NEW DELHI (BLOOMBERG) - At his crowded emergency room in central Delhi, Ali Raza can't focus much on when the next delivery of oxygen will arrive - 12 of his 20 doctors are down with Covid-19, and the patients just keep coming.
"We always anticipated a second wave in April and May, but we never knew it would hit us so hard and so fast," said Raza, the director of emergency and trauma at Moolchand Hospital. "They arrive gasping and they all need oxygen."
Outside the ward's double doors, Gagandeep Trehan had just found out there was no bed or oxygen available for his uncle, who was struggling to breath. Trehan had driven 310km to Delhi from the northern state of Punjab in search of a bed, his car packed with four oxygen tanks to keep his uncle alive. Six hospitals had already turned him away and he was about to get back in his car and try number seven.
"I am scared he won't live if he isn't treated," Trehan said. "I am ready to pay any amount for a hospital bed."
The scenes inside one Delhi hospital provide a glimpse into the desperation throughout India, where the world's fastest-growing virus surge now threatens to spawn new variants that undermine efforts in more developed countries to vaccinate the public and get back to life as normal.
India added more than 323,000 new infections Tuesday, pushing its total above 17.6 million cases, second only to the US.
On Tuesday morning, Delhi had just 12 intensive care beds available in a city of more than 16 million people. Social media feeds have been filled with a seemingly endless stream of calls for beds, oxygen, Remdesivir and more.
'I pushed the panic button'
Over the weekend things had gotten so bad at the 1,000-bed Moolchand Hospital - one of the main private Covid facilities in the capital - that it turned to Twitter to beg for oxygen. Tagging Prime Minister Narendra Modi and the head of Delhi's government, the hospital warned that its oxygen supply would run out in less than two hours for scores of patients on life support.
Vibhu Talwar, managing director of the Moolchand HealthCare Group, raised the alarm after his staff alerted him at 2am that oxygen supplies were running low.
"By 7am we were left with just an hour and I pushed the panic button," Talwar said. "Obviously those hours between 5am and 8am were the most stressful time for me, my management team and our doctors and nurses. We have close to 150 Covid patients, there was a lot of panic - something I hope we never go through again."
But every day still carries the same risk, as have hospitals across the Indian capital have no guaranteed oxygen supply. "We don't know the quantity or the time," he said on Tuesday.
With the political and financial capitals of New Delhi and Mumbai in lockdown, Modi has faced growing criticism over his handling of the pandemic and his focus on state election campaigns during an escalating health crisis.
"When we had six months and there were very low cases, the government could have built more hospitals with oxygen and more infrastructure," said Raza, who heads Moolchand's emergency department.
"At this time, the oxygen supply should be continued - that is the least the government can do for us." A week ago the Delhi High Court expressed "shock and dismay" over the government's neglect and directed Modi's administration to "beg, borrow, steal" to ensure adequate oxygen supply for hospitals. Since then the government approved the allocation of funds to install 551 machines to produce medical oxygen inside public health facilities "as soon as possible."
Modi this week spoke with US President Joe Biden, who agreed to send vaccines and other supplies to India. His administration has also announced plans to boost oxygen production and ramp up availability of beds, while the Delhi government announced Tuesday it would import 21 ready-to-use oxygen production machines from France and 18 oxygen tankers from Bangkok.
"The current wave is particularly dangerous - it is supremely contagious and those who are contracting it are not able to recover as swiftly as was noticed in the previous wave," Delhi Chief Minister Arvind Kejriwal said.
"All hospitals at this point are running over and above their real capacity. Beds are full, including ICU beds."
In Moolchand's emergency ward, a woman wailed with grief next to the prone body of a relative, as other family members looked quietly on. Raza has added more beds into every spare inch of the emergency department, increasing its capacity from 16 beds to 25 - but it's still not enough to keep up with demand.
"We try not to think about when the next oxygen tanker will come," he said. "Every hospital is running short of oxygen. Whatever limited resources we have, we have to work with that." Sanjog, a manager in the nurse unit at Moolchand Hospital, said every day is a struggle to keep people alive.
"In this situation we have to fight for this," he said. "It's like a war situation."