Highlighting capitalist governments’ failure to eliminate the COVID-19 pandemic, South Asia, home to one-fourth of humanity, is yet again on the brink of a devastating wave of the pandemic. As US and European hospitals overflow with rising numbers of patients and COVID-related deaths mount, many experts are repeatedly warning of a similar scenario in South Asia.

India

As of December 22, India, the country with the world’s second-worst confirmed COVID-19 death toll, had reported over 200 Omicron positive cases, reaching 213 a few weeks after first reporting cases of the highly-infectious new variant. Significantly, most are reported in the capital, Delhi, and Maharashtra, the state where India’s commercial capital, Mumbai, is located. Both areas were devastated during the second wave of COVID-19 in May.

Alarmingly, three of the 34 Omicron-positive cases at the Lok Nayak Hospital do not have travel history, Delhi Health Minister Satyendar Jain said, implying the virus is spreading within India. Maharashtra and Delhi reported 54 Omicron-positive patients each. So far, at least 11 regional states and Union Territories, including Telangana, Karnataka and Kerala in the south and Rajashthan in the west have reported Omicron cases.

Prime Minister Narendra Modi’s government has issued advisories to states and Union Territories to act to contain the spread of the new variant. On December 21, in a letter to regional states, the Health Ministry called to “activate war rooms/EOCs” [Emergency operation centres] and act based on “local conditions,” laying down guidelines for what it called “threshold limits.” These official thresholds are test positivity rates of 10 percent or more over the last week or 40 percent occupancy on oxygen-supported or ICU beds.

Such guidelines aim only to deceive people, as many states have carried out very few COVID-19 tests. On the other hand, a situation where 40 percent of oxygen-supported or ICU beds were occupied would mean that the fast-spreading Omicron variant would have already spread to wide swathes of the population, before authorities announced toothless “containment measures.”

Epidemiologist Dr. Giridhar Babu warned in a tweet that R-values (or the effective reproduction rate of how the SARS-CoV-2 virus is spreading) have risen in several Indian states. As of December 22, the seven-day average of COVID-19 cases stood at 6,837 and deaths at 312. Overall, India reports 34.75 million cases and 478,325 deaths, a gross underestimate as demographers estimate that several million Indians have died of COVID-19.

Though children are highly susceptible to COVID-19 variants, the National Technical Group on Immunisation (NTAGI) told the central government that kids do not need COVID-19 vaccination, claiming “kids are not at risk” and hence, that vaccinating them is “not a priority at the moment.” Meanwhile, the government has still not authorised booster shots for Indians.

While New Delhi maintains a vaccine-only policy on the pandemic, like many governments internationally, its vaccination strategy has fallen massively short. Just under 40 percent of the Indian population has received two doses, according to Our World in Data. With only 59.51 percent of the population having received at least one dose of vaccine, it means over 40 percent has not received any vaccine at all.

Pakistan

The provincial government in Balochistan imposed a lockdown on the Kech district after a surge of COVID-19 cases, while reports emerged on Tuesday of 30 suspected cases of Omicron variant in Balochistan’s Kalat district. Authorities confirmed Omicron cases in Pakistan on December 13, several days after the first suspected cases were reported in Karachi, the country’s most populous city.

Punjab, Pakistan’s most populous province, home to large cities such as Lahore and Faisalabad, lifted restrictions on businesses and markets on Tuesday so they could operate around the clock. To claim that it is not risking a new pandemic upsurge, the Punjab provincial government claimed it was respecting standard operating procedures (SOPs). These include minimal public health measures, like social distancing, wearing face masks and using hand sanitizer, that Prime Minister Imran Khan used to reopen the economy during the first wave of the pandemic.

Officially, Pakistan has recorded just under 1.3 million cases and 29,000 deaths of COVID-19. The government claims that it does not have the resources to take proper public health measures and that its response has been successful. On the one hand, the cost of living is surging as the government implements International Monetary Fund (IMF) economic cuts, while on the other, the government massively underestimates case numbers due to lack of testing and reporting.

Less than 30 percent of the population is fully vaccinated. Apart from the sheer lack of funding for vaccination, the promotion of the religious right and state indifference to the pandemic have substantially increased obstacles to vaccination.

Bangladesh

Officially, Bangladesh records low COVID-19 statistics. Deaths total over 28,000, while new cases stand at 291 for over 1.58 million cases total. Nevertheless, the only 20,000 total daily tests are a horrifically small number in a country of 167 million, far below the 50,000 recommended by experts. Though vaccination has somewhat mitigated the contagion, these statistics are highly dubious, as state measures to curb the pandemic are behind those of other South Asian countries.

In terms of full vaccination and tests per one million people, as recorded by Worldometer, Bangladesh is the lowest in South Asia. Only 27.2 percent have two doses of vaccine, compared to Pakistan at 28 percent, Nepal 29.9 percent, India 39.9 percent, Sri Lanka 63 percent and Bhutan 73 percent. Tests per million population stands at 67,666—behind Pakistan’s 101,036, Nepal’s 159,975, Sri Lanka’s 265,794, India’s 475,825, and Bhutan’s 1,626,260.

While the country has detected just two cases of Omicron variant, experts suggest the possibility of unidentified cases across the country and have expressed their concern.

Virologist Dr. Nazrul Islam suggested to the government to screen travellers, increase testing, regularly sequence viral genomes, maintain health rules, and enforce mask-wearing. Health expert Professor Rashid E Mahbub told the Dhaka Tribune: “The pressure of Omicron will eventually fall upon the health care systems, meaning hospitals and clinics. So, they should be prepared well.”

Already in July, the health system was overwhelmed with patients. It marked the country’s deadliest month since the pandemic started in March 2020. Bangladesh registered a record 6,182 deaths and 336,226 cases in just 31 days, the highest figures in the country’s pandemic history to date .

The country followed a vaccination-only policy against the pandemic, blaming the people for infections. Health Minister Zahid Maleque, cited by Dhaka Tribune, said the state is worried as people were not following health rules, which could lead to a surge in infections.

The country started administering vaccine boosters on December 19 for people over 60 years old and front-line personnel, including doctors, nurses, government officials and journalists.

Sri Lanka

While this country of around 22 million is reporting at least four Omicron-positive cases, medical experts have already warned of a surge in cases in coming days. As the government has fully opened not just the tourist sector but also non-essential factories, schools, public transport and markets, there is little doubt that the new variant has spread widely. Even limited restrictions are increasingly being abandoned. On the other hand, the government has carried out fewer than 5,000 daily tests, ignoring medical experts’ calls for at least 40,000 daily tests to curb the virus.

Even with such limited testing, around 700 COVID-19 patients are identified daily; daily deaths stand at around 20 people.