The Statesman 5 May
The Indian public is trying to cope with the gravest medical crisis in recent history. There is an acute shortage of hospital beds and oxygen, leading to a high fatality rate among Covid patients. Everywhere, people are grieving over the loss of loved ones and there is palpable anger at the lack of preparedness. These shortages which hinder treatment and cost lives make even doctors feel very helpless. Over and above their medical duties, doctors find themselves being pulled in different directions. They are having to get involved in chores such as sourcing scarce oxygen supplies and to get multiple forms signed from relatives. These protect them from liability not related to medicine – such as medicine stocks running out or ICU beds not being available.
Where they were once able to offer comfort and reassurance to most people, they themselves are at their wits’ end. They feel very uncomfortable at having to ask prospective patients to come for admission with their own medicines and cylinders. Outside, at the hospital gates, people wait expectantly, hoping a miracle will happen and an empty ICU bed will surface. Such miracles are rare.
Many people don’t make it to the inside of a hospital and breathe their last on the roadside. Even crematoriums are overburdened and have run out of space. The new mutated virus strain in this wave is causing a lot more medical uncertainty as it is not easily detected anymore. Because the Rt-Pcr tests were designed on the genome of the original strain, they are often not able to detect the presence of the new virus.
Could the virus be having a dormant form like the Varicella Zoster virus (Chicken pox, – which rests in various nerve ganglia and gets active producing shingles years later), when the host immunity is lower or the environment conducive? Maybe this form erupts suddenly once its gestation cycle is complete. Who knows? In India, this massive outbreak has occurred just when the beautiful flowers of spring were blossoming everywhere.
Echoing Darwin’s theory, the virus is trying to survive, by evolving. Whereas evolution in contemporary species is slow, this virus seems to be doing so at supersonic speeds. It also now seems to be taking a faster route to its target organ of choice, the lungs, bypassing the nose and throat areas. And it has cast its net over a much wider area.
We see so many younger people getting infected with Covid compared to the ancestral strain which largely spared the young and healthy. Matching this uncertainty are various man-made ones. There is uncertainty about the availability of vaccines and their efficacy against newer strains. The data on the disease is not fully reliable or transparent. It does not seem to accurately reflect ground realities.
For example, in many instances, the official death toll has been starkly different from the crematorium records by a factor of 20-25 on some days. Due to this patchy data, it becomes difficult to formulate and test various medical hypotheses.Yet, in the midst of this absolute pandemonium caused by the stealthy attack of the virus, there is a group of people carrying on with their lives with an enviable certainty as if nothing of import has happened.
We have an international cricket league tournament going on towards which already meagre resources are being diverted. People fly off on exotic holidays and post vacation snaps even as journalists post pictures of a profusion of pyres and lines of waiting ambulances.
We have seen elected representatives host crowded public religious events and address large election rallies, totally unmindful of the fact that this can help propagate the virus and spread sickness and death countrywide. This indifference is strange, coming as it does after a severe round of suffering caused by the first wave of the pandemic last year.
Can we really live in a bubble, impervious to what is happening around us? We have suggestions from people to stay happy even as the world around us collapses. Of these, some sensitive souls are truly well meaning. Some others do not want to face reality, and want to bury their heads in the sand. A third group wants to hide reality and diffuse public anger. It may be most healthy to allow feelings and moods to play out in people in their own natural way.
Hiding rage and grief beneath an artificial veneer of inappropriate cheerfulness may adversely impact minds already traumatized with worry and sorrow. A false sense of security may also cause people to lower their guard. Accepting harsh reality may render us better placed to deal with it. Far worse than callousness, are those trying to profiteer from the grim situation.
We have medical vendors who are building up their personal fortunes by selling oxygen cylinders and medicines at highly inflated prices, while people desperately fight to save their loved ones. We even have priests who have hiked rates fourfold for performing the last rites of the deceased. For immediate redressal of the black marketing in medical commodities, the answer is likely very straightforward – the products should be made freely available.
A simple regulation can be made for suppliers and chemists to not sell more than a limited amount to an individual buyer to ensure a more equitable distribution and pre-empt hoarding. The huge amounts of foreign aid in the form of medical supplies coming into India from countries all over the world needs to be transparently documented by customs and distributed to the most vulnerable. The public will feel very reassured if they can track the life-saving goods directly.
Not everything, however, can be painted black. We are also witnessing models of selflessness. People rallying round to help others. There is a sea of concerned humanity, people sharing resources with each other- literally saving lives and stepping in wherever the need arises. Gurdwaras have been at the forefront of providing free oxygen to the community and NGOs are back in action distributing free meals.
Despite having faced severe scrutiny and an acute depletion of funds due to complex regulatory laws, NGOs have still bounced back. Even in an extremely weakened state they are standing tall and inspiring everyone with their work ethic and abundant social responsibility. In fact, in his public address on combating Covid, a prominent leader appealed chiefly to civil society groups and NGOs to help turn the tide. What would undoubtedly add punch to this effort would be for the leaders to themselves lead by example – in terms of wearing masks and ensuring distancing when addressing the public.
The pandemic has brought out both the generous as well as the selfish sides of humans – ‘the good, the bad and the ugly’ as the title of a popular Western movie goes. In this macabre dance for survival, hope springs eternal that it is the human species that survives. That it can mutate into a superior species after its literal trial by fire. Our fervent hope is that the new human variant can live in a responsible manner and in greater harmony with each other and with nature. Apart from healthcare resources, what human behaviour patterns prevail may well decide the fate of mankind during and after this pandemic.
(The writer is a Delhi-based medical practitioner)
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