For the second month, India is experiencing another, an extremely severe wave of coronavirus. The rapid rise of the disease actually brought down the health system, people died on the doorsteps of hospitals, and crematoriums could not cope with the flow of bodies. To this day, the situation with COVID-19 in the country remains extremely difficult, and it is aggravated by the epidemic of black mold, which quickly spreads in a warm and humid climate. Free News “spoke with those who are at the forefront of the fight against the coronavirus, and learned why the country, which is called the “world pharmacy,” was powerless before the next blow of the pandemic.
“Like you were swallowed by a whale”
The grimmest evidence of the first wave of coronavirus that hit the world in March 2020 was footage from northern Italy. In Bergamo alone, the daily newspaper was published with 10 pages of obituaries, and there were not enough places in the morgues for the bodies of the dead. In 2021, when it would seem that humanity already knows much more about this virus, knows how to treat the disease caused by it, and even developed several vaccines, the tragedy was repeated in another corner of the world — in India.
In the first wave, the country managed to avoid the worst-case scenario. Either the rapid quarantine, or the high proportion of the young population, or both, helped. Local authorities, apparently, expected that in the second wave everything will be fine again. However, since the end of March 2021, a new, more contagious strain of the virus began to spread in India, and soon the country was covered by a “coronavirus storm.”
India found itself in an unexpected predicament. Nothing was lack: no beds, no medicines, and no medical oxygen. Suffocating patients had to wait for hours for their turn to be hospitalized in ambulances or right on the streets, without any medical assistance.
Throughout April and May, headlines about the coronavirus crisis in India were constantly on the front pages of the world media. “COVID-19 patients are dying on a stretcher outside a hospital in Delhi.” “Crematorium furnaces are melting due to the hasty burning of bodies in Gujarat.” “Delhi hospitals beg for oxygen.” “India’s crematoriums are overflowing with COVID-19 victims, funeral pyres burning all night.”
“People died simply because they didn’t wait for a hospital bed. Those who managed to arrange for hospitalization could often arrive at the hospital and find that their bed was already occupied by another person. And I had to search again, wait again,” he told. Ralph Alex Arakal, a reporter for the Indian Express, covering the crisis in one of the hardest-hit states, Karnataka.
According to the journalist, if in the first wave most people were worried about their career and how to make ends meet, now the very question of survival was at stake: many were afraid that they simply would not see the next day. Terror gripped those who, like Arakal, had to go out and work “on the front line”, and the howling of ambulance sirens did not allow them to close their eyes at night.
“They could be heard around the clock, the sirens did not subside even after two or three o’clock in the morning. Their howls echoed in their ears and drove many to despair,” Ralph Alex, Arakal Indian Express journalist.
Dr. Gautam Harigovind joined the team of the non-profit medical humanitarian organization Doctors without Borders (MSF) three years ago. In September-October 2020, the first wave of the pandemic hit India, then the medic went to Mumbai, which became the epicenter of COVID-19. When the incidence of the disease subsided, the organization suspended its temporary hospital, and Harigovind returned to his native village in southern India.
In mid-April 2021, the doctor received another call from MSF asking him to return to Mumbai. Harigovind told.” He said that when he first entered the hospital — a giant tent with 2,000 beds – he was struck by the scale of the new crisis. Four times as many patients were admitted each day as in the first wave, many suffering from severe symptoms and needing oxygen support. People constantly came to the hospital and begged for help, but there were simply not enough places for them.
“At this time of year, Mumbai is extremely hot and very humid. You’re wearing overalls, personal protective equipment, and two pairs of gloves. You’re sweating, you can’t drink for six or eight hours, you can’t go to the toilet. All around-a terrible heat. Your patients are rapidly getting worse, they are dying, and their beds are immediately occupied by new patients. It’s something surreal. It feels like you’ve been swallowed by a whale and you’re sitting in its stomach,” Gautam Harigovind, MSF Doctor, said.
According to Harigovind, even ordinary wards, in fact, turned into intensive care units. The patients ‘ well-being deteriorated dramatically, and they died before there was a free space with a ventilator. “There was nothing we could do to help them, we were powerless,” the doctor said, fighting back tears.
The SOS hashtag
Farah Zaiba works as a volunteer for an organization that helps COVID-19 patients in Bangalore find a hospital bed and the necessary medicines. She says that patients, having learned about the diagnosis, often find themselves in complete confusion and simply do not understand where and how to get the necessary help. “When you find out that the COVID is positive, you find yourself in complete darkness, you are sucked into a black hole. There is so much information around, but you don’t know how to approach it,” the volunteer shared.”
In such a situation, the only option is social networks, WhatsApp chats, and volunteer groups like the one in which Zaiba works. Instagram Facebook, Twitter, and Twitter still feature posts with the hashtags #COVIDemergency or #COVIDSOS, asking relatives and friends of patients to help them find the right medications, oxygen, or hospital beds.
Sometimes publications resemble medical records: the patient’s name, age, diagnosis, city, and a list of what is required. There are also more emotional posts, from which you can understand the full extent of the despair that has gripped the patient’s relatives. According to Reuters calculations, in early May, such messages were published on Twitter every 30 seconds. “What you see on the Internet is a mirror image of what is really happening,” Arakal said.
Zaiba said that patients who turn to volunteers often literally suffocate and beg for oxygen. Call and those who initially managed to find one cylinder, but do not know where to get a spare or replenish the one that is — at the time of the call, they are already running out of oxygen. “Most of them are unable to wait. For them, procrastination even for 5-10 minutes is a matter of life and death,” the volunteer said.
At this stage, patients can still be treated on an outpatient basis, but when the blood oxygen saturation drops to critically low levels, there is no choice – you need to look for a bed. It is difficult to reach hospitals, the information published on the Internet about the availability of places is rapidly becoming outdated, and patients are often unable to hang on the phone. Here again, volunteers have to intervene, who call hospitals, and in some cases, accompany patients to clinics themselves. But they can’t accept everyone.
“In the hospital, conditionally, 100 beds. And there are 200 patients with COVID-19. It is impossible to help everyone, and doctors have to make difficult choices and decide which of them to try to save, and who not,” Farah Zaiba, an emergency response team volunteer in Bangalore, said.
Even if a person manages to achieve hospitalization, the tests do not end there. “In the hospital, relatives are given a prescription for medicines and they say: find and buy them yourself,” Zaiba said. – Relatives often do not have the necessary money, and simply do not understand what to do with this recipe. They start frantically searching for medicines, but they don’t find them anywhere. It’s a helpless situation. There is little that volunteers can do because the supply of medicines is under the control of the government.” The girl admits that if she was in a similar situation, she would not be able to find the necessary medicines in the same way.
A new attack
One coronavirus crisis in India could not do without: it was overlaid by an epidemic of mucormycosis – an infection that causes black mold to enter the lungs. The disease is insidiously waiting for people who have just had COVID-19. They happily return home, believing that they are completely cured, but suddenly begin to experience strange symptoms: fever, inflammation of the eyes, difficulty breathing. “Often people seek help already in the late stages of the disease, simply because they do not know what mucormycosis is,” says Zaiba.
Medicines for black mold are difficult to obtain and expensive: in the multi-million dollar Bangalore, they are offered in only three hospitals, but even there are supply disruptions. The death rate from this extremely rare disease is 50 percent. Many patients have to have their eyes removed.
Everyone’s personal tragedy
There is probably not a single person in India who has not been personally affected by the current wave of COVID-19. Everyone has lost a loved one. On April 23, Arakal itself lost five friends at once; all of them were less than 30 years old. “We lost a lot of people in the second wave, more than in the first. During the first wave, little was known about the virus, but the mortality rate was not too high. Then mostly people over 60, people 45-50 years old, people with chronic diseases died. Now so many young people have died!” says the journalist.
Harigovind also said that in the midst of the crisis, doctors had a particularly difficult time. Seeing how rapidly the patients were fading away, the doctors at the hospital decided to discuss the possible fatal outcome with them in advance, while they were still able to talk and think.
“We said, look, your tests are bad, your CT scan looks bad, and your medication isn’t working. There’s a good chance your condition will get worse soon. We don’t have any beds available in the intensive care unit. We’ll do our best, but you can still die. What do you want us to do? Do you want us to let you go peacefully, or do you want us to fight for you to the end? Do you want us to contact your family, do you want to call them yourself?” Gautam Harigovind, MSFDoctor, said.
The death of the patients to whom the doctors attached themselves and whom they tried with all their might to save from the clutches of the disease became a personal tragedy. After crying, the doctors returned to work again — they could not afford time off or vacation.
The deadly wave of coronavirus was truly terrible for the Indians. The horror of a new disease that mercilessly mows down entire families, as well as little available help, actively pushes the religious and superstitious population of the country to non-standard methods of treatment and prevention.
So, many Indians for the sake of protection began to drink urine and smear themselves with the dung of cows, which are considered sacred animals in the country. Even the politicians of the ruling party are in favor of such an extraordinary method of “increasing immunity”, although doctors warn of the lack of any evidence of its effectiveness.
From the coronavirus, they offer yoga treatment, and in the south of India, there is even a temple where they worship the “Crown of Devi” – the goddess of the coronavirus. The priests pray to the virus deity every day, begging for mercy.
Scammers took advantage of the general panic and despair of people. Many people across the country have become victims of criminal schemes, and law enforcement authorities have yet to find the perpetrators.
Prevent a disaster
The scale of the disaster was difficult to predict. But it was still possible to predict it: experts warned the Indian government about the risks of a new wave of coronavirus a few months ago. “In most states, the authorities were completely unprepared. They had three or four months to prepare the health care system, but little was done,” Arakal says.
At the same time, the journalist admits that the government of the country is faced with a dilemma. Lockdown, introduced in India in the first wave, hit the low-income population hard. A huge number of Indians survive on the money they get every day, working as drivers or handymen. Therefore, to impose quarantine again immediately after the number of infections began to grow, would deprive these people of all means of subsistence and would force the government to once again pay huge benefits.
However, when the situation became quite critical, the lockdown was still introduced: but it was not the central government that did it, but the leadership of the states themselves. “The introduction of lockdown was left to the local authorities, but in fact, it turned out that it was introduced all over the country,” the journalist noted.
At the same time, the volunteer organization in which Zayba works, in fact, took over the functions that the government and health authorities were supposed to perform.
“They failed miserably, let down by their own carelessness and hope for the future. They may say that they did not expect the situation to take such a turn. But they had plenty of time and the example of the United States before their eyes. They thought India had immunity against COVID. And then the second wave happened. Death, madness, and chaos are everywhere,” Farah Zaiba, an emergency response team volunteer in Bangalore, said.
Plateau or new peak?
In recent weeks, the incidence in India has been reduced: the number of new cases detected daily has decreased from 390 to 120 thousand. But even now, the situation is still difficult.
As Mas-Koma notes, the peak of the incidence in April-May fell on large Indian megacities. Now, the virus has begun to spread to rural areas, where more than 65 percent of the population lives, and the health system is even worse prepared than in cities. “Therefore, in my opinion, the situation in India is far from a final decline in the incidence,” the expert stressed.
Harigovind also noted that the situation in rural areas of the country may remain critical. At the height of the second wave, those with smartphones had access to information about the disease and vital resources: beds and medicines were searched for in volunteer groups, in WhatsApp chats, and on government portals.
“This makes you wonder: what about people who don’t know how to use smartphones, who don’t have access to them? Think of small towns and villages. How can their residents get access to the medicines they need? Who does anything for them? COVID-19 is a silent killer in these regions. This is happening everywhere, in every corner of the country. People in the villages are dying from the coronavirus, and we don’t even know about it. Officially recorded deaths may be just the tip of the iceberg,” Gautam Harigovind, MSF Doctor,said.
At the same time, Indians do not even have access to up-to-date official statistics, Arakal notes. In many states, most of the deaths reported in regular bulletins are from 10 to 12 days ago.
The current low vaccination rates are also disappointing. Back in January, the Indian government announced the launch of the world’s most ambitious vaccination program: it was planned to vaccinate 300 million people by July. However, at the beginning of June, about 45 million people in India are fully vaccinated — that is, less than 5 percent of the adult population of the country.
Even if the authorities, as promised, can increase the rate of vaccination by three times, it will still be extremely difficult to contain the virus. Local scientists have found that in some cases, the vaccines used in the country — at least in their current modification-are unable to prevent infection with a new mutation of the virus. This means that the new virus will be able to spread among the vaccinated population.
Avoiding the third wave of coronavirus will also be extremely difficult, given the country’s high population density: people are simply deprived of the luxury of much-needed physical distancing. Immediately close the country to lockdown, as this time, will not allow the economic situation, so the Indian authorities may once again face a similar dilemma. Whether they will be able to effectively apply their bitter experience and avoid a repeat of the tragedy — time will tell.