Strength amid despair in India: Life at the epicentre of the latest wave of Covid-19

Family members of Vijay Raju, who died due to Covid-19, mourn at a crematorium on the outskirts of Bengaluru, India, on May 13, 2021. PHOTO: REUTERS

INDIA - Under normal circumstances, driving around the capital city Delhi, like any other India metro, means navigating tricky and noisy traffic conditions as motorists, bus drivers and even cyclists try to outmanoeuvre each other.

These days, traffic is sparse, just the occasional truck or motorcycle pass by. Delhi's famous traffic snarls are nowhere to be seen.

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Almost at the other end of the country, in Andhra Pradesh, the normally bustling Vijayawada International Airport also has only a handful of passengers, and even fewer flights.

The empty Vijayawada International Airport on April 3, as cases began to peak in India. ST PHOTO: ROHINI MOHAN ​

An uneasy quiet has settled across India as the Covid-19 crisis unfurled, in part because of localised lockdowns, in part because many in the country are gripped by the fear of catching the coronavirus.

The quiet puts the bursts of activity into even sharper relief - ambulances racing to the next patient, ordinary people frantically criss-crossing the city looking for medicine, oxygen refills and hospital beds.

For people who have barricaded themselves at home, the regular wail of the siren is a constant reminder of how the South Asian country is going through its worst crisis in recent decades.

After a relatively unscathed year, the country of nearly 1.4 billion people has seen the Covid-19 pandemic belatedly and quite suddenly explode.

The number of new cases has overwhelmed health systems across the country, and even in large urban centres such as Delhi, which has the best infrastructure, hospitals in April and early May were making desperate public appeals for oxygen.

With new case numbers still exceeding 300,000 a day, India regularly accounts for around 50 per cent of all new cases around the world each day.


The problems start with testing

In late April, in the corner of the compound at Artemis Hospital in Gurgaon, a man keeps falling down and has to be helped up by those around him standing in a long queue, waiting for a real-time polymerase chain reaction (RT-PCR) test.

The man is made to sit in a chair but falls off again, his mask slipping off, creating some alarm around him. He is taken to the front of the long queue but is too weak to make it, sliding once again to the ground.

As hospital staff half carry him towards the main hospital building, he resists, pointing instead to an elderly man seated in a corner. He has actually come here not to get a RT-PCR test for himself, but for his father.

In front, the doctor in charge, clearly overwhelmed by the number of swabs he needs to take, screams at a patient for breaking the queue.

Most people in line will wait for at least two hours to get tested. And the results will not be available for at least another 48 hours.

As infections spiked, more people began to line up for testing, creating huge backlogs in the labs. ST PHOTO: ROHINI MOHAN

And unlike the first wave that affected the elderly, the second wave has seen many young people falling sick. Middle-aged parents are seen bringing their visibly feverish, coughing young adult children to testing centres.

People lining up at the Covid-19 testing centre in a Bangalore hospital. Unlike the first wave, many Covid-19 patients in the second wave are young. ST PHOTO: ROHINI MOHAN

The long delays are having a tragic impact. Without quick and reliable test results, people are not able to get the care they need and end up transmitting the virus to many others too - a situation Mr Claudien Jacob now understands only too well.

He lost his 71-year-old bedridden mother on April 29 at home in Bangalore. She was burning up with fever and her oxygen saturation levels were dipping.

By the time she was able to get a lab technician to come home to collect the swab sample for the RT-PCR test, everyone else in the family was also showing classic symptoms of Covid-19. But her test result has yet to come, without which the government would not allot her a hospital bed.

On April 29, at 7am, she breathed her last. At 7.30am, Mr Jacob's phone beeped with the test result: Covid-19 positive.

He has yet to get his own test results. He said: "I'm dead tired, but there is no one else to do this, so I have come to the graveyard. My mother's death feels unreal."

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Last March during the first wave of the pandemic, the country instituted a strict 21-day lockdown. While it affected the country adversely, it helped scale up infrastructure from beds to testing facilities.

As a result, testing was ramped up from fewer than 100 tests to over 1.4 million per day.

The number of labs doing tests has also increased from 14 early last year to more than 2,400 this year. But even this has proven to be insufficient.

Doctors now advise patients to start treatment the moment Covid-19 symptoms appear and not wait for test results anymore.

Yet it's not just tests that are in short supply.

The fight for survival

In the midst of dangerous shortages and policy breakdown, the endurance Indians have for pain and struggle can be baffling, but also strangely affirming.

Anyone who survives Covid-19, despite extreme shortages of medicine, oxygen and chaotic health systems, has done so because they spent every penny, every bit of strength in their tired limbs, and every sliver of optimism in saving their loved ones at any cost.

It is common to see people rush about for basic essentials that one always assumed hospitals would have. Never before did regular citizens have to hunt for life-giving oxygen.

Looking out the window, it is not hard to find someone rushing an oxygen cylinder on a scooter to a sick patient.

A common sight on India's roads, people rushing oxygen cylinders to hospitals. ST PHOTO: ROHINI MOHAN

Getting admission in a hospital is a matter of willpower, wealth, connections, and of course, luck. Indians joke now that before the pandemic, people panicked when a loved one was admitted in the critical care unit of a hospital, but now, they rejoice- getting a bed is akin to a competitive sport.

The Straits Times met Ms Shalini, a 22-year-old student, outside a hospital in Bangalore in an autorickshaw with her breathless grandfather. This was the fourth hospital they had visited that day without luck. "All Covid beds are full," the nurse said.

Ms Shalini and her grandfather are turned away from four hospitals in one day. ST PHOTO: ROHINI MOHAN

Once there, however, Covid-19 survivors and their families told us the loneliness was intense. Families are not allowed to meet patients in the Covid-19 wards or critical care units. In the sheer isolation, all one can hear is heavy, lonely breathing.

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Still they are considered the "lucky" ones.

Coping with trauma

More than 266,000 people have died from Covid-19 in India since the pandemic began, many of them in dire circumstances.

When ST visited a crematorium near Delhi last month, the sight was crippling: Raging fires were the backdrop for dozens of bodies and their families - all waiting their turn.

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One young woman, kitted out in a full personal protective equipment (PPE) suit, said she had been waiting for a few hours with her mother for a spot to open up for her father's cremation.

And while she waited, she would often walk away from her mother to face her father's body. She would stand desolate in a corner, her arms outstretched, and wept softly.

Here she is at her father's pyre, moments after it was lit.

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Most Indian funerals offer closure through overt expressions of every stage of grief: disbelief, anger, sorrow, celebration of life and acceptance.

But bans on funeral gatherings have made mourning harder and lonelier. Unable to process the sudden loss of their loved ones who were inside an intensive care unit they could not enter for two weeks, many families were inconsolable.

A wife and daughter wail from afar as they cannot touch or hug the entirely bagged body of Mr Raja, a trader who died of Covid-19 in a government hospital in Bangalore. ST PHOTO: ROHINI MOHAN

Outside the Old Seemapuri crematorium in Delhi, ST sat with Mr Jitender Singh Shunty, founder of Shaheed Bhagat Singh Sewa Dal - a non-profit organisation - as he has his first cup of tea at 2pm in his car. He said he felt faint and had to take a break even though he had little time to spare.

Mr Jitender Singh Shunty has a break in his car. His non-profit organisation which helps cremate unclaimed bodies has been getting 400 calls a day. PHOTO: NIRMALA GANAPATHY

Mr Shunty, whose outfit helps cremate unclaimed bodies and immerse ashes according to Hindu traditions, gets multiple calls on his phone. "Yes, we will come and prepare the body. Don't worry," he tells one desperate caller.

He has been getting over 400 calls in a day.

He has been living in his car for multiple days. Everything he needs, including his toothbrush, is in the car, he said, pointing to his car boot overflowing with PPE kits, masks and disinfectant. He has a fleet of 18 ambulances and has lost one driver, Mr Arif Khan, to the pandemic.

"It is a calamity. We burn bodies day and night."

People such as Mr Tanveer Ahmed, from Mercy Mission in Bangalore, put their own lives at risk every day, transporting at least 12 bodies to crematoriums or graveyards on behalf of sick or quarantined families.

After cremating the seventh body on April 29, Mr Ahmed realised that he was passing through his neighbourhood. He called his children on the phone. "Come quickly down for a moment to see dad," he told them.

Stopping for a moment outside his house, Mr Tanveer Ahmed, a pandemic volunteer cremating and burying bodies, meets his children from a distance after days of not returning home. ST PHOTO: ROHINI MOHAN

The plight of migrants

As affluent Indians stay holed up at home or are in a desperate search for health resources from beds to oxygen refills, migrants have once again fled India's urban centres for the safety of their rural homes.

While the pandemic is now ravaging rural parts, which means going home is no safer for migrants, it is the psychological sense of being surrounded by family and friends in familiar surroundings that draws them home.

The loss of work is also a driving force.

Mr Athar Niyazi, 28, went to the New Delhi railway station every day for a week in a bid to get a train ticket home to Bihar state after the factory he works in closed temporarily. With no income or savings, he is fearful that if he does not return home, his debts will continue to pile up.

In rural parts, health infrastructure is weakest and getting medical help means travelling long distances, so this also constitutes a challenge for the Indian state as migrants move back to their rural homes.

The exodus from urban centres also threatens to overwhelm the public transport system. Migrants push and shove to get onto buses leaving Delhi. Three to four people often share one seat.

Migrant workers gathering at a bus station near New Delhi to return to their villages on April 19. PHOTO: REUTERS

Delhi has been under a lockdown since April 19 and neighbouring districts in the state of Uttar Pradesh have followed suit. With no sign of immediate let-up in the pandemic, many migrants wait on a highway that leads out of Delhi on April 28 to get a seat on a bus.

They are on their way to villages and towns in western Uttar Pradesh, a major source of labour for the National Capital Region in and around Delhi. Instead of heading for crowded bus stations, migrant workers wait at this major intersection closer to where they live for buses they can wave down.

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One normally comes across such a scene on the eve of major festivals when people return home for a short happy break. But this time, happiness is nowhere around and those leaving are not even sure when they will return.

Hope amid the horror

If there is any silver lining to this cloud, it is in the way ordinary men and women have become pandemic superheroes, helping battle not only the coronavirus, but also the labyrinthine Indian bureaucracy.

An autorickshaw driver in Bhopal sold his wife's jewellery to convert his vehicle into a makeshift ambulance. Another person in Mumbai sold his SUV for 2.2 million rupees (S$39,500) to buy people oxygen cylinders.

In Kerala, an elderly man donated almost his entire savings of 200,000 rupees for Covid-19 relief efforts.

The examples are too numerous to list exhaustively. The generosity can also be strikingly intimate, like when a lactating mother in Bangalore donated breast milk to a premature baby whose mother had died of Covid-19 last week.

And it is these moments that provide temporary respite from the horrors of the crisis.

At the Aster RV Hospital in Bangalore, a child who has just recovered from Covid-19 finds himself isolated from his parents who are both still unwell. So a nurse has to double as his caregiver too. As she hugs the baby, the child smiles and the doctor captures that fleeting moment on his phone camera.

At Aster RV Hospital in Bangalore, a nurse plays with a child who has just recovered from Covid-19. PHOTO: DR CHETAN

The doctor and staff at the hospital look at the photo often. It is encouragement, relief and a promise that this darkest of days will one day pass.

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