Washington Post reporter Niha Masih joins Milan to give an update on the state of the coronavirus pandemic in India. She also reflects on her own family's struggle with the pandemic and India's ongoing race to get more people vaccinated.
In India, there are growing signs that the country is slowly exiting the second wave of the COVID crisis as people get back to work, localities lift lockdown restrictions, and markets reopen. But the second wave leaves behind a trail of devastation, loss, and widespread anger. And Indians may not have much time to enjoy a return to normalcy, as government officials are already warning of a third wave of the virus.
To discuss where things stand in India today, Milan is joined Niha Masih, a Delhi-based correspondent for the Washington Post. Niha reflects on her family’s struggle with the COVID-19 pandemic, the mental toll the pandemic has taken, and the under-reported challenges rural India faces. Plus, the two discuss the Indian government’s new vaccine policy and the political implications of the crisis for Indian Prime Minister Narendra Modi.
Milan 00:11
Welcome to Grand Tamasha, a co-production of the Carnegie Endowment for International Peace and the Hindustan Times. I'm your host, Milan Vaishnav.
In India, there are growing signs the country is slowly exiting the second wave of the COVID pandemic as people get back to work, localities lift lockdown restrictions, and markets reopen. The second wave leaves behind a trail of devastation, loss, and widespread anger, and Indians may not have much time to get used to a return to normalcy, as government officials are already warning of a third wave of the virus.
To discuss where things stand in India today, I'm joined by the journalist Niha Masih. Niha is a Delhi-based correspondent for the Washington Post. Before joining the Post in 2019, she reported on politics, conflict, and religious fundamentalism for the Hindustan Times and NDTV. I'm pleased to welcome her back to the show. Niha, good to see you.
Niha 00:58
Thank you so much for having me.
Milan 01:00
I want to ask you about the very moving and deeply personal essay that you wrote for the Washington Post that was published at the end of May. You wrote about your own family's COVID crisis, and I'm sure that, as a journalist, this must have been a difficult decision for you. You're usually reporting on the stories of others; in this case, you're reporting on your own story. Tell us a little bit about why you decided to write this piece.
Niha 01:24
Well, it wasn't an easy decision, and it did take me some time to get to writing it. I didn't write it in real time as it was happening.
I think what happened to my family was quite representative of what was happening to so many others in India, and I obviously had the opportunity and space to tell that story. So, in a way, it was kind of like writing it on behalf of all those who went through the same experience of devastation but didn't really have a chance to share it. And I think it was also partly that, again, my experience and my family's experience pulled on all these different threads that we were reporting on [elsewhere] which all came together in this in this story – whether it was the oxygen crisis or the overwhelmed health system or missing deaths. So, in that sense, this one story gives you a comprehensive view of what was happening in India instead of touching at different angles and points.
For those of your listeners who haven't read that piece, I won't be able to go into much detail, but essentially, my whole family contracted COVID at the peak of India's second surge, and we went through a whole set of problems in trying to get them help. Some of them did receive help, and some didn't. And so I wrote about that experience of being in the middle of it as well as reporting it. This was one of those rare situations where my lived reality – and I guess this is true for many journalists in India – went through similar things, where our lived realities collapsed seamlessly into what we were reporting on. So, if I hadn't had this experience, I would have tried to find someone else to write about. But given that I had seen everything firsthand, and given how difficult the situation was, I felt that I could only honestly write about myself, [rather] than to try to distill what was happening to others.
Milan 03:54
One of the things you talked about in the piece, Niha, is that you yourself, in the middle of trying to take care of your family and friends, contracted COVID and had to quarantine with a friend. Tell us a little bit about what that was like. I'm sure it must have been a really frightening experience given what was happening around you.
Niha 04:11
Yes and no. I say that because I think by the time I had COVID, most of my family had already contracted it – my mom and dad had a much worse infection than I did – and my threshold for bad was really already very high. So, in that sense, in a slightly grim way, it wasn't so scary, I think. And again, I was lucky that a friend and I tested positive at the same time, so we could isolate together, where she actually took care of the daily stuff and I could focus on my writing and reporting and taking care of my family and attending to hospital calls. So, in that sense I was sort of lucky, I think.
The unknowns at that time were so many that it was impossible to try to do anything in case something went wrong. There were no hospital beds; the tests would take, like, four days to come. Medicines were in short supply, but you could get them. Doctors were available on call irregularly. So, all of those things, of course, were not easy, but given the extent and scale of what was happening outside, my own COVID experience was pretty mild, I would say.
Milan 05:55
I want to ask you one more thing about this story – and we'll link to it, of course, in the show notes. It was a deeply harrowing piece to read. You write about losing your grandfather to COVID and not having proper time to grieve because there were just too many logistics to worry about. Now, of course, you're focused on helping your family recuperate, get back on their feet. We hear a lot, and there have been numerous stories about, the physical toll the crisis has taken on people's families, on their bodies, but how would you characterize the sort of mental or psychological impact the second wave has had? I mean, I was talking to a friend the other day, and we were sort of discussing how so much of the country is probably suffering from some kind of PTSD given the sorts of things they've had to endure.
Niha 06:44
Absolutely. And, again, I think maybe it's too soon to even assess that impact because there is still so much to do. Right now, people have just about recovered or come back from hospitals, and there are hospital bills to pay and medical arrangements. To me, the emotional toll of it hasn't really registered fully – at least for me, and I think it would probably be the case for a lot of other people. People have jobs to go to or work to look for.
But I think what this crisis has done, unlike in any other previous crisis that I have seen or reported on, is that there was a sense of universalization of grief. What you were seeing on the news, what you were reading on the papers, was also happening either to you or to your friends or family, and everyone would know someone who was going through some kind of problem. I mean, there would be a few people who may have remained untouched, luckily, but even if you were in that category, your social media, your WhatsApp groups were overwhelmed with desperate pleas for help. So, it was impossible to remain untouched in any which way.
Last week, for instance, someone who I barely knew and had never met or interacted with but who I followed on Twitter passed away. And there were so many people suddenly sharing stories of that person – who, again, most people hadn't met but only interacted with on Twitter – that at the end of the evening, after I saw some of those messages, I was crying, too. Each loss feels very personal now because you've seen it all play out in front of your eyes.
Milan 08:49
I guess this is a good segue to talk about the current situation on the ground. You had a recent piece in the Post in which you note that case numbers across India have improved dramatically, but the country is still experiencing anywhere between 1500 to 2000 deaths per day. We know that those deaths numbers are a severe undercount. But you write that local authorities in Delhi, which was hit extremely hard in the second wave – in many ways, it felt like the epicenter – those authorities are preparing for an inevitable “third wave.” What exactly are authorities doing to get ready for what could be a third wave of this crisis?
Niha 09:29
So, this is a difference I've noted at the end of this second wave: at the end of the first wave, Indian authorities went into a self-congratulatory mode and didn't talk about preparing for the second wave, which as we had known at that time, was going to come, and countries like the U.S. and U.K. had had a terrible time managing them this time. Instead of that complacency, what I see is people actually trying to make plans, and some of those include the problems that we did see in the second round.
So, for instance, Delhi doesn't have a large oxygen plant – they plan to set one up, but that will take more than a year to get ready – so they are trying to set up smaller oxygen plants. Large-size hospitals are trying to make in-house plants; oxygen storage capacities are being increased. Some experts have suggested that children may be most vulnerable in the third wave, and so there are plans to try and have more ICU beds for children, the kind of masks that will fit for children. So, there are various things happening, not just in Delhi, but also in Maharashtra in particular, as well. They were the first ones off of the ground to start preparing for a third wave.
Of course, when and how that will come remains unknown. But that's the difference: this time, states are actually trying to do something about it.
Milan 11:18
But obviously, when the rubber meets the road, the most foolproof form of prevention is vaccination. We know that India is lagging well behind – at least on a per capita basis – when it comes to vaccinating the population. The central government's vaccine policy has come under fire from a number of sources, not least India's own state governments. The prime minister recently gave a nationwide address in which he announced a complete rethink of how the government is going to vaccinate its citizens. What, to the best of your knowledge, is the new policy going forward?
Niha 11:53
The new policy going forward is actually the old policy in the sense that the central government is now going to be in charge of the bulk procurement of vaccines, again, instead of the state governments. So, from June 21 onwards, 75 percent of vaccines will be procured by the center and provided free of cost to all adults in the country at government sites. Twenty-five percent of the supplies are reserved for private hospitals that can charge a fee for people who vaccinate at private centers. So, that's going to be the new policy.
And it has gone through various twists and turns, and it has been quite muddled so far, because in the middle, the government announced that states can now procure their own vaccines and charge people in one age group, but people in another age group would get it for free. So, the Supreme Court recently called that arbitrary and irrational, and it asked the government to overhaul the system. And this came days after that [announcement].
But it's a bit unfortunate because in January, when India began its vaccination drive, it was in a really strong position. It had two vaccine candidates, both of which were being produced locally; it has manufacturing heft – Serum Institute is the world's largest vaccine producer by volume – and it also had managed to escape the worst of the first wave – it had gone relatively smoothly compared to what happened next. And yet, despite all of that, the percentage of people who have received vaccines remains very, very low, even if in itself it's a high number. So, it remains to be seen now, going onwards, whether this will pick up. Supplies still remain an issue.
Milan 13:56
We've been reading a lot about inequalities in the vaccination drive – you touched upon this in your reporting as well. One of the things that's come up in recent days is a sort of worrying degree of vaccine hesitancy in certain parts of the country, including in places that you might not expect, like the state of Tamil Nadu, which is one of the most well-developed, richest, most industrialized states. Do we know anything about what seems to be fueling this hesitation? I mean, we're seeing reports of pretty large quantities of vaccine that are being wasted because there's not enough take-up in certain localities.
Niha 14:34
This is a bit of a complex issue, I think, and given the diversity of class and regional divide, it's also hard to say what the reason is nationally. I think there are several aspects to it. One is, of course, lack of awareness. A lot of people, even in urban centers – migrant workers or laborers [for example] – do not have enough information, not just about what vaccines do but also how to avail of them, where to avail of them. That's definitely one. The government's system of registering for vaccines is also complex: you have to log onto a website and put in your phone number, receive an OTP, register yourself through an identity card, and then book a slot. So, it's a complicated system, which again, a lot of people may not be able to do. I have myself had to do it for so many people who work in households because they're just not going to be able to do that. And initially, when the drive had opened to everyone above the age of 18, there were just no slots available. So, it was actually like playing a game: every half an hour, log on and try it.
So, all of those are logistical difficulties. But there's definitely no doubt that there is also just hesitancy in going and taking the vaccine, and part of it is, I think, related to the fact that a lot of people got the vaccine just when the wave was peaking. My mother, for instance, contracted COVID days after getting the vaccine. And for a lot of people, that can seem as if it was happening after the vaccine. So, in rural areas, people were equating getting a vaccine with getting COVID or falling sick. So, that's also part of the reason.
Milan 16:46
You mentioned the situation in rural areas, and I want to ask you to dig a little deeper on this. From a media perspective, I think it's fair to say we're still hearing far too little about what's happening in rural sections of the country. But you spent some time in a village in rural Uttar Pradesh back in May, and you documented pretty frightening accounts from one village that had been really ravaged by the virus, and you spoke with a farmer who told you, “Not a day goes by when there are no deaths. If things continue like this, the village will empty out soon.” Could you tell us a little bit about what you saw during your travels in rural UP?
Niha 17:27
Absolutely. Going from Delhi, which had seen 30,000 cases a day, I did not realize that the scale of what was happening in villages would also be so vast. Essentially, what was happening in this village that I went to was that a lot of people began to complain of flu-like symptoms, fever and cough, and then in the days to come, they would die. A lot of them developed breathlessness. Most of them were never tested, and most of them could not access medical care. Many of them didn't even know what was happening to them and were never diagnosed with COVID. So, you found people sick with these symptoms in many households, and the local health center at the village had no doctor, no testing facility, no medication for COVID, or any treatment facilities. The closest you had was a nearby town to get tested where, the day I went, tests ran out by the afternoon, which the technician said happened almost every day. To get an RT PCR test, you had to wait for four days because the results of the samples are sent to a major city close by. A rapid antigen test is what a lot of them were using, which is not so accurate. To get treatment, you had to again go miles. Most people didn't have the financial wherewithal to afford a private hospital.
So, essentially, people were dying at home in this village. And as we saw on the national scale with super-spreader events like the Kumbh Mela and political rallies in West Bengal – we also saw that happening in rural UP, where so many people told me that in April, there were local village head elections held which were responsible for this surge. People came from outside; there were gatherings, there were rallies held in villages to elect the head of the village. That contributed to the spread.
Milan 19:47
You mentioned people dying at home, not being able to access proper care. One of the issues which has emerged – and in fact has been in the news a lot these past couple of days – is the extent of undercounting of COVID-related deaths. You yourself reported a story from the western state of Gujarat talking about the gap between official statistics and, say, what you would find going to crematoria or hospitals. Just last week, authorities in the state of Bihar revised that state's COVID fidelity account by, I think, a whopping, like, 72 percent. The data journalist Rukmini, who has been on the show a few times, has uncovered a dramatic, unexplained rise in excess mortality in several states: Andhra Pradesh, Madhya Pradesh, Telangana.
To what extent are we seeing, do you think, deliberate undercounting? Or is this more a symptom of weak state capacity, a poor statistical system and an overwhelmed bureaucracy? What do you think are some of the factors going on behind the scenes to lead to this kind of variance?
Niha 20:54
It's not any one factor but a whole host of factors. Most of it you listed out. India, even before the pandemic, had a poor death registration system, which meant that a large number of deaths – particularly in rural areas – would go uncounted. So, you're already starting off from that position. Secondly, as I said, in villages with people dying at home without ever being tested, there is a big chunk of people that never make it to the system. However, there is also deliberate undercounting, as we found particularly in the state of Gujarat. We spoke to death audit committee members – Gujarat constituted these death audit committees last year to ensure that reporting was accurate, and instead, what ended up happening was that it became a tool to undercount deaths.
So, each district has a death audit committee at the main government hospital, which is supposed to be the auditor of deaths across the district. Now, all hospitals are supposed to send case files to this committee. Not all hospitals do that, or they send it late – no one's catching them – and then this committee is supposed to look at the case files to determine what they think are deaths due to COVID and what they think aren't deaths due to COVID. Some of the people I spoke to on these death audit committees in at least two cities said that there was informal pressure from the top to keep the death count low, and so what they ended up doing was excluding deaths of elderly people with comorbidities – like kidney diseases, heart diseases, diabetes – so a majority of the deaths ended up getting excluded by the audit committee itself.
So, it's happening at various levels and in various ways, and to actually get a full extent of it is very hard to say, and I think we'll never really know how many people died because of COVID.
Milan 23:15
I want to end by asking you about some of the broader implications of your reporting. In your own essay of your family's trials and tribulations, you single out the heroic work of so-called frontline functionaries – doctors, nurses, sanitation workers, civil society organizations – who were trying to help those who are sick or in need. I was struck by the fact that we often denigrate the local state and local civil society for not living up to a certain expectation, but in this case, it seems that they actually were quite resilient in a way that we typically don't give them credit for. Is that a fair takeaway, in your view?
Niha 24:00
Absolutely. But I think in India, we actually have now learned to rely on some of these networks, sometimes, much more than the government. A large part of India doesn't expect the government to deliver, and so to have the system missing is not a surprise, unfortunately, and they have mostly relied on civil society networks to get by. So, for instance, last year, when we had a huge crisis of migrant workers who were stranded without food and aid in cities or trying to trek back hundreds of miles home, it was the civil society organizations that stepped up and provided for them much before the government sprang into action. So, yes, these informal networks, and also the NGOs that are not informal, are very, very robust here, and very often fill in the gaps that the government is unable to provide.
Milan 25:11
In late April, you and your colleague at the Post, Joanna Slater wrote a piece on the rising tide of popular disenchantment directed at Prime Minister Narendra Modi. This seems to dovetail with whatever limited polling data we have, which suggests that Modi's popularity has dipped somewhat. We're recording this on June 14 – there's a piece in the New York Times today on this point as well. In recent weeks, though, the slide seems to have stopped. His ratings have sort of stabilized, at least according to one weekly tracker conducted by the global polling firm Morning Consult. So, if you sort of step back, what is Modi's political standing as the second wave ebbs? How do you see it? I mean, it seems like there's a rising tide of anger, but already the government is talking about how they're willing to share lessons learned for what to do right with other countries. So, is this something that's going to have a lasting impact, do you think?
Niha 26:10
I think you would be better placed to answer this question. It's hard for me to make a prediction. However, there are some things we know. One is that there is anger, a lot of anger, amongst people who are not just critics of the government – these are people who are supporters and who have been lifelong supporters, or who have stood by Mr. Modi through many other controversial decisions. So, there is definitely anger amongst even his loyal supporters. A lot of them that we spoke to did say to us that they will never vote for him or his party again. (That's not something that is necessarily going to be true.)
However, as you said, the slide seems to be stemming. That could be a function of that the wave is waning and things are looking better, and the government is now revamping its vaccine program, is trying to provide health through other means. So, for now, given that the general election is still a couple of years away, it's hard to see whether this will translate into a vote against him or not. And I think your piece in the Post earlier reflected that accurately.
However, this time, the difference is that the lives of people have been touched in a different way. People have lost their friends and family, and that's not something that is easy to forget, even if the anger subsides. So, I would say that the upcoming state elections, particularly in Uttar Pradesh, is going to be a potentially a good parameter to check whether the anger against Mr. Modi holds and in which form.
Milan 28:24
Let me maybe end with a follow-up on that. Uttar Pradesh is your home state; you traveled back there during the COVID pandemic to take care of your family; it's a place you've reported from on many occasions. Without asking you to predict the future – I agree, it's totally unknowable how things will go in the next week in Indian politics, much less next year – but as you think about Uttar Pradesh and you talk to people there on the ground, was there a sense of an opening for some kind of alternative government at the state level? Here's a place where the BJP won a three-fourths majority and has ruled the state since 2017. Do you do have the sense that there is some churning underway, or is it too difficult to discern that?
Niha 29:14
No, absolutely. There is definitely a churn, and that churn can be evidenced also by what has been happening within the BJP in UP. So, while the pandemic was happening, multiple members of their own party in UP – MPs and MLAs – wrote to the chief minister, Yogi Adityanath, as well as other party functionaries, pointing out the problems, criticizing the government in a veiled way. Some of the MP and MLAs actually died of COVID; some of their families suggested that they didn't receive enough care, or not good enough care, or not in time. So, it has been tough. There has been churn, and that's why we've seen meetings of top BJP functionaries in Lucknow and in Delhi.
And, again, Uttar Pradesh was also one of the worst-affected states this time around, unlike last time, and a grim indication of the extent of the crisis was bodies found floating in the Ganges or buried on the shores. So, people know that things have been bad. There is anger. Again, a lot in Indian politics also depends on how the opposition bands together or comes together. Uttar Pradesh has like four major parties, and so much of that is also in the political realignment or possible alignments which will also determine the course of that election, not just the BJP's performance. But they definitely do sense that it's not going to be a slam-dunk for them as it could have been at any other point of time.
Milan 31:07
My guest on the show this week is the journalist Niha Masih. She's a Delhi-based correspondent for the Washington Post. She was previously with the Hindustan Times and NDTV. Niha, thank you so much for joining us. I know you and your family have been through a lot. Your reporting has been absolutely invaluable. Thanks for sharing some of your thoughts with us today.
Niha 31:26
Thanks so much for having me and for your ever-sharp questions, some of which you should have answered rather than me. [laughter]