Health workers shifted a Covid-19 patient from Covid-19 ICU to general ward in an ambulance after she was stable, in Gauhati Medical College Hospital in Guwahati on April 30, 2021.

Despite warnings of rising Covid-19 infections in February, India’s national government failed to prepare for a second wave and allowed mass gatherings that went on to cause a sharp surge in cases and a high death rate across the population. The pandemic also revealed systemic deficiencies and inequalities in India’s health system.

These are the conclusions from social scientists who have analysed the second Covid-19 wave in India and made recommendations on measures that the Indian government must take to prepare for future outbreaks.

The researchers recommend that in the short-term, local and national government in India should focus on immediate relief, provision of critical care and equitable and universal vaccine rollout. In the new analysis published by the Social Science in Humanitarian Action Platform (SSHAP) they add that medium and long-term measures must look to build effective processes to improve future responses – to further possible waves of Covid-19, and other epidemics.

These include mitigating impacts on people’s existing vulnerabilities and inequalities by guaranteeing rights to basic needs such as food, water, health, a minimum income and shelter. This is vital for vulnerable and marginalised groups, including Dalits, Muslims, Adivasis and informal workers as well as the elderly, single mothers and people with disabilities.

The analysis comes from a new report published today. It makes the following recommendations:


Cases and deaths have been underreported in the second wave, which fuelled complacency and had severe implications for an effective and proportionate response. The government must ensure accurate and publicly available data on testing, active cases, hotspots and deaths within a National Surveillance Dashboard that gives real-time updates of virus spread and enable data-driven decisions.


The vaccine rollout has been inaccessible to those without internet access. The government should provide free vaccines accessible for all and should use appropriate modes of communication (radio, local media) to reach vulnerable and marginalised groups. Door-to-door vaccination campaigns, as well as walk-in vaccine centres must be ramped up.

Health care investment

The incidence and scale of the second wave were exacerbated by the gross neglect and underinvestment in the public health system. Public spending on health care must be increased from 1.25 percent of GDP to a level of investment that can strengthen the public health system and achieve delivery of Universal Healthcare Coverage.

Future planning

A national plan for at least the next three years should be published to set out the steps of the response and preparation for future pandemics.

Human rights

The national government and some states have treated the pandemic as a law-and-order problem, criminalising dissent and those who fail to comply with stringent lockdown rules.  It is vital to safeguard rights, such as rights to protest and dissent. Existing bodies set up to monitor human rights violations should be empowered to function independently.

Professor Lyla Mehta, Professorial Fellow at Institute of Development Studies and co-author of the SSHAP briefing said:

“Covid-19 has caused devastation across India and is the worst humanitarian and public health crisis the country has witnessed since independence. It is very important for the national government to learn from past mistakes made and to equip the country to better prepare for the future.  The human rights of all Indian citizens need to be protected during the pandemic and beyond.

“To prevent future waves, the country needs data-driven, decentralised decision-making and better coordination between the states and the central government. Vaccine rollout must be equitable, speeded up and include marginalised groups and those without internet access and in remote areas.”

The report also provides some hope with inspiring examples of effective local responses that national government can learn from. Such as in the tribal district Nandurbar, where the foresight of a doctor turned local official led him to install three liquid oxygen plants in September ensured there were local medical oxygen supplies.

The report is published by the Social Science in Humanitarian Action Platform, which publishes widely on the social dimensions of Covid-19. It is a partnership between the Institute of Development Studies, Anthrologica and the London School of Hygiene & Tropical Medicine.