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India’s Cascading COVID-19 Failures
The Staggering Cost of an Unscientific Response to the Pandemic
Ramanan Laxminarayan

May 26, 2021
Shallow graves of people suspected to have died from COVID-19, Prayagraj, India, May 2021
Ritesh Shukla / Reuters
At the outset of the COVID-19 pandemic in 2020, Vivian Balakrishnan, the foreign minister of Singapore, predicted that the novel coronavirus was going to pose an “acid test of every single country’s quality of health care, standard of governance, and social capital.” His observations turned out to be prescient; countries in Southeast Asia, including Singapore, escaped the worst of the pandemic by relying on their strengths in these three areas. By contrast, nearby India has failed on all three counts as it contends with an overwhelming, devastating second wave of the virus.
New case totals have dipped from their peak of over 400,000 in early May, but the scale of the crisis in India is still staggering. Official figures of COVID-19 cases and deaths in India are vast underestimates: the government itself suggests that reported cases reflect only one in 25 to 30 actual infections. By that metric, India may have had as many as 700 million cases even though it has reported only 26 million cases. The number of COVID-19 deaths is likely four times the official figure, reaching upward of roughly 1.2 million—by far the highest total in the world.
India had many disadvantages going into the pandemic. It has what can at
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RAMANAN LAXMINARAYAN is an economist and an epidemiologist. He is Founder and Director of the Center for Disease Dynamics, Economics and Policy in Washington, D.C., a Senior Research Scholar at Princeton University, and an Affiliate Professor at the University of Washington.
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