I arrived in the United States in March 2020—just in time for the birth of our first grandchild. I was scheduled to return to India in June but as the pandemic raged on, I kept postponing my flight. Finally, after fourteen months as a Covid refugee, I got my second dose of the vaccine and booked my ticket home for April 30. Then the pandemic blew up in India.

I’ve lived in India for more than forty years. My husband and two of our three children were born there; our youngest is buried there. My work and many of my closest friends are there too, and my own life and future is inextricably tied to its turbulent, chaotic present.

Every morning for the past ten days I have been waking in California with a feeling of dread. The pharmacist who was interviewed on NBC one day last week about the shortage of drugs is the one I buy medicine from when I am in Delhi. The hospital in Mumbai where the dead are piling up is on the street where my in-laws lived. I understand what the rickshaw drivers are saying about their desperate, gasping passengers before the voiceover cuts in to translate. India is my home and it is on the brink of collapse.

Today my husband and I spent hours on the phone (he in India, I in the United States) finding a hospital bed for his Covid-positive brother in Pune—four hours south of Mumbai—who was struggling to breathe. We felt a huge relief when Rakesh was finally transferred by ambulance. “It feels so nice to breathe,” my brother-in-law messaged me from the hospital.

We were also relieved to hear that the BJP, currently the ruling party in India, had been trounced in midterm elections in three states. Prime Minister Narendra Modi has been to India what Donald Trump was to the United States: a malevolent force intent on amassing power at any cost, leaving misery and destruction in his wake. He taps into the worst of the human spirit with unerring precision, resurrecting old grievances and pitting communities against each other in an effort to strengthen his political base of Hindu nationalists. And, like Trump, Modi has ignored the responsibilities of governing. During his tenure, already-weak public institutions have been further undermined, while incompetent and dishonest sycophants have been put in charge of massive departments they have no idea how to run. The apocalyptic scenes we are witnessing in India right now are inevitable in a vast country with no functioning public health-care system [1].

India got off lightly in Covid’s first wave. Widely expected to be one of the world’s worst-hit countries, India had fewer reported cases than the United States or the United Kingdom, and most of those infected survived. Less than five months ago Modi was proudly boasting at the World Economic Forum in Davos about his country’s excellent infrastructure and Covid-preparedness. He even claimed that India had “saved humanity [2]” by containing the virus.

Such complacency led to a predictable relaxation of the very limited Covid precautions people were taking. (Mask wearing was spotty from the beginning and social distancing virtually impossible in India’s congested cities). In spite of Modi’s big claims about vaccination proceeding apace, supply couldn’t meet demand. Even now, though it produces much of the world’s supply of Covid vaccines, only 1.7 percent of the country is fully vaccinated.

The sudden surge in new cases at the end of March took everyone by surprise. Within days, hospitals were overwhelmed. People began dying on the streets while waiting to get oxygen. On the BBC, a woman described trying to find help for her mother-in-law. A doctor in one hospital showed her a corridor lined with dead bodies, saying: “I don’t have staff to remove them. How can we care for her here?” Cremation grounds and cemeteries worked around the clock. I saw one heart-wrenching video of ten bodies being burned together.

Meanwhile, Modi was preoccupied with that major election campaign. Until April 23, he ignored the pandemic. Crisscrossing three battleground states, he held one super-spreader rally after another, drawing unmasked crowds of tens of thousands and gloating about never having seen such numbers before. At the same time, a major Hindu pilgrimage was underway in the state where I live. Over the course of seventeen days, millions thronged to the Ganges river for a holy dip. Each event caused new infections [3], but Modi remained indifferent to the mayhem he was creating. He seemed not to realize that he was supposed to be running the country.

India was in the grip of its greatest crisis in living memory and its elected leader was busy promoting his own political fortunes. Realizing no help would be forthcoming from the government, people began organizing on their own. Young people set up hotlines and took it upon themselves to monitor availability of hospital beds and oxygen supplies. Civic and religious groups devised ingenious “oxygen stations,” where patients could share communal cylinders. Social media was flooded with desperate requests for help, and people leaped in to amplify the messages, making use of their networks to get people connected with what they needed. Rickshaw and taxi drivers converted their vehicles into makeshift ambulances, while retired people started preparing homemade meal packets for families too sick to cook for themselves.

Yet public altruism, however heartening, is not enough. With the lockdown, a vast army of India’s migrant population returned to their villages, carrying the virus with them. Covid is now raging in rural areas where medical care simply does not exist. Accurate numbers of infections and deaths will never be known because the majority will not make it to a health center, nor would it occur to them to try. The poor know that there will be no doctor, no nurse, no medicine, and no equipment: Why bother?

The government’s response [4] has been to limit testing, ban any mention of shortages on social media, issue strict instructions about what are acceptable “Causes of Death” on death certificates, and publish grossly inaccurate daily statistics. And in a move widely condemned by public health experts, Modi has ordered that his $2.8 billion vanity project to construct a new parliament building and a house for himself continue as an “essential program,” even as hospitals scramble to find oxygen.

Epidemiologists say that India is living in a state of “data denial” and that the official numbers [5] being shared with the world are probably only a fraction of the actual figures. While these are the pathetic and familiar ploys of a banana republic, a global pandemic is not an internal matter for any one country to deal with as it sees fit. The variant of the virus now sweeping through India like a deadly scourge will affect the entire world [6] eventually. We all have a stake in how India handles this crisis.