Dr. Gautam Singh dreads the daily advent of the ventilator beeps, signaling that oxygen levels are critically low, and hearing his desperately ill patients start gasping for air in the New Delhi emergency ward where he works.
Like other doctors across India, which on Monday set another record for new coronavirus infections for a fifth day in a row at more than 350,000, the cardiologist has taken to begging and borrowing cylinders of oxygen just to keep patients alive for one more day.
On Sunday evening, when the oxygen supplies of other nearby hospitals were also near empty, the desperate 43-year-old took to social media, posting an impassioned video plea on Twitter.
“Please send oxygen to us," he said in a choked voice. "My patients are dying.”
India was initially seen as a success story in weathering the pandemic, but the virus is now racing through its population of nearly 1.4 billion, and systems are beginning to collapse.
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SOS messages like the one Singh sent reveal the extent of the panic.
In addition to oxygen running out, intensive care units are operating at full capacity and nearly all ventilators are in use. As the death toll mounts, the night skies in some Indian cities glow from the funeral pyres, as crematories are overwhelmed and bodies are burned in the open air.
On Monday, the country reported 2,812 more deaths, with roughly 117 Indians succumbing to the disease every hour — and experts say even those figures are probably an undercount. The new infections brought India’s total to more than 17.3 million, behind only the United States.
The deepening crisis stands in contrast to the improving picture in wealthier nations like the U.S., Britain and Israel, which have vaccinated relatively large shares of their population and have seen deaths and infections plummet since winter. India has four times the population of the U.S. but on Monday had 11 times as many new infections.
Doctors like Singh are on the front lines, trying to get the supplies they need to keep their patients alive.
Singh received 20 oxygen cylinders on Monday, only enough to enable the hospital to limp through the day until the ventilators start sending out their warning beeps again.
“I feel helpless because my patients are surviving hour to hour,” Singh said in a telephone interview. “I will beg again and hope someone sends oxygen that will keep my patients alive for just another day.”
As bad as the situation is, experts warn it is likely to get worse.
Krishna Udayakumar, founding director of the Duke Global Health Innovation Center at Duke University, said it would be impossible for the country to keep up over the coming days as things stand.
“The situation in India is tragic and likely to get worse for some weeks to months,” he said, adding that a “concerted, global effort to help India at this time of crisis” is desperately needed.
The U.S. said Monday that is working to relieve the suffering in India by supplying oxygen, diagnostic tests, treatments, ventilators and protective gear.
The White House has also said it would make available sources of raw materials urgently needed for India to manufacture the AstraZeneca vaccine.
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“Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, we are determined to help India in its time of need,” President Joe Biden tweeted on Sunday.
Help and support were also offered from archrival Pakistan, which said it could provide relief including ventilators, oxygen supply kits, digital X-ray machines, protective equipment and related items.
Germany’s Health Ministry said it is urgently working to put together an aid package for India consisting of ventilators, monoclonal antibodies, the drug remdesivir, as well as surgical and N95 protective masks.
But many say the aid is too late — the breakdown a stark failure for a country that boasted of being a model for other developing nations.
Only three months ago, India's leaders were boisterous, delivering messages that the worst was over.
In January, Prime Minister Narendra Modi declared victory over the coronavirus, telling a virtual gathering of the World Economic Forum that India’s success couldn’t be compared with that of anywhere else.
A little less than a month later, his Bharatiya Janata Party passed a resolution hailing Modi as a “visionary leader” who had already “defeated” the virus.
By the second week of March, India’s health minister declared that the country was “in the endgame” of the pandemic.
At the same time, the patients arriving at India's hospitals were far sicker and younger than previously seen, prompting warnings by health experts that India was sitting on a ticking time bomb.
Millions of Hindu devotees celebrated the festival of Holi across the country at the end of March, disregarding social distancing guidelines and masks. Modi and other politicians spearheaded mammoth election rallies where tens of thousands participated without masks. And millions more gathered by the Ganges River for special Hindu prayers as recently as last week.
Now it’s suspected all these events might have accelerated the unprecedented surge India is seeing now.
“Many people across India are paying with their lives for that shameful behavior by political leaders,” Udayakumar said.
In a radio address on Sunday, Modi sought to deflect the criticism over what he called a “storm” of infections that had left the country “shaken.”
“It is true that many people are getting infected with corona," he said. "But the number of people recovering from corona is equally high."
India's government said last week it would expand its vaccination program to make all adults eligible, something long urged by health experts.
But vaccinations take time to show their effect on the numbers of new infections, and there are questions of whether manufacturers will be able to keep up with the demand. The pace of vaccination across the country also appears to be struggling.
Ordinary citizens are taking matters into their own hands, doing what they say the government should have done a long time ago.
Volunteers, from students to technology professionals, nonprofit organizations and journalists, are circulating information on the availability of hospital beds, critical drugs and oxygen cylinders.
Like Dr. Singh, many have taken to social media, particularly Twitter, to crowdsource lists of plasma donors and oxygen supplies.
The system is imperfect, but some are getting badly needed help.
Rashmi Kumar, a New Delhi homemaker, spent her Sunday scouring Twitter, posting desperate pleas for an oxygen cylinder for her critically ill father. At the same time, she made countless calls to hospitals and government help line numbers, to no avail.
By evening her 63-year-old father was gasping for breath.
“I was prepared for the worst,” Kumar said.
But out of nowhere, a fellow Twitter user reported an available oxygen cylinder some 60 kilometers (37 miles) away. Kumar drove to the person's house, where a man handed over the cylinder.
“I was helped by a stranger when my own government continues to fail thousands like me,” she said. “Unfortunately, everyone is on their own now.”
