vaccinated, according to the AP report.
According to the US Centers for Disease Control and Prevention, people with severe cases of COVID-19 “are particularly vulnerable to bacterial and fungal infections.” The use of “high-dose corticosteroids and tocilizumab,” a monoclonal antibody, can also predispose patients to infection from fungal spores.
Signs of infection include black lesions on the nose or inside the mouth, according to the CDC.
The problem of black fungus has been particularly acute in India, where several states have declared it an epidemic amid the spread of a coronavirus variant officially known as B.1.617, but more recently renamed Delta, that appears to be more contagious than the original. As Insider has reported, black fungus has a 50% mortality rate “and requires all infected tissues to be removed for patients to have a fighting chance.”
In the past five months, Indians have seen thousands of people die due to lack of oxygen, medication, ventilators, and hospital beds. The COVID-19 pandemic has swept the nation with trepidation and has cost Indians more than it should.
Last Monday, Prime Minister Narendra Modi announced that vaccines were free for all adult citizens. As delightful as the news sounds, later clarification showed this wasn’t actually the case. Private hospitals will continue charging for the vaccine, and the supply at government hospitals – where the vaccine is free – has been tragically low so far. From the start, India’s vaccine drive has been terribly mismanaged, costing thousands of Indians their lives.
Not enough people vaccinated
As of June 10, 359,000 Indians have lost their lives to the disease. Some of them could have been saved if the vaccine drive was better managed.
India began its inoculation drive on January 16 when it managed to administer a little less than 200,000 doses to frontline workers. On April 2, the number of administered vaccines rose to 4.3 million doses, and starting May 1, when the government announced vaccinations were available for everyone 18 years and older, the number of administered vaccines, on average, was around one million doses per day – far less than it should be for a country with 1.38 billion people.
As the 18 and older population attempted to sign up for a vaccine appointment on May 1, the registration websites crashed, and when people finally managed to get themselves registered, there were no slots available in most states. (Based on personal experience, the situation is still the same). Modi basically announced the second phase of the biggest vaccine drive in the world while knowing there wasn’t sufficient stock available.
So far, only 5% of eligible adults have been completely vaccinated in India – when we look at the entire population, the percentage drops to 3%.
High cost barrier
One of the primary reasons why more people haven’t gotten their jabs is due to the cost barrier and unavailability of doses.
India’s two leading vaccines, Covaxin and Covishield (AstraZeneca), have been administered to eligible citizens in government hospitals for free, but private institutions have been charging a whopping rate of 800-1400 rupees ($10.92-$19.11) for the jab. It’s next to impossible to register for an appointment at a government facility due to low stock, so most of the population, including me, had to choose the private option. I personally paid 850 rupees for my shot, a price which is completely unaffordable for a lower-wage worker who is looking to get their entire family vaccinated.
“I am so scared of the disease,” Dinesh Ramkumar, a watchman in the state of Rajasthan, told me. “One of our family members got infected a month ago and we spent almost all our savings for his treatment. Now, we were dependent on the government to provide us with free vaccines, but every time I go to the government center, they say that they don’t have any stock left … there’s no way I can pay 1,000 rupees for one vaccine as my family has 10 people, and it would cost me 10,000 rupees.”
On Tuesday, after Modi’s announcement the day before that vaccines would be free, the government announced several changes to its vaccine policy, including a new cap on prices that private hospitals can charge. However, in many cases, these caps are higher than what the prices were before. The government has also capped the service charge for getting the shot at 150 rupees – a price which makes the whole thing unviable for the people who need the vaccine most.
Just last week, the US Food and Drug Administration (FDA) dismissed Bharat Biotech’s proposal for emergency use authorization for their Covaxin vaccine in the US. This news has certainly added to the already existing vaccine hesitancy concerns in India. It will also put a strain on India to develop enough doses of Covishield for the country’s population.
The Indian authorities have released a statement saying that Covaxin not getting emergency approval in the US won’t affect India’s vaccine drive, but that likely won’t change how residents see the news.
It’s baffling how mismanaged the entire immunization drive has been from the beginning. How did the world’s biggest antibody producer, dubbed the “pharmacy of the world,” end up with so few vaccines for itself?
More than 200,000 people have died in India since inoculation began. That’s how many lives would have been saved if the authorities had prepared for the second wave by arranging resources, ordering more vaccines, and making them available for free.
We all know that the only way to beat this deadly virus is through vaccines. So, why weren’t we ready? After the declarations this week, it still doesn’t feel like the vaccine has really been made free.
Based on how things have gone, I worry that people still won’t be able to register for the free shots as promised. Is there any meaning attached to Modi’s words? Only time will tell.
Doctors in India claim that the highly infectious Delta variant could cause unusual symptoms such as gangrene and hearing loss, which they say are becoming more common in COVID-19 patients of all ages.
The highly infectious variant has spread to 67 countries and is becoming more common around the world. But, with fewer cases in India sequenced, there isn’t enough data to know for sure whether the symptoms are unique to the variant, or are caused by COVID more generally, which has already been linked to unusual symptoms such as diarrhea and blood circulation issues.
The Delta variant is estimated to be 60% more infectious than the Alpha variant that’s currently the most common in the US. It also has mutations that mean it can partially avoid the immune response.
Dr. Anthony Fauci, President Joe Biden’s chief medical advisor, warned last week that the fast-spreading Delta variant could take hold in the US, if more Americans didn’t get their COVID-19 shots. A Public Health England document from May reported the Pfizer and AstraZeneca vaccines were respectively 88% and 60% effective against the Delta variant after both doses.
Dr. Ganesh Manudhane, consultant cardiologist at Seven Hills Hospital in Mumbai, told Insider that he used to see four patients a year who had small blood clots causing gangrene, a serious condition where a loss of blood supply causes body tissue to die. Now it’s one person every week, he said.
“I suspect it could be because of the Delta variant, because of the increased number of cases,” Manudhane said – but he added that he hadn’t genetically sequenced the patient’s coronavirus tests to check for the Delta variant, which has become the most common COVID variant in the country since first being identified there in October.
Dr. Abdul Ghafur, infectious disease consultant at Apollo Hospital in Chennai told Insider that he had experienced far more cases of people with COVID-19 presenting with diarrhea than in the first wave in 2020.
But “all of the inferences from local doctors across the country were based on their clinical experience and not on any published data,” he said.
It isn’t clear how many people in India are infected with Delta compared with other variants. It is one of three similar virus strains that all originated in India.
Some statistics group these three together, and not all positive coronavirus tests are sequenced in the lab to check for variants. As of April, 0.75% of all India’s cases were sequenced, according to a report in Nature. The country has had 29.45 million recorded cases since the pandemic began.
This lack of data is holding back doctor’s understanding of the variant.
Ghafur added that “despite having the second highest number of [COVID-19] patients in the world, India’s premier research institute, the Indian Council of Medical Research, hadn’t conducted any scientific studies of value.”
Anurag Agarwal, director at the Institute of Genomics and Integrative Biology in Delhi, told Insider that there was no clear link between the Delta variant and atypical symptoms.
Agarwal said the rise in people with atypical symptoms may be because of the increases in overall COVID cases in India, rather than the rise of the Delta variant.
Neil Ferguson, director at the MRC Centre for Global Infectious Disease Analysis at Imperial College London, explained at a briefing in the UK on Wednesday that, when a large number of people get sick, there can be a spectrum of rare conditions that aren’t typical at all.
Dr Jeffery Barrett, director at the COVID-19 Genomics Initiative at the Wellcome Sanger Institute, UK said at the same briefing that the UK processes up to 20,000 tests each week.
INSACOG, a group of research labs that conducts India’s sequencing, said it had sequenced more than 10,000 samples since it was set up in December.
Barrett told the briefing there was no data to suggest the Delta variants caused different symptoms to other variants.
Dr. Harsh Vardhan, India’s health minister, said Monday that there were more than 28,000 recorded cases of black fungus infection that occurs in people with compromised immunity or diabetes. Of these, 86% had had COVID-19.
The link between black fungus and suppressed immunity or diabetes is not proven – but it’s been suggested the high numbers of both in India could explain the number of cases of it.
Ghafur said he believed the Delta variant was most likely the cause of the rise in black fungus cases.
“India has always been the diabetes capital of the world and use of [immune system suppressing] steroids was rampant in the first wave,” Ghafur told Insider. “The only difference this time is the Delta variant.”
Dr Shailesh Kothalkar, an ear, nose, and throat (ENT) surgeon at Seven Star Hospital in the western city of Nagpur, told the Telegraph that the Delta variant was “causing damage to the beta cells in the pancreas, which produce insulin and regulate blood glucose levels.”
“We need more investigation into this but […] around 40% more patients are developing diabetes after having COVID-19 during this second wave,” he said.
Professor David Denning, a professor of infectious diseases at the University of Manchester and chief executive of the Global Action Fund for Fungal Infections told the Telegraph: “It’s possible that a different variant would produce more disruption of the lining of the nose or the lungs… and then that would allow fungus to get in more easily.”
Imagine a wall of rock and ice 1,800 feet wide falling the length of four Empire State Buildings stacked end-to-end.
A slab that size is responsible for the disaster in northern India that killed more than 200 people and destroyed two power plants four months ago, according to a new study published Thursday.
Just before dawn on February 7, a massive chunk broke off a glacier on Ronti Peak in the Indian Himalayas. The slab dropped more than a mile into the valley below, from its position roughly 18,000 feet above ground, at almost 134 miles per hour.
As the chunk landed, the rock disintegrated and the ice melted, creating a wall of water and debris that swiftly funneled into the river valley below. From there, the mixture cascaded toward the Rishiganaga and Tapovan hydropower plants in India’s Chamoli district. After a curve in the valley slowed the sludge down, it swept into tunnels underneath the plants at speeds of up to 56 miles per hour, trapping and killing many workers inside.
The severity of the event, known as the Chamoli disaster, initially stumped scientists. Typically, landslides in the region don’t kickstart floods as rapid or lengthy as the one that occurred in February.
“A ‘normal’ dry rock avalanche would not have traveled as far as this one did – in other words, would not have reached either the Rishiganga or Tapovan hydroplants,” Dan Shugar, a geoscientist at the University of Calgary and co-author of the new study, told Insider.
Shugar’s team discovered key elements that could explain the disaster’s severity: The initial avalanche’s composition (about 20% ice and 80% rock), coupled with its mile-long fall, resulted in a hyper-mobile torrent of debris that doomed workers in the valley below.
The researchers calculated that the flood was 27 million cubic meters in volume – enough to cover more than 1,600 football fields in 10 feet of debris and still have some left over.
The flood climbed 722 feet up the valley walls
Flooding and landslides are not uncommon in Uttarakhand, the area of northern India where Chamoli is located. In 2013, heavy rainfall set off devastating floods in the area than killed up to 5,700 people.
After the February disaster, experts initially thought a lake near the top of Ronti Peak had burst after the chunks of glacier holding it together cracked or broke off. Some glacial lakes can hold hundreds of millions of cubic meters of water.
But satellite imagery showed there were no such lakes along the debris flow’s path.
By analyzing maps of the valleys’ terrain, video footage of the event, and earthquake data in the area, Shugar’s team was able to reconstruct what happened.
The chunk of glacier that broke off Ronti Peak in the early morning was, on average, 262 feet thick. When it touched down at the mountain’s base, the slab flattened a section of nearby forest, and threw a thick dust cloud into air. The impact with the valley floor was so violent that the rock and ice therein blended together to form a flood that climbed 722 feet up the valley walls.
It was “almost the ‘optimal’ combination” for melting glacier ice, Holger Frey, a glaciologist at the University of Zurich in Switzerland, told Insider. The massive flood, he added, “facilitated the large reach and destructive nature of this disastrous event.”
‘It’s only a matter of time’ until a disaster like this happens again
The flood caught workers at the hydroplants in Chamoli by surprise.
But according to the study, an early warning system could have given workers six to 10 minutes of notice before the flood reached them. Seismic sensors – which monitor rumblings in the Earth for signs of earthquakes or shifting rock – can detect when an avalanche happens and let workers know if a flood is on its way.
Even if the Chamoli disaster couldn’t have been prevented, Frey said, “a well-designed warning system should be able to warn workers at these plants and allow them to seek safe grounds.”
After all, the conditions that led to the Chamoli disaster aren’t going to disappear any time soon.
Evidence from other mountainous regions, like Alaska, suggest glacier-related landslides are increasing in frequency as the climate warms, according to Shugar.
“I expect this would be similar in high mountain Asia,” he said.
Rising air and surface temperatures are linked to more instability in glaciers and an increasing likelihood of landslides high in the mountains. The warmer the Earth becomes, the more glaciers shrink.
“It’s only a matter of time before the next such massive event will happen somewhere in the Himalayas,” Frey said in a press release.
The Delta variant accounts for more than 6% of sequenced tests in the US and 60% of infections in the UK, Fauci said. The actual figures could be higher, as not every test is sequenced. The highest rates of transmission in the UK are people aged between 12 and 22, he said.
Fauci urged Americans to get vaccinated to stop the Delta variant spreading across the country.
“Particularly if you had that first dose, make sure you get that second dose. If not, please get vaccinated,” Fauci said in the briefing.
The Alpha variant, first identified in the UK, is currently the most common virus strain in the US.
The Delta variant is at least as infectious as the Alpha variant, and has now spread to more than 60 countries. It also has extra mutations that means it may escape the antibody response, so vaccines offer less protection against it when just one dose is given.
A UK-based study posted on May 24 found that Pfizer’s COVID-19 vaccine was 88% effective at preventing symptomatic COVID-19 caused by the Delta variant after two doses, but 33% effective after a single dose.
Another lab-based study from the UK posted Thursday found that the antibody response, a part of the immune system that fights the virus, was “significantly lower” against the Delta variant compared to the Alpha variant after one dose.
Nearly 19 million of the doses will be given through COVAX, the UN-backed global vaccine sharing program that helps vulnerable countries.
In total, 7 million of those doses will be donated to nations in South and Southeast Asia, including India, Nepal, Afghanistan, Philippines, and Vietnam. Another 6 million doses will be shipped across Central and South America, including to Brazil, Honduras, Guatemala, Haiti, and El Salvador. Approximately 5 million doses will be delivered to countries in Africa, coordinated through the African Union.
The remaining 6 million doses will be given directly to allies and countries seeing surges in COVID-19 cases, including Canada, Mexico, South Korea, Egypt, Iraq, and the West Bank and Gaza, the White House said.
“As long as this pandemic is raging anywhere in the world, the American people will still be vulnerable,” President Joe Biden said in a statement. “And the United States is committed to bringing the same urgency to international vaccination efforts that we have demonstrated at home.”
“This is just the beginning,” White House COVID-19 response coordinator Jeff Zients said during a Thursday briefing. The doses will consist of Pfizer, Moderna, and Johnson & Johnson vaccines, Zients confirmed.
Vaccine shipments will take place over the next several weeks. The US plans to share a total of 80 million excess doses with the rest of the world by the end of June – five times the amount any other country has committed to donating, according to the White House.
“A number of those are even going to go out as soon as today,” White House press secretary Jen Psaki said in a news conference Thursday.
The White House reiterated that the US has secured enough supply to fully vaccinate Americans and the doses that will be shipped come from a surplus in the US stockpile.
The announcement comes ahead of Biden’s meeting in the United Kingdom with the Group of Seven nations next week. National Security Advisor Jake Sullivan noted on Thursday that the US plans to work with those countries to help end the pandemic.
“Our goal in sharing our vaccines is in service of ending the pandemic globally,” Sullivan said during a White House coronavirus task force briefing Thursday. “Our overarching aim is to get as many safe and effective vaccines to as many people as fast as possible.”