India scrambles to supply oxygen as COVID-19 patients gasp for breath

Indian hospitals and government leaders scrambled for supplies of oxygen and other emergency aid Friday, as the country reported another record number of new coronavirus infections and a rising death toll that has strained the country’s resources.

India recorded more than 330,000 new cases in 24 hours, the health ministry said Friday, the second consecutive day that the country has set a global record for daily infections. The reported death toll Friday was more than 2,200, also a new high for the country.

About half of the cases in Delhi, the capital city of more than 20 million people, are testing positive for a more contagious variant of the virus, first detected last year in India, that is afflicting younger people, said a health ministry official, Sujeet Singh.

It is unclear to what extent the variant is driving the surge in cases around the country, with large gatherings of unmasked people and widespread neglect of preventive measures also suspected.

As India’s catastrophic second wave of the coronavirus deepened Friday, Canada joined Britain, Hong Kong, Singapore and New Zealand in barring travellers from the country. The US State Department advised people against going to India after the Centers for Disease Control and Prevention raised the country’s risk level to its highest measure.

“Demand for hospital beds and medical supplies have taxed the health care system to capacity in many cities, and critical care bed space is severely limited,” the travel advisory said.

With the mutant strain of the virus racing through Delhi, the capital territory’s government has imposed a weeklong lockdown. That has stranded thousands of people who rely on daily wages, leaving many to camp on the banks of the Yamuna River, where they survive on a Sikh temple’s twice-daily food deliveries.

In Maharashtra, which includes Mumbai and is one of India’s worst-hit states, a hospital fire attributed to a faulty air-conditioning unit killed at least 13 COVID-19 patients Friday. Two days before, at least 22 patients were killed in a hospital in the city of Nashik, also in Maharashtra, after a leak cut off their oxygen supplies.

Facing a barrage of criticism for his government’s handling of the second wave, Prime Minister Narendra Modi cancelled plans to travel to West Bengal for a campaign rally ahead of an election in that state.

Even as cases have climbed, Modi’s governing Bharatiya Janata Party and other parties have continued to hold mass rallies with thousands of people unmasked. The government has also allowed an enormous Hindu festival to draw millions of pilgrims despite signs that it has accelerated the spread of the virus.

“Leadership really matters. We saw the early loosening of appropriate measures. Election rallies continued, and religious festivals turned into superspreader events,” said Krishna Udayakumar, an associate professor of global health and director of the Duke Global Health Innovation Center.

“There was perhaps a lost opportunity to learn from the first wave,” Udayakumar said.

That initial wave peaked in August and September, months after India abandoned a nationwide lockdown that crippled the economy.

The disaster now consuming India is playing out vividly on social media, with Twitter feeds and WhatsApp groups broadcasting hospitals’ pleas for oxygen and medicines, and families’ desperate searches for beds in overwhelmed COVID-19 wards. With many hospitals short of ventilators, television news reports have shown patients lying inside ambulances parked outside emergency rooms, struggling to breathe.

Swati Maliwal, an activist and politician in Delhi, tweeted that her grandmother had died while waiting outside a hospital in Greater Noida, near New Delhi.

“I kept standing there for half hour and pleading for admission and nothing happened,” she wrote. “Shame! Pathetic!”

On April 15, the health ministry said in a statement that India had a daily production capacity of about 7,700 tons of oxygen, with 55,000 tons in reserve. Not all of it goes to medical use — some is used for industrial purposes, including India’s enormous steel-making industry.

On April 21, a government official told the Delhi High Court that medical demand had reached 8,800 tons per day, beyond the daily production capacity.

Modi’s government is in charge of allocating the national oxygen supplies, and Thursday, India’s Supreme Court gave the government a week to come up with a “national plan” for distribution. The health ministry was told to issue a purchase order to import 55,000 additional tons of oxygen.

Oxygen is difficult to store and transport, and it isn’t generally manufactured near India’s biggest cities, which are now reeling from the sudden spikes in cases.

The body of a man who died of complications from the coronavirus is prepared for cremation in Mumbai on Wednesday, April 21, 2021. Indian hospitals and government leaders scrambled for supplies of oxygen and other emergency aid on Friday, as the country reported another record number of new coronavirus infections and a rising death toll that has strained the country’s resources. (Atul Loke/The New York Times)

States have accused each other of hoarding oxygen and blocking tankers at border crossings. Looters stole several cylinders of oxygen from a tanker making a delivery to a hospital in the state of Madhya Pradesh.

At least three states, including Madhya Pradesh, have asked Modi’s government to send so-called Oxygen Express trains with large oxygen tanks for hospitals.

On Thursday, Fortis Healthcare, one of India’s top hospital chains, tweeted an SOS message to Modi and his chief deputy, Amit Shah, the minister for home affairs, appealing for more oxygen at a hospital in Haryana state, on the Delhi border.

“Fortis Hospital in #Haryana has only 45 minutes of oxygen left,” the company wrote, asking government officials “to act immediately and help us save patients’ lives.”

Four hours later, the hospital received a tanker, the company tweeted.

It wasn’t clear whether every hospital with a critical need for oxygen was getting it in time.

Arvind Kejriwal, the top elected official in Delhi, said that the city needed a daily supply of 770 tons of oxygen. Modi’s government has allocated 530 tons.

At AIIMS Hospital in Delhi, India’s premier research hospital, contact tracing among health care workers was suspended because there weren’t enough personnel to spare for the exercise, according to Srinivas Rajkumar, a representative for the resident doctors’ association.

A person who died of complications from the coronavirus is prepared to be cremated in Mumbai, India, on Wednesday, April 21, 2021. India's rapidly worsening coronavirus outbreak is now expanding on a scale beyond any previously measured in more than a year of the pandemic: The health ministry reported more than 310,000 new infections on Thursday, the most recorded in any country on a single day. (Atul Loke/The New York Times)

Beginning Saturday, all residents of India age 18 or older can register for a COVID-19 vaccine, but demand is expected to far outstrip supply. So far, more than 135 million people have received at least one dose, about a tenth of India’s population of nearly 1.4 billion. Two vaccines have received emergency use authorisation, with at least five others in the pipeline.

A makeshift COVID hospital in Mumbai’s Bandra neighbourhood was well supplied with oxygen, but the nearby vaccination centre halted operations after running out of vaccine.

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