Los Angeles Times

Drowning in COVID, Indians beg their officials for oxygen

- By David Pierson and Ahmer Khan

MEERUT, India — The men stood shoulder to shoulder in the blazing heat, their chests leaning against empty oxygen cylinders lodged in the dirt.

They had come from all over to this makeshift center for refilling oxygen tanks in a city 40 miles northeast of the Indian capital of New Delhi, in a desperate bid to score what has become the most precious commodity in this pandemic-stricken nation.

Police and government officials guarded what little supply was available. They demanded to see medical records to ensure that oxygen wouldn’t be siphoned to the black market.

One man who didn’t have the proper paperwork held up a video showing his 6year-old daughter struggling to breathe.

“How am I supposed to show and prove that my daughter is dying?” he said. “There are no beds available at the government hospital.”

A 25-year-old man who gave only his first name, Arif, pleaded with a police officer for help.

“I beg you. Please give me one cylinder of oxygen,” he said. “If I don’t get one, my mother will die.”

The policeman apologized and said there was nothing he could do. Arif

collapsed to the ground and sobbed.

“COVID isn’t killing us,” yelled a man in line. “The lack of oxygen is killing us.”

The situation in Meerut is a snapshot of the despair spiraling across India as demand for oxygen far outpaces availabili­ty, in a nation where hundreds of thousands each day are becoming infected with COVID-19. The crisis is reminiscen­t of the shortages of masks, sanitizer and gloves earlier in the pandemic, though with consequenc­es that are far more devastatin­g.

Patients are suffocatin­g to death in hospitals with empty tanks. Many are paying the equivalent of several months’ salary to buy oxygen cylinders on the black market. Gangs are hoarding cylinders and devices called “concentrat­ors” that draw medical oxygen from the air. Meanwhile, social media are flooded with hashtags such as #OxygenCris­is.

“Oxygen cylinder required in Deoria. Patient name — Vedvyash Saini. Age — 45. Oxygen level — 80%,” said a typical tweet. A blood oxygen level of 95% or above is normal for most adults.

The clamor for something so elemental to life has eclipsed India’s vaccinatio­n drive and brought widespread criticism of its leaders, some of whom declared the virus defeated months ago, despite warnings of highly contagious variants. India’s crisis foreshadow­s what may unfold in neighborin­g countries, such as Nepal, whose overburden­ed medical systems are also facing steep rises in COVID-19 case numbers.

A lack of preparatio­n for the March surge meant that India did not increase its production of oxygen, in a country that already lacked an adequate supply. Prime Minister Narendra Modi has at times appeared more interested in silencing critics of the COVID-19 response and threatenin­g hospital workers who report oxygen shortages than in confrontin­g the breadth of a pandemic that has infected more than 24 million people

in India.

The death toll in parts of the country is rising faster than bodies can be cremated, leading to scores found floating in the Ganges River.

The national response has been in disarray as Modi has been mostly absent during the crisis and the central government has largely delegated policy and procuremen­t of medical supplies to the states.

“India’s COVID-19 response has failed because it ignored a fundamenta­l first principle of good governance — the principle of subsidiari­ty, which means that the central authority performs only those functions that cannot be performed at the local level and no other,” Yamini Aiyar, president and chief executive of the New Delhi-based Center for Policy Research, wrote in an editorial published Sunday in the Hindustan Times. “Rather than a coordinate­d response, states are at war with the [central government]

and each other.”

The mishandlin­g of medical support prompted India’s Supreme Court to announce on Saturday that it would establish a task force to ensure the “effective and transparen­t” distributi­on of oxygen.

Modi’s government says the country produces enough oxygen, up to 9,000 tons a day, to meet demand. The problem, it says, is getting the oxygen to people in need. Many of India’s oxygen plants are on the coasts, far from the areas hit hardest by the second wave, including New Delhi and Bengaluru, the city of more than 8 million formerly known as Bangalore.

India has mobilized the military to airlift oxygen supplies and has sent thousands of tons across the country on trains dubbed the “Oxygen Express.” Despite those efforts, oxygen remains scarce — leading to rising tension and anger.

In Muzaffarna­gar, a city just north of Meerut, more

than 200 people lined up recently to request oxygen from a government official. When many learned they would leave empty-handed, they berated the official, who was guarded by police.

“The government has failed and collapsed completely,” said Muzamil Rana, 28, who was denied a cylinder and said he has spent nearly $1,300 — for him, an astronomic­al sum — on black-market oxygen for a relative. “We can pay money to the government if they can at least provide us oxygen.”

Medical experts warn it will be impossible to distribute enough oxygen if cases keep multiplyin­g. Calls are growing for a national lockdown to break the chain of transmissi­on that has resulted in 262,000 recorded deaths, though the actual number is believed to be significan­tly higher.

Additional­ly, doctors are reporting the emergence of a rare fungal disease called mucormycos­is in current and former COVID-19 patients who have weakened immune systems. The infection, also known as black fungus, attacks the nose, brain and lungs and has required doctors to remove some patients’ eyes.

The country’s second wave is being partly blamed on a coronaviru­s variant known as B.1.617, first found in India last year, that the World Health Organizati­on has classified as a “variant of global concern” because it has shown signs of being highly infectious.

The variant has renewed fears of a major resurgence of the disease just as restrictio­ns have eased in countries with high vaccine rates, including the United States. New outbreaks have swept across Asia, including in Singapore, Taiwan and other places that had succeeded over the last year in keeping infection rates down.

The crisis in India underscore­s how ill-equipped poorer countries are at delivering basic medical treatment.

Hospitals in the U.S. often have their own oxygen plants, but medical facilities in impoverish­ed countries rely on the delivery of tanks — a far more costly and inefficien­t form of distributi­on. It is common these days in India to see people trying to move unwieldy cylinders weighing more than 100 pounds over unpaved roads. And with all that effort, a single tank may last only a few dozen hours, depending on how badly the virus has affected the patient’s lungs.

The pandemic has fueled an unpreceden­ted worldwide demand for oxygen. In the last four months alone, global oxygen needs have nearly tripled, primarily because of the crisis in India. Shortages have also been reported in Brazil, Iran, Mexico, Argentina, Turkey and the Philippine­s.

“While no country has ever needed oxygen as much as India does right now, other countries who are far less prepared than India may soon experience similar surges,” said Evan SparkDePas­s of PATH, a global nonprofit health organizati­on. “The COVID-19 pandemic is the biggest wake-up call the world has ever faced, revealing decades of inequities regarding access to oxygen.”

‘The government has failed and collapsed completely. We can pay money to the government if they can at least provide us oxygen.’ — Muzamil Rana, who bought black-market

oxygen for a relative

 ?? Ahmer Khan For The Times ?? MEN WAIT to refill oxygen tanks in Meerut, India, northeast of New Delhi.
Ahmer Khan For The Times MEN WAIT to refill oxygen tanks in Meerut, India, northeast of New Delhi.
 ?? Avishek Das SOPA Images/LightRocke­t ?? A COVID-19 PATIENT is transporte­d via rickshaw Thursday to Kolkata Medical College and Hospital. In the last four months alone, global oxygen needs have nearly tripled, mainly because of the crisis in India.
Avishek Das SOPA Images/LightRocke­t A COVID-19 PATIENT is transporte­d via rickshaw Thursday to Kolkata Medical College and Hospital. In the last four months alone, global oxygen needs have nearly tripled, mainly because of the crisis in India.

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