A thick layer of dust and scatterings of dried animal excrement covered the deserted intensive care unit in Amravati, a small city nestled in a far-flung, rural district in central India. Rows of hospital beds lay empty next to sets of unplugged ventilators on a recent afternoon and only the sound of roosting pigeons punctured the ghostly silence.
The uneasy calm contrasted starkly with the chaotic scenes in early 2021 that confronted Ravi Bhushan, a 44-year-old doctor based in this cotton-growing region about 650 kilometers east of Mumbai. Toward the end of January, Amravati and its surrounding districts began to register a number of sudden and explosive coronavirus outbreaks, just as the rest of India saw a lull after a first nationwide wave of infections.
Unknown at the time, Amravati¡¯s flare-ups were the first visible warning that the SARS-CoV-2 variant now known as delta had started along its devastating path. Within weeks, thousands of people flooded Amravati¡¯s underfunded health care network as the city turned into Ground Zero for what would become the most confounding version of the pathogen first identified in Wuhan, China, a year earlier.
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