NEW DELHI — Shaukat Ali Shaikh worked as a doctor in India’s financial capital, tending to a stream of patients inside a small clinic at a busy train station. But when the pandemic came for him, he couldn’t get admitted to a hospital.
The first hospital he went to told Shaikh, feverish and laboring to breathe, that it couldn’t admit him because he did not have a confirmed case of the novel coronavirus. The next hospital was full. A close friend called five more, searching for a bed in an intensive care unit. All full.
By the time Shaikh was admitted at a hospital through a personal connection late on the night of June 5, his condition had deteriorated, his nephew said. The 44-year-old father of three died less than 48 hours later. His coronavirus test result came back around the same time: positive.
As India battles a growing number of coronavirus cases, its health-care system is starting to buckle. Some patients are facing a desperate struggle to access treatment: Government hotlines fail to respond, testing can take days and hospitals are full.
The situation is especially dire in Mumbai, the epicenter of the country’s outbreak. Home to more than 12 million people, Mumbai had just 14 intensive-care beds available for patients with COVID-19, the disease caused by the coronavirus, as of Friday. The other 99 percent of such beds were full.
Delhi, India’s capital city, is also facing a looming shortage of beds. Earlier this week, Delhi’s chief minister said coronavirus cases in the city could skyrocket from the current 35,000 to more than 500,000 by the end of July. That means Delhi will need 80,000 hospital beds for COVID-19 patients, he said – about 10 times the number available now.
“There is a tsunami of trouble,” said Vishal Chopra, a doctor who specializes in diabetes treatment in Mumbai. “And your system was never built to handle a tsunami.”
The Washington Post interviewed four families in Mumbai and Delhi who recounted how overburdened hospitals had turned away their sick relatives in recent weeks, saying they had no room. All four people ultimately died. Such stories are no longer uncommon, appearing with regularity in newspapers and on social media.
The surge in coronavirus cases comes weeks after India began dismantling what was one of the world’s most stringent lockdowns. The measure slowed the spread of the virus but did not reverse the trend of rising cases. In the meantime, it exacted an enormous human and economic cost in this nation of more than 1.3 billion people.
India and two of its neighbors – Pakistan and Bangladesh – concluded that the cost of such lockdowns was too high to bear. With the restrictions withdrawn, cases are rising quickly in all three countries, turning South Asia into a new hot spot for the pandemic. Global health officials have expressed alarm at the current course of the virus in the region: Earlier this week, the World Health Organization urged Pakistani authorities to implement “intermittent lockdowns” to rein in the spread of infections.
In India, the government has mandated mask-wearing and counseled physical distancing. It has not indicated if or when it believes infections will peak, except to say that moment is still “far away.” Even as India’s total number of cases has soared to around 300,000 – the fourth-highest in the world – senior health officials have refused to acknowledge that community transmission is underway.
Compared with the United States and some countries in Europe, India has recorded relatively few deaths in the pandemic. About 8,500 people here have died of COVID-19. Half of those deaths have occurred in the last three weeks, a sign of the rapid spread of the virus and the increasing pressure on an already weak health-care infrastructure.
Government spending on health care in India is equivalent to just over 1 percent of its gross domestic product, far lower than the global average. Before the pandemic hit, India had only 0.5 hospital beds per 1,000 people, according to data from the Organization for Economic Cooperation and Development, compared with 3.2 in Italy and 12.3 in South Korea. It also suffers from a chronic shortage of medical personnel.
Now, authorities across the country are scrambling to build capacity as cases rise, turning stadiums, banquet halls, hotels and unused train cars into field hospitals or isolation facilities. In Mumbai, authorities have asked for medical personnel from other parts of the state and other parts of India to help in the effort.
Deepak Baid, a physician in Mumbai who oversees a ward for 100 COVID-19 patients in a government-run hospital, said many hospitals are already severely short-staffed. Some employees are either afraid to come to work or unable to get there due to transportation issues as the lockdown is gradually withdrawn, he said.
His unit is nearly always full, Baid said, and the main thing it can offer patients is oxygen. Sometimes it is forced to take care of patients who need intensive care because of a dearth of such beds. The most difficult part, he said, is when patients arrive with critically low levels of oxygen in their blood. They “become unconscious gradually,” he said, “and we can’t do much about it.”
Chopra, the diabetes specialist, said he is seeing about 50 patients a day and at least 20 percent of them are testing positive for coronavirus. Some recover on their own at home, but for those who require more care, arranging a hospital bed is “practically getting impossible now.” Four of his patients, all senior citizens, have succumbed to the virus in recent weeks.
They include Viren Jadhav’s father, an 80-year-old former banker with diabetes and heart disease, who came down with a fever and diarrhea last month. The family tried to get him admitted to Dr L H Hiranandani Hospital in Mumbai. Jadhav said he was told that a coronavirus test was required for admission – and that getting a result could take 48 hours.
On May 14, a day after it collected a sample, the hospital called Jadhav to pick up his father’s test: positive. But it had no beds available. Jadhav said his family called more than 20 hospitals, both private and government-run, to see if they could admit his father. None would confirm they had room, he said.
By the time Jadhav’s father was admitted to the publicly run SevenHills Hospital in Mumbai, his blood-oxygen level was dangerously low. The facility had a bed, but no space in its intensive care unit, Jadhav said. The next day, an ICU bed opened up, but it was too late: Vinayak Jadhav died two hours later.
His father lost crucial time, Jadhav said. “You know that he is deteriorating,” he said. “Why are you waiting?”
Sujit Chatterjee, the chief executive officer of Hiranandani Hospital, said that admission to the facility depends on the availability of beds and that in Jadhav’s case, none were available. A representative of SevenHills Hospital did not respond to requests for comment.
The outlook is rapidly worsening in Delhi as well. Anil Goyal runs a bicycle repair shop in the city. His 75-year-old father, Motiram, tested positive for the coronavirus on May 30 while receiving treatment for a separate neurological ailment. The hospital treating him advised the family to transfer Motiram immediately to a facility for COVID-19 patients.
From morning until night, Anil, 55, together with his son and his brother, tried to find a bed with a ventilator in at least six such hospitals, both private and government-run. “All the hospitals turned us away,” said Anil. The family petitioned the Delhi High Court for help, but to no avail. His father died on June 2, the same day the legal brief was filed. Anil believes his father might “have survived had he received treatment at the right time.”
Zuber Shaikh, the nephew of Shaukat Ali Shaikh, the doctor, thinks his uncle would have lived if the second hospital they visited that fateful afternoon had not been full. He was the sole breadwinner in his family and leaves behind a wife and three children ranging in age from 5 to 16. His eldest daughter is due to take the nationwide exam for a spot in the country’s medical schools next month.
“We are told to respect the front-line warriors like doctors, nurses, policemen,” said Zuber Shaikh. But the hospitals “couldn’t save one of their own.”
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The Washington Post’s Tania Dutta contributed reporting.