India’s high rates of tuberculosis, pneumonia, smoking and poor air quality won’t help when it comes to a respiratory disease. Some were counting on the summer heat and humidity to bail India out, but there was no evidence that the rising temperature would stop the disease.

Our initial estimates showed that 300 million to 500 million Indians were likely to be infected with the coronavirus by the end of July. Most of the cases would be without symptoms or with mild infections, but about a tenth — 30 million to 50 million — would most likely be severe.

Our model predicted that at the outbreak’s peak, even with conservative assumptions, there would be 10 million patients with severe Covid-19 disease in India, many of whom would need to be hospitalized.

India has fewer than 100,000 intensive-care unit beds and 20,000 ventilators, most of which are only in the large cities. The scenes where Italian doctors had to choose between multiple patients to determine who would get a ventilator would increase multifold in India’s weak health system.

Although the proportion of Covid-19 patients who die has averaged between 2 percent and 3 percent globally, they were in places where the health system is better equipped. India does not have the strong health system and economic resources of Covid-19-affected high-income countries or China’s ability to control population flows in the country. A lockdown was the only option to control the disease.