India Covid crisis: Hospitals buckle under record surge

India's healthcare system is buckling as a record surge in Covid-19 cases puts pressure on hospital beds and drains oxygen supplies.

Families are left pleading for their relatives who are desperately ill, with some patients left untreated for hours.

Crematoriums are organising mass funeral pyres.

On Friday India reported 332,730 new cases of coronavirus, setting a world record for a second day running. Deaths were numbered at 2,263 in 24 hours.

Oxygen crisis

Dr Atul Gogia, a consultant at the Sir Ganga Ram hospital in Delhi, told the BBC there had been a "huge surge" in patients, leaving no space in the emergency room.

"We do not have that many oxygen points. Whatever oxygen points are there, they're full. Patients are coming in with their own oxygen cylinders or without oxygen. We want to help them but there are not enough beds and not enough oxygen points even to supply them oxygen if it is there," he said.

"All our telephone lines are jammed. People are continuously calling the helpline. There is a big rush outside the hospital: there are ambulances parked, patients wanting to get deboarded, but the problem is, there is no space.

"We try to mobilise, we try to discharge patients who become stable as early as possible so that we can increase the turnaround, but things are difficult right now."

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Every morning, for the past few days, I have been waking up to my phone buzzing with desperate messages for help.

People are seeking hospital beds, life-saving drugs, oxygen and plasma for their infected and sick friends and relatives. Often, after a period of silence, the same people announce the deaths of their "patients". My Twitter timeline is India's Covid-19 war-room, as the state appears to have largely withered away.

Every essential to save a life is in short supply or available on the black market. Then there's the fear of the virus literally "at your door". Over the past week, three buildings in the gated complex where I live have become "containment zones", with entire skyscrapers sealed because of too many infections. The days and nights are filled with helplessness, anxiety and fear. The bad news is unrelenting.

The Supreme Court of India has called this a "national emergency". This is beyond an emergency. It is a "complete collapse of the goddamn system", as one of India's leading virologists says. In hotspots like Delhi and Mumbai, life, itself, is now a privilege.

Maharashtra, the worst-hit state in India, faces an oxygen shortfall. In the state capital, Mumbai, at least 13 patients died after a fire broke out in an intensive care unit of a hospital treating Covid patients.

Two days earlier, 24 Covid patients died in another part of the state after a leak interrupted the flow of oxygen to their ventilators.

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On Friday morning, Max Healthcare, which runs 10 private hospitals around Delhi, put out an "SOS" message, saying it had less than an hour's supply remaining at two of its sites. The shortage was later resolved.

Three other states - Gujarat, Uttar Pradesh and Haryana - are also facing a critical shortage. The Indian Air Force is being used to lift oxygen tankers and supplies to different parts of the country.

Crematoriums have resorted to mass funeral pyres as the number of bodies from Covid victims continues to rise

How is medical oxygen made?

A separation process takes air and splits it into various gases, including oxygen. The oxygen is then purified, super-cooled and stored as a liquid, which is less bulky than keeping it as a gas.

The compressed oxygen is used to fill insulated tanks, which supply hospitals, or canisters for individual patients.

A vaporiser is used to turn the oxygen back into a gas before it is delivered to patients.

Hospitals are struggling to get enough oxygen for Covid patients

Why are cases so high in India?

Cases have surged during India's second wave, driven by a number of factors. Health protocols have been lax, with mask mandates sporadically enforced.

Millions of people attended a Hindu festival, the Kumbh Mela, which culminated 10 days ago with a mass dip in the River Ganges. New strains of the virus have emerged, including a "double mutant" strain.

Bollywood composer Shravan Rathod tested positive shortly after returning from the city where the Kumbh Mela was held and died not long after, his family confirmed.

As well as the Indian double-mutant strain, the UK strain is the primary variant found in the state of Punjab, National Centre for Disease Control Director Sujeet Kumar Singh told local media.

The UK strain is also particularly prevalent in Maharashtra and the city of Delhi, he added.

Dr Saswati Sinha, a critical care specialist in the eastern city of Kolkata, said emergency rooms and wards were packed to capacity.

"We are getting direct calls from our patients, our acquaintances, our neighbours: they are pleading with us to be able to accommodate some of their next of kin. But unfortunately, our situation is such that, although we are trying our best, we still have a huge number of patients whom we are not able to accommodate," she told the BBC.

"In 20 years of working in intensive care, I have never seen anything of this kind, ever."

Indian Prime Minister Narendra Modi met chief ministers of the most affected states and oxygen manufacturers on Friday.

He asked states to work together to stop hoarding and black marketeering, saying that the government was also looking at diverting industrial oxygen to ease the crisis.