Grieving relatives ATTACK Indian doctors who could not save Covid-19 victims as anger over health care collapse grows – and Pakistan fears their neighbour’s deadly second wave will hit them next
- Relatives of 67-year-old Covid victim attacked medics in Delhi today as anger at virus response grows
- Last week, another medic was beaten in Pune by relatives of a 65-year-old patient that he couldn’t save
- Attack comes as India’s health system collapses under the weight of the world’s worst second wave of Covid
- Medics in neighbouring Pakistan are now warning they could be next as military is deployed to help enforce new mask wearing rules and strict 6pm curfew
Doctors in India are being attacked by relatives of Covid victims as anger mounts over the country’s collapsing healthcare system which has been crippled by a brutal second wave.
In one piece of footage shot in Delhi today, a group of men can be seen attacking medics and security guards with a large wooden stick after their 67-year-old relative died in the waiting room because no ICU beds were available.
Apollo Hospital, where the attack took placed between 9am and 10am, said a number of medics were hurt in the brawl but had to immediately return to duty because of the number of patients who need treatment.
Meanwhile another piece of footage shot in Pune last week showed 25-year-old Dr Siddhant Totla being punched, kicked and beaten with a pipe after a 65-year-old man died and his relatives turned on staff.
India’s healthcare system has all-but collapsed under a brutal second wave of virus that saw the country report more then 323,000 new cases of virus on Tuesday and 2,700 new deaths.
Amid warnings that the wave is being driven by a ‘far more infectious and probably more deadly’ variant, medics and politicians in neighbouring Pakistan now fear they could be next.
‘We are clearly heading towards a situation India is facing today,’ Dr Muhammad Suhail of Hayatabad’s Medical Complex hospital warned on Tuesday, as India reported 323,00 new cases compared to Pakistan’s 4,500.
‘Both Pakistan and India have same issues. People in both countries aren’t following the [precautions],’ he told The Telegraph.
Officially, Pakistan has no cases of the Indian variant but authorities are clearly worried – bringing in a tranche of new restrictions last week and this week deploying the army to enforce them.
Soldiers carrying rifles marched alongside police through the streets of Lahore on Tuesday keeping an eye out for anyone violating new mask-wearing laws or staying out after the 6pm curfew.
Furious relatives attacked a 25-year-old medic outside a hospital in Pune, India, last week after he failed to save a 65-year-old man who was sick with Covid amid mounting anger at the government’s Covid response
CCTV shows a ground of 15-20 people brawling with medics outside the hospital, as police say they pelted the building with stones and ransacked a nearby security hut
Medics were attacked by a group of men wielding large wooden sticks at a hospital in Delhi today after their 67-year-old relative died in the waiting room because all the intensive care units were full
Medics have warned that India’s second wave is probably being driven by a more infectious and more deadly variant of the virus, though investigations are still being carried out into its effects (pictured, a crematorium in New Delhi)
Relatives weep as they perform funeral rites for a coronavirus victim as their body is cremated in the capital Delhi
Doctors in neighbouring Pakistan have warned that their country could be next if measures are not take to stop the ‘Indian variant’ of the virus spreading, prompting authorities to launch a crackdown (pictured, soldiers in Lahore)
Pakistan last week brought in new Covid measures including mandatory mask wearing and a 6pm curfew, and this week deployed soldiers and armed police to enforce them
Soldiers patrol the streets of Lahore, just 15 miles from the border with India, to enforce new Covid rules in the hopes of avoiding a wave of infections like the one that has crippled India
Army and Rangers personnel patrol on a street to implement new restrictions imposed as a preventive measure to curb the spread of the Covid-19 in Lahore
Soldiers patrol in Lahore, Pakistan, just 15 miles from the border with India, in an effort to prevent the spread of Covid
Army, Rangers and police personnel patrol the streets of Lahore in Pakistan, just across the border from India, as part of a drive to prevent the spread of Covid
India reported 323,000 Covid cases today, slightly less than on Monday though officials warn it is likely down to less testing at the weekend (left). The country also logged 2,700 deaths amid warnings of under-counting (right)
WHAT DO WE KNOW ABOUT THE INDIA VARIANT?
Real name: B.1.617
When and where was it discovered? The variant was first reported by the Indian government in late March.
But the first cases appear to date back to October 2020.
It has been detected in 21 countries as of April 19, Public Health England bosses say.
How many people in the UK have been infected with it? Public Health England figures show 132 cases of the Indian variant have now been spotted in the UK, including 55 in the past week.
Three people who caught the mutant strain in the past week had no travel links, suggesting the virus is spreading in the community.
But scientists say the true figure will be much higher because it takes up to three weeks for virus samples to be thoroughly analysed in a laboratory.
What mutations does it have? It has 13 mutations that separate it from the original Covid virus that emerged in China — but the two main ones are named E484Q and L452R.
Scientists suspect these two alterations can help it to transmit faster and to get past immune cells made in response to older variants.
Is it more infectious and can it evade vaccines? The L452R mutation is also found on the Californian variant (B.1.429), even though the two evolved independently. It is thought to make the American strain 20 per cent more infectious.
The E484Q mutation is very similar to the one found in the South African and Brazil variants known as E484K, which can help the virus evade antibodies.
The South African variant is thought to make vaccines about 30 per cent less effective at stopping infections, but it’s not clear what effect it has on severe illness.
Professor Sharon Peacock, of PHE, claimed there was ‘limited’ evidence of E484Q’s effect on immunity and vaccines. Lab studies have suggested it may be able to escape some antibodies, but to what degree remains uncertain.
How deadly is it? Scientists still don’t know for sure. But they are fairly certain it won’t be more deadly than the current variants in circulation in Britain.
This is because there is no evolutionary benefit to Covid becoming more deadly. The virus’s sole goal is to spread as much as it can, so it needs people to be alive and mix with others for as long as possible to achieve this.
And, if other variants are anything to go by, the Indian strain should not be more lethal.
There is still no conclusive evidence to show dominant versions like the Kent and South African variants are more deadly than the original Covid strain – even though they are highly transmissible.
Doctors in India claim there has been a sudden spike in Covid admissions among people under 45, who have traditionally been less vulnerable to the disease.
There have been anecdotal reports from medics that young people make up two third of new patients in Delhi. In the southern IT hub of Bangalore, under-40s made up 58 percent of infections in early April, up from 46 percent last year.
There is still no proof younger people are more badly affected by the new strain.
Should we be worried? Scientists are unsure exactly how transmissible or vaccine-resistant the Indian variant is because it hasn’t been studied thoroughly.
The fact it appears to have increased infectivity should not pose an immediate threat to the UK’s situation because the current dominant Kent version appears equally or more transmissible.
It will take a variant far more infectious strain than that to knock it off the top spot.
However, if the Indian version proves to be effective at slipping past vaccine-gained immunity, then its prevalence could rise in Britain as the immunisation programme squashes the Kent variant.
The UK currently classes the Indian strain as a ‘Variant Under Investigation’, a tier below the Kent, South African and Brazilian variants. But there are calls to move it up to the highest category.
Scientists tracking the constantly-evolving virus say it’s still not clear if India’s third wave has been caused by the variant, or if it emerged at the same time by coincidence.
On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, behind only the United States. India’s Health Ministry also reported another 2,771 deaths in the past 24 hours, with 115 Indians succumbing to the disease every hour. Experts say those figures are likely an undercount.
Inside hospitals, junior doctors say they are being treated as ‘cannon fodder’ and left to treat four or five times their usual number of patients while their more senior colleague – who are more at risk from the disease – stay off the front lines.
They say the government is paying them two months in arrears while forcing them to work day and night, even if they begin showing Covid symptoms.
Dr. Siddharth Tara, a postgraduate medical student at New Delhi’s government-run Hindu Rao Hospital, says he has been showing Covid symptoms since the beginning of the week but has been told to keep working until a test for the disease – which has been delayed due to the wave of infections – comes back.
‘I am not able to breathe. In fact, I’m more symptomatic than my patients. How can they make me work?’ asked Tara, who suffers from asthma.
The challenges facing India today, as cases rise faster than anywhere else in the world, are being compounded by the fragility of its health system and its doctors.
There are 541 medical colleges in India with 36,000 post-graduate medical students, and according to doctors’ unions constitute the majority at any government hospitals – they are the bulwark of the India’s COVID-19 response.
But for over a year, they have been subjected to mammoth workloads, lack of pay, rampant exposure to the virus and complete academic neglect.
‘We’re cannon fodder, that’s all,’ said Tara.
In five states that are being hit hardest by the surge, postgraduate doctors have held protests against what they view as administrators’ callous attitude toward students like them, who urged authorities to prepare for a second wave but were ignored.
Jignesh Gengadiya, a 26-year-old postgraduate medical student, knew he’d be working 24 hours a day, seven days a week when he signed up for a residency at the Government Medical College in the city of Surat in Gujarat state.
What he didn’t expect was to be the only doctor taking care of 60 patients in normal circumstances, and 20 patients on duty in the intensive care unit.
‘ICU patients require constant attention. If more than one patient starts collapsing, who do I attend to?’ asked Gengadiya.
Hindu Rao Hospital, where Tara works, provides a snapshot of the country’s dire situation. It has increased beds for virus patients, but hasn’t hired any additional doctors, quadrupling the workload, Tara said.
To make matters worse, senior doctors are refusing to treat virus patients.
‘I get that senior doctors are older and more susceptible to the virus. But as we have seen in this wave, the virus affects old and young alike,’ said Tara, who suffers from asthma but has been doing regular COVID-19 duty.
The hospital has gone from zero to 200 beds for virus patients amid the surge. Two doctors used to take care of 15 beds – now they’re handling 60.
Staff numbers are also falling, as students test positive at an alarming rate. Nearly 75 per cent of postgraduate medical students in the surgery department tested positive for the virus in the last month, said a student from the department who spoke anonymously out of fear of retribution.
Tara, who’s part of the postgraduate doctors association at Hindu Rao, said students receive each month’s wages two months late. Last year, students were given four months’ pending wages only after going on hunger strike in the midst of the pandemic.
Dr. Rakesh Dogra, senior specialist at Hindu Rao, said the brunt of coronavirus care inevitably falls on postgraduate students. But he stressed they have different roles, with postgraduate students treating patients and senior doctors supervising.
Although Hindu Rao hasn’t hired any additional doctors during the second wave, Dogra said doctors from nearby municipal hospitals were temporarily posted there to help with the increased workload.
India – which spends 1.3% of its GDP on healthcare, less than all major economies – was initially seen as a success story in weathering the pandemic. However, in the succeeding months, few arrangements were made.
A year later, Dr. Subarna Sarkar says she feels betrayed by how her hospital in the city of Pune was caught completely off guard.
‘Why weren’t more people hired? Why wasn’t infrastructure ramped up? It’s like we learnt nothing from the first wave,’ she said.
Belatedly, the administration at Sassoon Hospital said last Wednesday it would hire 66 doctors to bolster capacity, and this month increased COVID-19 beds from 525 to 700.
But only 11 new doctors have been hired so far, according to Dr. Murlidhar Tambe, the hospital’s dean.
‘We’re just not getting more doctors,’ Tambe said, adding that they’re struggling to find new technicians and nurses too.
In response to last year’s surge, the hospital hired 200 nurses on a contractual basis but fired them in October after cases receded. Tambe said the contract allowed the hospital to terminate their services as it saw fit.
‘Our primary responsibility is towards patients, not staff,’ the dean said.
Cases in Pune city have nearly doubled in the last month, from 5,741 to 10,193. To deal with the surge, authorities are promising more beds.
Sarkar, the medical student at Sassoon Hospital, says that’s not enough.
‘Increased beds without manpower are just beds. It’s a smokescreen,’ she said.
To handle the deluge, students at Sassoon said authorities had weakened rules meant to keep them and patients safe. For instance, students work with COVID-19 patients one week and then go straight to working with patients in the general ward.
This increases the risk of spreading infections, said Dr. T. Sundararaman of the University of Pennsylvania’s National Health Systems Resource Center.
Students want Sassoon’s administration to institute a mandatory quarantine period between duty in the COVID-19 and general wards.
Over the last month, 80 of the hospital’s 450 postgraduate students have tested positive, but they only get a maximum of seven days of convalescence leave.
‘COVID ruins your immunity, so there are people who are testing positive two, three times because their immunity is just so shot, and they’re not being allowed to recover,’ said Sarkar.
And after a year of processing COVID-19 tests, she says she knows everything there is to know about the virus, but little else. Nationwide, diverting postgraduate students to take care of virus patients has come at a cost.
At a government medical college in the city of Surat, students said they haven’t had a single academic lecture. The hospital has been admitting virus patients since March of last year, and postgraduate medical students spend almost all their time taking care of them. The city is now reporting more than 2,000 cases and 22 deaths a day.
Having to focus so heavily on the pandemic has left many medical students anxious about their future.
Students studying to be surgeons don’t know how to remove an appendix, lung specialists haven’t learned the first thing about lung cancer and biochemists are spending all their time doing PCR tests.
‘What kind of doctors is this one year going to produce?’ said Dr. Shraddha Subramanian, a resident doctor in the department of surgery at Sassoon Hospital.
Family members and ambulance workers in PPE carry the body of a victim who died of the Covid-19 coronavirus at a cremation ground in New Delhi
Crematoriums in Delhi are now working around the clock with parks, playgrounds and car parks converted into temporary pyre pits in order to deal with the number of people dying
Crematorium workers pile wood on top of bodies for burning at a cremation ground in New Delhi
Queues of desperate Indians wait in line for Covid vaccines in hard-hit Mumbai as doctors call on foreign countries to donate spare doses to help them out of the current crisis
Medics have accused Indian ministers of ‘complacency’ for donating Covid vaccines to neighbouring countries while not ramping up production to ensure domestic demand is met
People queue up to receive a dose of a Covid-19 coronavirus vaccine at a vaccination centre in Mumbai
Video take in Delhi showed a line of bodies waiting to be cremated (left) while pyres burned nearby (right). Staff are now working around the clock due to the wave of death caused by Covid
Patients rest inside a banquet hall temporarily converted into a Covid-19 coronavirus ward in New Delhi
An elderly woman suffering from Covid rests her head in her hand at a hospital in Delhi amid India’s Covid crisis
Cases and deaths are still soaring in India as the country suffers through the world’s worst second wave of Covid, with another 323,000 infections and 2,700 deaths reported today (pictured, a ward in New Delhi)
Hospitals are running desperately short on intensive care beds and oxygen to give to Covid patients, who are now dying at the rate of more than 100 per hour (pictured, a hospital in New Delhi)
Meanwhile the first emergency medical supplies trickled into Covid-stricken India on Tuesday as part of a global campaign to staunch a catastrophic wave in the latest pandemic hotspot, with the United States also pledging to export millions of AstraZeneca vaccine doses.
India’s infection and death rates are growing exponentially, overwhelming hospitals, in contrast to some wealthier Western nations that are starting to ease restrictions.
The virus has now killed more than 3.1 million people worldwide, with India driving the latest surge in global case numbers, recording over 350,000 new infections on Tuesday.
Crates of ventilators and oxygen concentrators from Britain were unloaded at a Delhi airport early Tuesday, the first emergency medical supplies to arrive in the country.
Dr Zarir Udwadia blamed ‘complacency’ for India’s current crisis, saying: ‘We let our guards down, and we were urged to by our leaders’
Elsewhere in the capital AFP images showed smoke billowing from dozens of pyres lit inside a parking lot that has been turned into a makeshift crematorium.
‘People are just dying, dying and dying,’ said Jitender Singh Shanty, who is coordinating the cremation of around 100 bodies a day at the site in the east of the city.
‘If we get more bodies then we will cremate on the road. There is no more space here.’
The United States, France, Germany, Canada and the World Health Organization have all promised to rush supplies to India.
President Joe Biden announced on Monday the United States would send up to 60 million doses of the AstraZeneca Covid-19 vaccine abroad.
White House spokeswoman Jen Psaki said the recipient countries had not yet been decided and that the administration was still formulating its distribution plan.
But India appeared to be a leading contender after Biden spoke with Prime Minister Narendra Modi – whose Hindu-nationalist government is under fire for allowing mass gatherings such as religious festivals and political rallies in recent weeks.
‘India was there for us, and we will be there for them,’ Biden tweeted after the call with Modi, referencing India’s support for the United States when it was enduring the worst of its Covid crisis.
World Health Organization chief Tedros Adhanom Ghebreyesus on Monday described the situation in India as ‘beyond heartbreaking’.
‘WHO is doing everything we can, providing critical equipment and supplies,’ Tedros said.
France also said it would send eight oxygen production units, as well as oxygen containers and respirators, to India.
However many nations have also sought to close borders to travellers from India, fearful of a variant that appears to be one of the drivers of the surge.
Australia on Tuesday became the latest nation to cut all passenger air travel with India, suspending flights until at least May 15.
Among the Aussies still in the country are a host of high-profile cricketers playing in the lucrative Indian Premier League, which has attracted criticism for continuing during the crisis.
Before the ban was announced, News Corp reported that batsman Chris Lynn of the Mumbai Indians had requested the Australia cricket board put on a chartered flight home for the players once the IPL finishes.
‘I know there are people worse off than us… We are not asking for short cuts and we signed up knowing the risks,’ Lynn said. ‘But it would be great to get home as soon as the event is over.’
Meanwhile the second wave has so overwhelmed crematoriums that grieving families are being forced to burn victims in their own gardens.
In Delhi, 348 deaths were recorded on Friday, one every four minutes, and in the southern state of Karnataka, the government has been forced to allow families to cremate or bury victims in their own farms, land or gardens.
Karnataka Chief Minister B. S. Yediyurappa said the situation was ‘out of control’, adding: ‘It is prudent to swiftly and respectfully dispose the body in a decentralised manner keeping in view the grieving circumstance and to avoid crowding in crematoriums and burial grounds.’
A construction entrepreneur from Bangalore told The Straits Times his family had to dig up their lawn to bury his father this week.
Bangalore’s seven crematoriums have been working 24 hours a day as they try to manage four times their normal workload.
Bookings for wooden pyres in Ghaziabad have run out and bodies are having to be burnt in the spaces between the platforms.
One electric furnace even broke down and had to be repaired due to its excessive use, while a chimney in another furnace cracked from the constant heat.
There are fears the situation could become even worse in the coming days, with senior virologists warning the second wave still has two weeks to run before it reaches the peak of 500,000 infections a day.
Shahid Jameel, director of biosciences at Ashoka University, said virus models suggest case numbers will continue to rise despite vaccination efforts.
The U.S. Chamber of Commerce on Monday warned that the Indian economy – the sixth largest in the world – could falter as a result of a record spike in coronavirus cases, creating a drag for the global economy.
Myron Brilliant, executive vice president of the Chamber, the biggest U.S. business lobby, said the risk of spillover effects was high given many U.S. companies use Indian workers to run their back-office operations.
‘We expect that this could get worse before it gets better,’ Brilliant told Reuters, citing a ‘real risk’ the Indian economy would falter given the circumstances.
‘There’s a big concern about the draft on the economy by a devastating, spreading virus in India.’
A health worker walks through a banquet hall temporarily converted into a COVID-19 ward in New Delhi
India’s current fatality rate per 100,000 cases is 1.14 per cent, meaning if the nation reaches this anticipated peak there is the potential for 5,700 deaths per day
A worker stands nexrt to beds during preparations to convert an indoor stadium into a Covid-19 ward in Srinagar
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