Wednesday, April 28, 2021

India Afire

"The health-care system in India, both public and private, is literally bursting at its seams."
"People come to the emergency room, the hospitals, then they keep waiting for hours, they don’t find a bed. Unfortunately, some of them die while waiting."
"They’re [health care workers] emboldened by the fact most of them have been vaccinated. I generally see a lot of purpose and dedication amongst all the health-care workers at all the hospitals."
Dr. Arvinder Soin, chief surgeon, Medanta Hospital, New Delhi
 
"We need global solidarity to end a global pandemic."
"Many parts of the world should look at India right now and recognize that until we have a sizeable number of people who have been vaccinated across the world, we need to be very careful about how we lift restrictions."
Dr. Swapneil Parikh, internal medicine physician, Mumbai
 
"Today, the situation is that between 15 and 20 percent of people from every village in Rajnandgaon [district] are COVID-19 positive but these cases aren't on any government record."
Motilal Sinha, social activist, Chhattisgarh

"For seven days, most of us haven't slept."
"Because of the scarcity [of oxygen], we are forced to put two patients on one cylinder."
Dr K. Preetham, administrator, Indian Spinal Injuries Centre
Workers unload a medical oxygen tanker from the 'Oxygen Express' train at Delhi Cantt railway station in New Delhi on Tuesday. (Anindito Mukherjee/Bloomberg/Getty Images)

India is in dire straits as it continues to be ravaged by COVID-19. Its situation has fixed the attention of the world on the desperate scenes unfolding there, where its capital, New Delhi, and its financial centre, Mumbai, are engulfed in a huge wave of COVID infection rates and ultimately, deaths among a population so immense that crowded living conditions are unavoidable, and with them, upward cascading infection rates.
 
Thousands of people are dying every day in Delhi and Mumbai, infected by a hugely devouring pathogen, inexorably spreading in the Indian rural hinterland where 800 million people live. The health-care system, like most others worldwide, has been underfunded for decades, leaving rural areas facing wide-spread shortages of oxygen, tests, medication and worse than all of that, no medical professionals, resulting in a critical care vacuum.
 
The Indian Armed Forces was ordered on Monday to assist in tackling surging new coronavirus infections. The international community is pledging aid to the nation, urgently required. World Health Organization chief Tedros Adhanom Ghebreyesus said of the situation that it is "beyond heartbreaking". The World Health Organization is tasking 2,600 of its own staff to arrive in India alongside supplies, including oxygen concentrator devices.
 
Health workers wearing personal protective equipment carry a patient suffering from the coronavirus disease outside the casualty ward at Guru Teg Bahadur hospital in New Delhi on Saturday. (Adnan Abidi/Reuters)

Lockdowns imposed in Indian cities over the past two weeks in an urgent effort to try to stem the spread of the virus, has seen thousands of migrant workers travel back to their home villages. Some, inevitably carrying the virus back with them. The central government had sent out an urgent message to the hundreds of thousands of migrant workers to remain in place, not to leave, promising that they would be well looked after where they were. That message failed to resonate, obviously.

Perhaps for the simple fact that it has become glaringly obvious that those becoming ill, seriously ill with COVID, cannot find an open hospital bed, and in some instances, the knowledge that deaths caused by a lack of oxygen treatment has reached the ears of migrants who feel they would prefer to take their chances back home, rather than remain where the chances of contagion are higher and that the medical system will be capable of serving them well.
 
People prepare funeral pyres for those who died from COVID-19 during a mass cremation at a crematorium in New Delhi on Monday. (Adnan Abidi/Reuters)

One such example is Thakurtola, a village in t he central state of Chhattisgarth, devastated by COVID-19. A village where the 1,000 residents are subsistence farmers, poor even by Indian standards, with strong family attachments. Its residents have experienced a wave of grief, the entire village overcome with sadness and regret at the deaths it is experiencing. 

One of the village's residents returned in early April from Nagpur where he worked, and had left when it was placed under lockdown. Returning home to Nagpur, he complaned of a severe cough and flu-like symptons, swiftly becoming more serious.When his family brought him to the village doctor, "He started saying that there was no need for a COVID-19 test and just to take medicines, like paracetamol", his brother said.
 
People wait their turn to get tested for COVID-19 in Hyderabad, India, on Sunday. After having largely tamed the virus last year, the country is in the throes of the world’s worst coronavirus surge and many of the country’s hospitals are struggling to cope with shortages of beds, medicines and oxygen. (Kumar A. Mahesh/The Associated Press)

The village doctor, like two thirds of doctors in rural India, had no formal training as a physician, no medcal qualifications whatever. The man began gasping for air overnight but there was no oxygen supply in the village. "His death came like a storm, everything happened so quickly", his brother Ramesh said. The village had no testing kits so it could not be confirmed that the man had COVID. When officials, however, sampled 48 people the man had been in contact with, 25 tested positive for     COVID.

Taking into account the shortage of testing kits and delays, the interpretation is that most deaths remain unrecorded, with the actual daily toll estimated to be at least twenty times higher than official figure of 195,123. The epidemic in its furious pace and outcome is believed to be driven by new, more contagious variants.

People wearing protective face masks wait to receive a COVID-19 shot at a vaccination centre in Mumbai on Monday. (Niharika Kulkarni/Reuters)
 

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