Why is India's 2nd COVID Wave Deadlier than any other country's?

Current situation in India is horrendous. People are dying in parking lots, waiting for hospital beds, begging for life-saving oxygen and medical attention. Most hospitals in megacities like Delhi, Mumbai... are overrun, with no room to accommodate any more people, and many have run out of life-saving drugs, PPE, and even oxygen.

India's second wave of daily infections exceed numbers seen anywhere else in the world, higher than the US, Brazil or EU. They are three times higher than what was seen during the 1st wave that peaked last September. Cases are rising exponentially, and apex is nowhere in sight. At this rate India's total number of cases may surpass those of the US, which would mean another 400,000 people could perish without proper medical care. Lives of thousands could be saved by merely providing them Oxygen.

How did it get so bad so quickly? Why wasn't India better prepared? After all COVID has been around for more than 15 months.

1) India was fortunate to avoid the dire consequences (unlike the US) during its first wave of infections which peaked before the Diwali festival. Most thought Indians were somehow resilient to this virus or were dealing with less virulent strains. All that changed this February, when a new mutant variant was detected in parts of Mumbai. No one knows if this variant is derived from other strains (like the ones from UK, South Africa, Brazil) or is something entirely indigenous. This variant appears to be very contagious, spreading like wild fire.

2) Most Indian states have not invested enough in their healthcare systems (exp. Kerala and Andhra Pradesh). Rural India is particularly vulnerable due to lack of basic infrastructure (like roads, electricity and water). There is a huge income disparity between the rich and the poor in India which dictates who gets care and who doesn't.

3) There appears to be utter lack of planning by the Indian government or private sector. they should have seen this wave coming when it first started in Maharashtra in early March 2021. Once Mumbai realized this strain was spreading fast in and around the city, millions of migrant workers started to flee for their hometowns (in other states like Chattisgarh, Madhya Pradesh, Uttar Pradesh...) carrying the new variants to those states which were totally unprepared. State government of Maharashtra did not lockdown Mumbai or other cities to stop the leak. Central government had at least 6 weeks to prepare the other northern states where the current wave is striking down 200-300% more people (per capita) compared to the first wave.

4) While India manufactures most of the Astra-Zeneca (Oxford) vaccine it was unable to provide that to its own citizens. Less than 2% of the population is currently vaccinated. If the government had made this a priority it might have been able to vaccinate at least 30-40% of its population by March time frame which would have significantly reduced the growth of the 2nd wave.

5) The central government didn't want to shut down the economy like Mar 2020, due to the disastrous economic impacts. Moreover, government went ahead with holding the State Assembly elections in 5 of the states, permitting large campaign rallies and in person voting between 27 Mar - 6 Apr. However, the biggest super spreader event was the Kumbh Mela (held in Uttar Pradesh) with millions of people gathering over a two week period in the middle of April. All of these events have added fuel to the COVID positive fires in 10-15 mostly North Indian states.

Many of the southern with more robust healthcare systems and policies are lending a helping hand to the northern states by providing them Oxygen, testing supplies and even medical personnel. Even other nations like US, UK, Saudi Arabia... have offered their help. Will that help arrive in time or be enough to save thousands of lives. If not, this will be one of the worst tragedies.

Just a few months ago, it looked like India had dodged the COVID bullet but its more than a billion people are looking for our help. Pray for India where 1/5th of the humanity lives, so it can help the world.