NEW DELHI - The long separation and the risks faced by their loved ones working in the healthcare sector in Singapore have taken a toll on relatives in India, particularly with another Deepavali celebration come and gone without a reunion.

Mrs K. Padminiamma, 61, who retired from a job at the consumer courts and now does some social work, said she was worried about her daughter Akhila, a nurse, and her family. She has not seen her daughter as well as her grandchildren, aged seven and 14, in 18 months.

"It's very sad. They will come here every year in December and I will travel every year in June to visit them. Now I have not seen them in 18 months. I feel lonely," she said from the southern state of Kerala.

For families with loved ones in Singapore on the front line of efforts against Covid-19, the jump in cases in the Republic has triggered fresh worries, reversing the earlier scenario when those in Singapore were concerned for their families facing a surge in cases in India.

Earlier this year, India was hit by a devastating second Covid-19 wave, which saw daily cases in May climb to 400,000, overwhelming the country's healthcare facilities, with shortages of oxygen and hospital beds reported mostly everywhere.

In Chennai, in Tamil Nadu state, Mr Sankaran Jaikumar, 55, a chartered accountant, has been missing his brother, Dr Sriram Shankar, a cardiothoracic surgeon at Gleneagles Hospital, who used to visit every month.

Dr Shankar would take a flight on Friday evening to Chennai to visit their mother, who is now 89, and be back at work on Monday.

"It has thrown up a lot of challenges in the sense that him coming very often became the normal that we were used to. In a way, we made up for it by adopting technology, but there is nothing like meeting in person... Mum used to see him very often. We miss that a lot," he said.

"Of course, him being in the healthcare sector and directly exposed to people with various ailments does throw up a lot of concerns. I suppose it's part of the profession he has taken up. I suppose we have made our peace with it."

Dr Shankar, 61, admitted it was very difficult that he was not able to spend Deepavali with his mother and his family. "Every year I celebrated Deepavali in Chennai with my mother. It has been horrendous for me to not be able to go to Chennai," he said.

The rise in Covid-19 cases in Singapore has put an inordinate amount of pressure on those in the healthcare sector.

In an indication of the impact, Singapore's Senior Minister of State for Health Janil Puthucheary told Parliament last Monday that 1,500 healthcare workers had resigned in the first half of this year compared with 2,000 annually prior to the pandemic.

"Foreign healthcare workers have also resigned in bigger numbers, especially when they are unable to travel to see their families back home," said Dr Janil.

Close to 500 foreign doctors and nurses resigned in the first half of this year, compared with around 500 last year and about 600 in 2019.

Dr Asok Kurup, an infectious disease physician at Mount Elizabeth Hospital, pointed out that it has been even more challenging for healthcare workers in Singapore with the latest surge in Covid-19 cases.

Dr Kurup, 54, who treated patients in the foreign worker dormitories last year, said the difference this time round was that patients suffered far more serious complications.

The situation has "completely changed from what was mostly easy-to-manage dorm workers, trying to keep them isolated for a period, to treating patients with more complications," he said.

Now, he was treating far more elderly people above 80 years old, including those who were not vaccinated and had other medical conditions.

"Our volume has increased not just in terms of numbers, but also in terms of how sick patients are. It takes a toll from various angles. Numbers have gone up substantially, but there are only so few of us in infectious diseases," said Dr Kurup.

He said he was looking after 30 to 40 cases on average every day in the hospital while fielding multiple calls from other doctors, patients, family and friends.

Dr Mucheli Sharavan Sadasiv, 37, a consultant at the National Centre for Infectious Diseases in Singapore, has also found the separation from family difficult.

He said: "My family in India is not very worried as I have taken my vaccination and a recent booster dose, which give me protection from severe Covid-19 illness.

"The difficult part is not being able to meet them in-person, especially my parents. I last saw them in December 2019. They are hopeful that when the situation in Singapore settles, I will be able to visit them."

An oncologist in a prominent hospital in Singapore, who did not want to be named, sent oxygen cylinders to his parents as well as his in-laws in April.

Now it is his parents' turn to be worried about him after he was infected last month.

"I had to self-isolate in my home for 10 days and managed my patients online and with the help of colleagues. Fortunately, I remained asymptomatic during these 10 days," he said.

"We were of course very concerned for our family in the earlier part of the year. Conversely, my parents were concerned about my safety and were upset when I told them that I was diagnosed with Covid-19. "

A consultant cardiologist at Mount Elizabeth Hospital, Dr V. Parameswaran Nair, said his family was worried every time he had to go to work.

"Yes indeed, whenever I go to attend emergency heart problems in the hospital at night, my family is very much anxious and the rule at home is that I must have a full shower every time I am back from the hospital and my clinic," said Dr Nair, 82, who has relatives in Malappuram, on the Tamil Nadu-Kerala border, and in Thiruvananthapuram in Kerala, and immediate family in Singapore.