Losing a Brother to Coronavirus in Rural India

The novel coronavirus seemed like a distant problem in Boisar, a small factory town about two hours from Mumbai, until Daniel Tribhuvan died.

The 35-year-old tutor started feeling feverish in April, while bringing his father home from a chemotherapy appointment in the Indian financial capital. When a test confirmed Tribhuvan was infected, the local health system’s reaction was shambolic. After he checked into a public hospital, the first thing they did was try to pawn him off to a private facility in Mumbai. The ambulance turned around halfway when they discovered he couldn’t pay. Back at the public hospital, a doctor didn’t see him for three days, and when an elderly man occupying a bed nearby died, his body wasn’t collected for 12 hours. After a week, Tribhuvan’s blood-oxygen levels were dangerously low. He died on May 17, becoming Boisar’s first confirmed fatality from Covid-19.

“I think he would have survived if the system was good,” Samuel Tribhuvan, Daniel’s older brother, said in a recent interview at Boisar’s local administrative office, inside a rundown building that also houses a liquor store and a portrait studio. “This is the worst place where we could get the coronavirus.”

Six months after the start of the pandemic—as the developed world tries to restore some semblance of normalcy—the virus is arriving with a vengeance in India’s vast hinterland, where 70% of its more than 1.3 billion citizens live. The country is now adding more than 80,000 confirmed infections per day, with about 71,000 deaths so far, numbers experts say are likely being under-counted. On Monday it galloped past Brazil to become the world’s second-biggest outbreak, a sobering preview of what could happen once the coronavirus spreads in earnest across other poor, densely populated places from Nigeria to Myanmar. With such a vast reservoir of potential hosts and minimal ability to contain infections, it seems inevitable that India will at some point overtake the U.S. to have the most cases globally.

The result is likely to be a human and economic catastrophe, risking untold numbers of deaths and the reversal of years of rising incomes and living standards—developments that helped lift millions of people from grinding poverty into something like the middle class. The broader effects won’t be confined to the subcontinent.

With a gross domestic product last year of almost $3 trillion, India is the world’s fifth-largest economy and a crucial node in global supply chains. Despite the troubled state of its own medical system, it is by far the largest producer of both vaccines and the generic drugs that healthcare systems around the world rely upon. And with Asia’s economic giant, China, turning increasingly inwards, companies from Wal-Mart Stores Inc. to Facebook Inc. had been investing heavily in India, betting on its rising consumer market. India’s trouble containing the virus, therefore, could weigh on any global recovery from the coronavirus—either epidemiological or economic.

With infections gathering pace, Prime Minister Narendra Modi is facing criticism for not doing more to help the state and local-level officials on the front lines of fighting the virus, who face an excruciating choice. Failing to stop its spread could mean the collapse of already-fragile healthcare systems, potentially leaving thousands to die untreated. But the distancing measures that most experts see as essential to doing so will worsen an economic contraction that’s already among the world’s most severe, making it even more difficult for India to resume its progress toward broader prosperity and hampering the global recovery. That could ultimately cause just as many deaths, whether from malnutrition, other infectious diseases, or even suicide.

As the virus spreads throughout India, “the most immediate thing that will happen is people will die,” said Vivekanand Jha, executive director of the Indian branch of the Sydney-based George Institute for Global Health. “The second is that the people who have not died will lose their livelihoods.”

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