High in the air of Mount Everest Base Camp in Nepal, sherpas and climbers walked freely from one group of tents to the next, holding meetings, singing and dancing. Now the Sherpas who accompany climbers to the summit have a new task: enforcing unofficial rules on social distancing. “Climbing Everest is always a matter of life and death,” says Phunuru Sherpa. “But this year the risk from COVID has doubled.”

Dozens of people suspected of COVID-19 have already been evacuated by helicopter. The outbreak reflects a wider outbreak across Nepal, which has a long, permeable border with India. Daily confirmed cases in the Himalayan nation tripled from April 11 to May 11, when 9,300 infections were recorded. It’s a grim omen of how India’s devastating COVID-19 crisis can turn into an even bigger global emergency.

As countries around the world bring oxygen, vaccines, and medical supplies to India, they are also closing their borders with the world’s second largest country. It can be too late. The B.1.617 variant of the virus, which was first discovered in India, has now been found in 44 countries on every continent except Antarctica – including Nepal, the United States and much of Europe. Scientists say it could be more contagious and bypass human immune systems better. On May 10, the World Health Organization declared it a variant of “global concern”. And because only about 0.1% of positive samples in India are genetically sequenced, “others may have shown up,” said Amita Gupta, associate director of the Johns Hopkins University Center for Global Clinical Health Education.

Continue reading: India’s COVID-19 crisis is spiraling out of control. It didn’t have to be this WaY.

The true extent of the COVID-19 outbreak in India cannot be precisely quantified. Officially, confirmed daily cases hit a plateau of just under 400,000 but remain higher than any other country that has seen during the pandemic. Experts warn that the real numbers are far larger, and may still be rising rapidly, as the virus penetrates rural India, where two-thirds of the population live and testing infrastructure is weak. The University of Washington’s Institute of Health Metrics and Assessment (IHME) estimates that the actual number of new daily infections is around 8 million – the equivalent of the daily infection of the entire population of New York City. Official reports say 254,000 people have died in India since the pandemic began, but IHME estimates the real number is more than 750,000 – a number that researchers will double by the end of August. Dozens of bodies have washed up on the banks of the Ganges since the beginning of May. Some villagers said they were forced to leave the dead in the water amid rising funeral costs and a lack of wood for cremation.

Prakash Mathema – AFP / Getty ImagesTents at Everest Base Camp in Solukhumbu, Nepal, on May 3, 2021.

Experts say the crisis was completely predictable and that rich countries could have done more to prevent it. “The pandemic has again highlighted the extreme international inequality in access to life-saving vaccines and medicines,” said Bina Agarwal, professor of development economics and the environment at the University of Manchester. The Indian government has failed to order enough vaccines for its population – or to ramp up its vaccination program fast enough. But the US also blocked exports of essential raw materials India needed to make vaccines for months and stored 20 million Astra-Zeneca shots despite the FDA not approving their use. Although President Biden has now changed course, sent much-needed vaccine raw materials to India and pledged to export the Astra Zeneca shots, it will be a long time before the country catches up: only 2.8% of the population was complete as of now vaccinated May 12th.

India’s first wave, which peaked last September, was severe: by the time it began to disintegrate, almost 100,000 people had died across the country, according to official statistics. However, in a country of nearly 1.4 billion people, another message was also sent: India avoided what may be the most damaging effects of the pandemic. Now, India’s brutal second wave of COVID-19 is raising concerns that the worst is yet to come. Of particular concern are densely populated African countries, many of which have not yet seen major outbreaks. Versions of variant B.1.617 have already been reported in Angola, Rwanda and Morocco. Many of the vaccines that could contain outbreaks in such countries should come from factories in India – which have now ordered that most of their vaccine production be used to meet domestic needs.

The new outbreaks also threaten to roll back plans for post-pandemic economic recovery. Nepal’s vital tourism sector stalled in 2020. To make up for the lost ground, the Himalayan nation approved a record number of waivers for the mountain. Everest this year, which means the base camp is crowded with around 1,300 climbers, sherpas, and support staff.

Continue reading: Why the COVID-19 variants widespread in India are a global problem

The tragedy now spares only a few families across India. Rahul Thakkar, a 42-year-old vice president of a healthcare startup, died of COVID-19 on May 10 – after the intensive care unit in New Delhi where he was being treated ran out of oxygen in late April. “If the infrastructure breaks down, being rich or poor won’t save you,” says Ramanan Laxminarayan, a friend of Thakkar’s. Laxminarayan, an Indian-American epidemiologist and director of the DC-based Think Tanks Center for Disease Dynamics, Economics and Policy, launched an international fundraiser that raised more than $ 9 million for imports of oxygen cylinders and concentrators into the air converting oxygen into medical grade.

The effort should never have been necessary, says Laxminarayan. While India should have invested in its pandemic preparedness, developed countries share some of the responsibility. “Even for reasons of self-protection, the rich countries should have planned much better to vaccinate the whole world and increase production,” says Laxminarayan. “What happens in India doesn’t stay in India.”

– With reports from Rojita Adhikari / Mount Everest Base Camp, Nepal

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