Multiple funeral pyres of victims of COVID-19 burn in an area converted into a crematorium for mass cremations in New Delhi, on April 24. (ALTAF QADRI / AP)

As a second wave of COVID-19 wreaks havoc across India, with daily cases topping 300,000 many days in the past week, tens of thousands of people in the country are literally gasping for breath as hospitals turn away patients amid a severe shortage of medical oxygen and other critical supplies and infrastructure.

Amid the world’s worst surge in coronavirus infections, the death toll is mounting steadily in the South Asian nation, keeping fires burning around the clock in some crematorium grounds, including in the national capital New Delhi.

Meanwhile, families of suffering victims are making desperate calls, via social media and TV, calling for help for their loved ones, in what is turning out to be a humanitarian crisis of unmatched proportions in recent times. 

The scale and speed of the COVID spike has caught authorities off guard and exposed the shortcomings in the health system in the world’s second-most populous nation.

Some major hospitals in New Delhi tweeted over the weekend that they had less than two-hours of oxygen supplies left, while others announced that they were suspending the admission of new patients.

“We are running on backup, waiting for supplies…,” said a senior doctor at Fortis Healthcare, which runs a chain of hospitals across India.

Amid the crisis, oxygen machines are being imported, including from China, and efforts are also underway to step up domestic production. 

China said on April 22 that it is ready to provide India with necessary support and assistance to help the South Asian nation deal with the surge in COVID cases.

A Foreign Ministry spokesperson in Beijing said the pandemic is a “common enemy of all mankind that necessitates international solidarity and mutual assistance”.

Medical aid and supplies are also coming in from countries such as Singapore, Saudi Arabia, and the United Arab Emirates. 

The United States and European nations, too, have pledged vaccine and other assistance such as ventilators.

But for now, India seems still a long way off from overcoming the pandemic challenge.

Each day brings more grim news and stories of helplessness and escalating human tragedy.

India has been setting new records of newly confirmed cases and surging deaths since April 22 when 314,835 COVID-19 cases were reported in a 24-hour period.

A patient undergoes simple treatment inside an ambulance in the city of Ahmadabad, Gujarat state, in western India on April 26. (PHOTO / XINHUA)

On April 26, the country reported 352,991 fresh cases, marking a world record for the fifth day in a row in terms of daily coronavirus infections. 

On April 28, authorities announced 360,960 new daily cases, marking yet another record high globally and taking the total case count in the country to nearly 18 million.

Meanwhile, 3,293 new deaths were reported in a 24-hour period, taking the total number of fatalities past the 200,000 mark.

India is second only to the United States in terms of overall COVID cases, and the fourth highest in the world in terms of pandemic-related deaths, after the US, Brazil and Mexico.

World Health Organization chief Tedros Adhanom Ghebreyesus said on April 26 that “the situation in India is beyond heartbreaking”.

Yet the worse may be yet to come.

Karori Singh, emeritus fellow and former director of South Asia Studies Centre at the University of Rajasthan, said the case-spike may continue for a couple of weeks even though some preventive measures and medical services revamp are underway.

Bhramar Mukherjee, an epidemiologist and biostatistician at Michigan University in the US, said, “What we are seeing is that at the peak, which will be in mid-May, India will see 8-10 lakh (800,000 to 1 million) fresh cases per day; and the peak in deaths will come at the end of May, at 4,500 deaths per day.” 

Several experts and organizations have provided similar statistical points for India’s accelerating second COVID wave. The Institute for Health Metrics and Evaluation in Seattle in the US noted in its statistical reports that India could witness its pandemic peak in mid-May, after which there will be a sharp decline in cases and fatalities.

Unlike the strong wave last year which hit mostly poor people reluctant to visit clinics, the new wave victimized more people in the middle class, who are quickly exhausting hospital resources.

Queues of new patients and their fearful relatives have been building up outside hospitals across main cities including Delhi, Kolkata and Mumbai. Major healthcare facilities in many parts of the country are battling acute shortages of oxygen cylinders for many days.

At one hospital in Delhi, doctors said 20 patients in a critical care unit died on April 25 after oxygen pressure dropped. Doctors blamed the deaths on the city’s acute oxygen shortage.

India’s crematoriums and burial grounds are being overwhelmed by the devastating new surge of infections.

At Nigambodh Ghat, one of the biggest crematoriums in Delhi for COVID-related funerals, around 120 bodies were cremated on April 24, the highest number of cremations in a day so far this year, said Suman Gupta, general secretary of the crematorium’s managing committee. 

“From zero COVID-related cremations on April 1, the number of cremations has now reached around 50 per day,” said Gupta, adding that he had never seen such a never-ending assembly line of death.

People wait in line to refill empty medical oxygen cylinders for COVID-19 patients in front of a shop in New Delhi on April 26. (PARTHA SARKAR / XINHUA)

Facing severe criticism over its handling of the crisis, the Indian government decided to import oxygen concentrators from abroad while helping leading oxygen manufacturers in the country to increase production of oxygen and life-saving drugs in short supply. State governments were instructed to come down heavily on anyone hoarding supplies. 

Railways and navy ships are transporting oxygen cylinders and other equipment from one place to another where supply is inadequate. With the surge in cases showing no signs of abating, several states including Delhi have imposed lockdowns, night curfews, or created new mini-containment zones in an effort to contain the spread of the virus.

As the nation reels from the crisis, authorities have been accused of letting their guard down too early and focusing too much on the economy.

In a radio address on April 25, Prime Minister Narendra Modi said, “We were confident, our spirits were up after successfully tackling the first wave, but this storm has shaken the nation.” 

On April 20, Modi voiced reluctance to impose another round of nationwide lockdown, saying a lockdown should be used only as a “last resort”, as any adverse impact on the livelihood of the people must be minimal. 

“The pandemic was under control in January but the lean period was not used to augment healthcare facilities, and now people are paying a heavy price for it,” said a senior health ministry official who wished to remain anonymous.

Mohammed Saqib, secretary-general of the India China Economic and Cultural Council, which strives to promote understanding and ties between India and China, agreed with Modi’s logic.

“Imagine a situation when virtually the entire country slips into a shutdown mode for an indefinite period. People’s life and livelihood would go for a toss,” Saqib said.

It is a lot better that we keep ourselves safe by following safety protocols, he said.

“Memories of the earlier lockdown, which was clamped from March 25 last year and how it took a heavy toll on businesses, economy and jobs, are fresh,” said Prasun Dutta, a New Delhi-based independent power sector analyst and consultant.

He recalled how during the protracted countrywide lockdown in 2020 more than two-thirds of the country’s businesses wobbled as a result of reduced cash flows. 

Opposition political parties are accusing the Modi government of inadequate planning and an inappropriate strategy for preventing and controlling the spread of virus.

Shahid Jameel, director of Trivedi School of Biosciences, Ashoka University, in Delhi, said growing disregard for social distancing and mask-wearing in public places has contributed to the current COVID surge. 

Professor Singh from the University of Rajasthan cited various possible factors for the faster spread of the second wave. 

These include political rallies during local elections, socio-religious festival celebrations attended by millions of people mostly without protective masks, normalizing of business activities without strict observance of protocols, inadequate self-quarantine due to family structure, over-confidence in large-scale vaccination, and altered behavior of people amid a false belief that the pandemic is under control.

Lax preventative measures coinciding with country-wide election rallies and a popular festival are among causes for the spike, said Ruklanthi de Alwis, senior research fellow at SingHealth Duke-NUS Academic Medical Centre in Singapore.

She also pointed to the emergence of a highly infectious new SARS-CoV-2 variant in India. 

In Maharashtra, India’s richest state and home to the nation’s financial hub Mumbai, a “double mutant” strain named B.1.617 was detected in 220 out of 361 COVID samples collected between January and March, according to India’s National Institute of Virology. 

And the variant is said to have been spotted in more than 20 countries and regions including Hong Kong, though scientists are yet to determine its impact.

Singh said it is believed that the new strain of virus is mutating very fast and that it is becoming very difficult to prevent it expeditiously as the strain seems more asymptomatic or without uniform symptoms. 

“Now, the biggest challenge is to contain the spread of virus in order to save lives,” he said.

Authorities have begun to take cognizance of socio-religious gatherings, mandating appropriate safety and preventive measures. Further restrictions and localized lockdowns are likely to be imposed in various states. And new guidelines for election campaigns and related activities may be issued.

Others measures include night curfew, selective lockdown, local containment areas, revamping public health measures, regulations of private hospitals in treating patients and enforcing strict observance of COVID-19 protocols and guidelines at public places, organizations and institutions.

“However, I don’t think the government will opt for full-scale lockdown,” Singh said.

Anup Kumar Sinha, an economist, said, “March 2020 and April 2021 are different times. In March 2020, we were virtually defenceless against the virus, and lockdown was perhaps the only option. But now with the vaccine coming in, we are somewhat in a better position.” 

He said the second wave will be another cruel blow to migrant laborers.

Modi has urged all citizens to be vaccinated and exercise caution.

Samiran Panda, head of Epidemiology and Communicable Diseases division at the Indian Council of Medical Research, said the government has taken a slew of measures, including adding men and women above the age of 18 to the nation’s ongoing inoculation campaign — a measure that will take effect May 1. 

Production and supply of vaccines can be accelerated as the US has expressed willingness to lift export bans on vaccine materials. 

But a supply crunch, which is already affecting India’s vaccination drive, could slow down inoculations further, a senior doctor at the All India Institute Medical Sciences said.

According to the health ministry, India had given 140 million doses of vaccine in 99 days, the fastest in the world. 

However, that still leaves a huge gap in a nation that has a population of more than 1.3 billion. 

Aparajit Chakraborty and Arunava Das are freelance journalists for China Daily. 

Contact the writers at vivien@chinadailyapac.com