‘This is a total collapse’: India’s healthcare system reels as Covid ravages country

Closed hospitals, patients told to go elsewhere, people dying as they wait for treatment. India’s healthcare system has crumbled under the strain of a second wave, reports Shweta Sharma in Delhi

A Covid-19 patient gets oxygen on the spot provided by Sikh Organization at Gurdwara in Indirapuram, Ghaziabad, Uttar Pradesh (Anadolu Agency via Getty Images)

The clock was ticking for some 200 Covid patients dependent on oxygen in a Delhi hospital as they remained unaware their supply could end at any moment.

Desperate administrators made frantic calls to source any amount of oxygen to give them a few hours respite before their tanks hit zero.

It was just in time that Dr Kourser A Shah got “two to three hours of oxygen supply” after frantic calls to the government, which he described as a “do or die situation”.

“It would be an unimaginable disaster if supply runs dry,” Dr Shah, COO of Aakash Healthcare in Dwarka – a suburb of the capital – told The Independent. “It gives me goosebumps to even think my patients could have died due to the shortage.”

The situation has been the same in dozens of hospitals in Delhi – one of the best cities in which to live in India – and in the states of Uttar Pradesh and Maharashtra, where thousands of patients have narrowly escaped suffocating to death due to a lack of oxygen.

Warning: This video contains scenes some viewers may find distressing

Four hospitals were shut down in Delhi alone on Thursday after oxygen tanks were exhausted, and some of the biggest private and government hospitals like Fortis Healthcare, Max Healthcare group, and the Sir Ganga Ram raised desperate calls on social media for any oxygen.

“Fortis Hospital in Haryana has only 45 minutes of oxygen left. Requesting to act immediately and help us to save patients’ lives,” tweeted one hospital.

In Life Line Hospital, Delhi, the administration took the tough call of asking its 70 critical patients to move to another hospital or arrange oxygen supplies for themselves.

The grim message was blared over the hospital’s public-address system to worried relatives, informing them that “oxygen will not last for more than half an hour”.

Certain states in India are controlling oxygen supply to others, according to medical experts (AP)

The gravity of the situation and the scale of the crisis could be judged from the fact that the deputy chief minister of Delhi, Manish Sisodia, appeared on television screens, spoke of his sense of helplessness over the situation, and demanded that the army be deployed in order to ensure a smooth supply of oxygen to the metropolis.

“In many hospitals in Delhi, there is no oxygen. Many states are controlling oxygen supply (to other states) and that is leading to problems,” he said.

“This is a total collapse of the healthcare system,” Dr MK Saxena said. He was jittery as he spoke, saying Apex Citi Hospital has just three hours of supply remaining for 20 patients who are on oxygen support.

He choked with emotion as he said: “We are responsible for giving life and we are not able to give even oxygen to our patients. Nobody in the system is responding to our calls.”

Infections in India have increased exponentially since March.

The spike is so steep that the curve has turned into a long wall, and India is now the only country to have recorded more than 300,000 infections in a single day. The pressure on healthcare has turned the situation into a tragedy of unprecedented proportions.

The country has a total of 16.3 million coronavirus cases, with predominantly younger patients taking up hospital beds. In Delhi alone, 65 per cent of infections are in those under the age of 40.

Hospitals across the country have maxed out, with people pleading for assistance to acquire beds, oxygen and life-saving medicines, though even the commonest of medicines are proving difficult to obtain.

Social media platforms have become a source of desperate calls for help by hundreds of people. Many have volunteered to provide some help to the distressed or simply to amplify the message so that it reaches those who can help.

“I am not exaggerating when I say more than 50 small and big hospitals are just a few hours away from exhausting the supply as I speak. Delhi is not receiving an adequate supply of oxygen,” Dr Ashwini Dalmiya, president-elect of Delhi Medical Association, told The Independent.

The sight of oxygen tanks entering hospital gates at the last hour has now become a heartening scene. This has been the case in most hospitals across Delhi over the last four days.

On Thursday, oxygen tanks were rushed to many hospitals. But it was already too late for 25-year-old Prateek, who gasped for breath lying in the back seat of his SUV on the premises of Delhi’s Sir Ganga Ram hospital.

“I kept roaming with the money (for the treatment of my son) in my pocket. What do I do with it? My son is no more,” Prateek Kumar’s father said, with pain in his voice, outside the casualty ward. It was after a 675-bed multi-specialty private hospital stopped taking new patients after their oxygen supply fell critically low.

Three people died in one hour on the same day as they waited for admission.

Speaking to The Independent, the chairman of Sir Ganga Ram hospital Dr DS Rana said he is pained to see so many patients suffering and crowding outside the hospital just to get admission.

“There is no place to stand outside the hospital. Because of [the] acute rise in Covid cases and hospitals being full, there is a shortage of oxygen and beds in the whole country, not just our hospital,” Dr Rana said, as he denied that any patient had died inside the hospital due to the shortage.

India recorded 332,730 new daily infections on 23 April, the highest number seen in any country over a 24-hour period (Reuters)

The hospital had 4,000 cubic tons of oxygen on Friday morning that he said will last four to five hours if they use it “judiciously”.

India has the capacity to produce about 7,000 metric tons (MT) of oxygen each day and has a buffer stock of approximately 50,000 MT, according to industry experts. Out of the total about 6,600 MT was being supplied to states for medical purposes.

The largest player, Inox Air Products, which produces 2,000 tonnes of oxygen per day, says it is providing up to 60 per cent of the total medical oxygen supply across the country.

While the experts say black marketing and hoarding of oxygen during a pandemic is too small an issue to hit nationwide supply, the problem lies in transportation and scarcity of cylinders as well as tankers to supply the oxygen. India has just 1,500 of these tankers.

But that is not all.

Major cities like Delhi and Mumbai, and states like Madhya Pradesh that do not have their own manufacturing plants, depend on other states for their supply. For instance, Delhi solely depends on Haryana and Uttar Pradesh for its oxygen supply.

The crisis unfolded as oxygen tanks entering Delhi from Haryana were halted at the border. Delhi chief minister Arvind Kejriwal said on Friday in an online address that the “problem is that the state governments where these plants are located have stopped companies from sending these trucks to Delhi”.

He also raised the issue with prime minister Narendra Modi during a high-level meeting on the Covid crisis, almost pleading with him to ensure the smooth movement of trucks. “Will people of Delhi not get oxygen if there is no oxygen-producing plant here?” he asked Mr Modi.

The central government has diverted the oxygen supply from non-essential industries to medical usage following an order by the High Court of Delhi. The matter was raised in court by Delhi hospitals after they suffered a crippling shortage.

Dr Sangita Reddy, joint managing director at the Apollo Hospitals group, who flagged the issue of the Haryana government not allowing tankers, said there is no shortage of oxygen but a shortage of oxygen tankers.

“Every oxygen tanker must be treated like an ambulance at the moment” as the consumption of oxygen has risen five-fold, she said, adding that “every life is priceless and the country must invest in the healthcare industry”.

Jeremy Farrar, director of the charity Wellcome Trust, said the UK should donate spare coronavirus vaccine doses to India or else it “will come back to haunt us”. He spoke on BBC Radio 4’s Today programme on Friday after India recorded 332,730 new daily infections, the highest number seen in any country over a 24-hour period.

The epidemiologist described the UK’s vaccine rollout as “phenomenal”, as more than 60 per cent of adults have now received a jab. However, he reiterated that the country is not safe while Covid-19 cases soar elsewhere, facilitating the potential emergence of new variants.

He said: “The UK has done an absolutely phenomenal job with vaccine rollout.

“I think now is the time to donate the vaccines that we have available. Yes, it will delay the vaccine rollout in this country by a little bit. But the transmission is so low in the UK that we’re in a position to do that.

“And we would be better advised to prevent variants arising in the rest of the world, which will come back to haunt us if we don’t drive down transmission everywhere.”