CareTalk Podcast – Why is COVID Raging In India & Brazil?

John and David confer about the causes behind the uncontrollable spike in COVID cases in both India and Brazil.

David Williams:

John, for much of the last year, the US was a disaster zone when it came to the pandemic. Now, we can see a light at the end of the tunnel. What’s it looking like elsewhere?

John Driscoll:

Well, it’s burning pretty brightly in both India and Brazil. We still have an international COVID crisis.

David Williams:

Let’s dig in.

David Williams:

Welcome to CareTalk, your weekly home for incisive debate about healthcare, business and policy. I’m David Williams, President of Health Business Group.

John Driscoll:

And I’m John Driscoll, the CEO of CareCentrix.

David Williams:

John, we’re going to talk about India and Brazil today, both serious hotspots for COVID. What’s the current status?

John Driscoll:

What a mess. I mean it’s a human catastrophe in both countries. India is in dire straits. You’ve got 400,000 new cases today reported, it could be worse, and tens of thousands of people dying and a healthcare system that’s on the brink of collapse because of COVID. And in Brazil, you’ve got probably the most dangerous P1 variant, the new Brazilian variant that started in Manaus, coursing through the country. And in both cases, you’ve got leaders that aren’t really paying attention to their public health responsibilities.

David Williams:

John, in India, you were reporting the official numbers there. And I would say, in this case, Ashish Jha, who is the Dean of the Brown Public School of Health and of Indian descent, he says the real number is more like two to five million new infections a day and 25,000 deaths per day. It’s just hard to comprehend what that’s about. And at the same time, you can see the possibilities between the current state and the possible reality. There was an article in the Wall Street Journal, how in Brazil, a town of 40,000 people, they went and they vaccinated everybody in the town and the cases have plummeted so it can be done.

John Driscoll:

I mean you’re talking about a fundamental failure, David. I mean neither Prime Minister Modi, nor President Bolsonaro, Modi in India, Bolsonaro in Brazil, took this seriously. In fact, they kind of ignored it and both of them declared victory over it in December in the case of Brazil, in January in the case of Modi. And in both countries, you had dangerous variants that were just starting to take hold. The failure of containment means that this virus will continue to evolve. You’ve got the B117 variant from Britain that is both more toxic and more deadly spreading very quickly in India. You’ve got a new B1617 variant that’s emerging in India. You’ve basically created a laboratory of public health disaster where COVID can not only grow, but it can also morph and mutate and become even more dangerous for the populations.

David Williams:

I think in India, there was a real complacency after the case counts fell, and you saw kind of an opening up and an encouragement of large gatherings. Now it’s being addressed. I mean India is a democratic country and so the Prime Minister’s party lost a state election that they were expected to win and the Supreme Court has been coming down and saying that officials could be punished for not doing enough on the oxygen situation and so on. In Brazil, you’ve got the sort of mismanagement and the scoffing at social distancing and they say that Bolsonaro was almost intentionally driving the virus, or in fact maybe even intentionally driving it by sabotaging mask mandates, refusing aid, cutting funding for scientific research. And it’s just been a disaster, and in fact, a potentially criminal situation.

John Driscoll:

Let’s unpack that. You’ve got Prime Minister Modi who insisted on holding political rallies while the virus was starting to grow. He refused to admit that he had a public health crisis and there was clearly, even in a country that is an absolutely critical part of the pharma and vaccine supply chain, there was not really a plan to get a substantial number of people vaccinated, which is just crazy. I mean we knew that had to happen. And now the crematoriums are working around the clock and Modi continues to not shut the country down, which he had done prior. And there doesn’t appear to be a robust plan to vaccinate the country. And India is totally integrated into the international community, but particularly America, there are very few American companies, our own included, that doesn’t depend daily on an integration with Indian Americans who are part of our teams or integrated with companies that have staff on the ground. I mean it’s devastating to hear these stories of individuals who are on our teams, or who we’re friendly with, who are losing relatives to death that is completely avoidable.

David Williams:

John, it’s good that CareCentrix has stepped up to help with the oxygen and I know you personally have been involved. Let’s make sure we put in the comments a link to a proper site where people can help out. What’s going on in terms of the oxygen though? I mean where’s the bottleneck? Is there sort of one bottleneck in India?

John Driscoll:

There’s a number, but the fundamental problem, and we’re working with an NGO called Gautam, but the public health infrastructure in India to support this billion people is really pretty fragile. And so there are disconnects between where the oxygen is actually being created and where it needs to be delivered in hospitals all around the country. And there’s also a shortage of oxygen concentrators to take that liquid oxygen and make it available and consumable if you will at the hospital level. But I think what you’ll find is that the best help, and we encourage everyone to help, there’s nothing more scary than thinking of people going to the hospital and dying because their oxygens are collapsing for something that we can actually serve and care for. It’s a huge human tragedy and it’s avoidable.

John Driscoll:

But you’re going to have to see the NGOs, the nonprofit groups, the independent charities step up to accelerate just the support for caring for people with COVID. But you think right now the government, and I haven’t seen it, would be making a much more aggressive play for getting the country vaccinated. And what you’ve got is a country that’s actually manufacturing a lot of critical components for the vaccines. President Biden and the US government is now pushing for the release of the patents. And so the Indian manufacturers can now reverse engineer some of the components that they can to accelerate vaccine production, but they need a plan. But right now, I think the most important thing for anyone who’s listening who can afford to give anything is to try to help out our brothers and sisters in India who are really suffering right now.

David Williams:

John, you can look at the contrast in US government policy and see quite a bit’s being done for India. It’s about 100 million dollars sent in recent days. This may be updated by the time the podcast is posted. That’s where things like oxygen and PPE, manufacturing supplies for vaccines, treatments like Remdesivir, that’s a much broader partnership than there is with Brazil, where it’s just about 20 million committed by the US government, a bunch of small, little items. And I think that’s just because Bolsonaro is really not in the US’s corner, whereas India is a much more strategic ally at the moment.

John Driscoll:

Also, we are so integrated in David. I think it’s a much more natural partnership, but the needs are dramatic and I think that if there’s a slight differential, at least Modi acknowledges that COVID actually exists. I mean Bolsonaro, he’s extraordinary.

David Williams:

Yeah, and not in a good way. I mean the thing is, there has been a flight ban imposed on India. I think that that’s closing the barn door a little bit too late there, but I don’t think anybody here is under the impression that that’s going to really make a big difference.

David Williams:

John, I hope that we can do a follow-up episode on this soon that’s going to talk about how India and Brazil pulled themselves out of this and how other countries saw it as cautionary tales to avoid. But I think we’ve said about enough right now and we’ll wrap it up. That’s it for another edition of CareTalk. I’m David Williams, President of Health Business Group.

John Driscoll:

And I’m John Driscoll, the CEO of CareCentrix. If you liked what you heard, or you didn’t, please leave a comment and do subscribe.