For the family of the retired diplomat in Gurgaon, India, the terror struck as they tried desperately to get him past the entrance of a private hospital. For the New Delhi family, it came when they had to create a hospital room in their first-floor apartment. For the son of an illiterate woman who raised her three children by scavenging human hair, it came as his mother waited days for a bed in an intensive care unit (ICU) in Bengaluru.
Three families in a nation of 1.3 billion people. Seven cases of COVID-19 in a country facing an unparalleled surge, with more than 300,000 people testing positive every day.
When the pandemic exploded in India early last month, each of these families found themselves struggling to keep relatives alive as the medical system neared collapse and the Indian government was left unprepared.
Illustration: Mountain People
Across India, families scour cities for COVID-19 tests, medicine, ambulances, oxygen and hospital beds. When none of these can be found, some people have to deal with loved ones being put into body bags.
The desperation comes in waves. New Delhi was hit at the start of last month, with the worst coming near the end of the month. The southern city of Bengaluru was hit about two weeks later. The surge is at its peak in many small towns and villages, and just reaching others.
However, when a pandemic wave hits, everyone is on their own, regardless of whether one is rich or poor. Wealthy businessmen fight for hospital beds and powerful government officials write pleas on Twitter begging for oxygen. Middle-class families scrounge for wood to make funeral pyres, and in places where there is no wood to be found, hundreds of families have been forced to dump their relatives’ bodies into the Ganges River.
Rich and well-connected people, of course, still have money and contacts to smooth the search for ICU beds and oxygen tanks. Regardless, availability is limited, meaning that rich and poor alike have been left gasping for breath outside overflowing hospitals.
“This has become normal,” said Abhimanyu Chakravorty, whose New Delhi family frantically tried to arrange his father’s medical care at home. “Everyone is running helter-skelter, doing whatever they can to save their loved ones.”
Yet every day, thousands more people die.
THE CHAKRAVORTY FAMILY, NEW DELHI
COVID-19 tests. That is all the family wanted after a slight cough had spread from relative to relative.
However, in a city where the virus had descended like a whirlwind, even that had become difficult.
First they called the city’s top diagnostic labs. Then the smaller ones. They called for days.
The first-floor apartment, in an affluent neighborhood with a tiny garden and a spreading hibiscus tree in bloom, has been home to the Chakravorty family for more than 40 years.
There lives 73-year-old Prabir, the family patriarch and widower, a construction executive who has long ignored his family’s pleas to stop working, and his two sons, Prateek and Abhimanyu. Prateek Chakravorty, who runs an air-conditioning company, shares a room with his wife, Shweta, and their seven-year-old son, Agastya. Rounding out the clan is Prabir Chakravorty’s sister, Taposhi, and her adult son, Protim.
They tried to isolate as best they could, seven of them retreating to corners of the three-bedroom apartment, and kept calling testing centers.
It was not supposed to be like this.
In January, Indian Prime Minister Narendra Modi declared victory over COVID-19. In March, the health minister claimed that the country was in the pandemic’s “endgame.”
By then, medical experts had been warning for weeks of an approaching viral wave. The government ignored them, allowing the immense Kumbh Mela religious festival to go ahead, with millions of Hindu devotees gathering shoulder-to-shoulder along the Ganges River. Hundreds of thousands also turned out for state election rallies.
The Chakravorty family, like most Indians, had not expected the situation to grow so bad. Certainly not in the capital, which has much better medical care than most of the country, and where those with money have access to private hospitals.
Finally, Shweta Chakravorty found a lab that administered tests. A man inside arrived in head-to-toe protective clothing to swab everyone. He told them wearily that it seemed as though everyone in this city of 29 million people needed tests.
The family had their first scare the next day, when a weakened Prabir Chakravorty nearly fell and his sons had to carry him to bed. Stomach problems and a raging fever kept him there.
“He was visibly shaking,” said Abhimanyu Chakravorty, a 34-year-old news editor.
They received the results three days later. Four members of the family tested positive, with a few losing their senses of taste and smell, but it was far worse for Prabir Chakravorty.
Prateek Chakravorty struggled to find a doctor for his father. One would not answer the phone, another had his own emergency.
Finally, a relative in Thailand contacted a friend, a New Delhi doctor, who said that a chest CT scan would be required.
Prateek Chakravorty ventured out at the end of last month to find a lab in a scarred city, with roads empty except for ambulances and oxygen tanker trucks. The scan confirmed their fears: Prabir Chakravorty had pneumonia. Doctors warned the family to be extremely watchful.
Their worries deepened every night, when Prabir Chakravorty coughed relentlessly and his blood oxygen levels dropped dangerously.
“It was an alarm bell,” Abhimanyu Chakravorty said.
PADMAVATHI’S FAMILY, BENGALURU
In a small community of homemade huts, a short walk from one of Bengaluru’s wealthiest neighborhoods, one woman’s sore throat was turning into breathing problems.
The people in this community are at the bottom of India’s caste ladder, “rag pickers” who support themselves by collecting the city’s waste and selling it to recyclers.
Shunned by most Indians, they are an informal, although pivotal, part of the urban infrastructure. India is among the world’s largest waste producers, and a city such as Bengaluru — the Silicon Valley of India — would drown in its own trash if not for them.
Yet when vaccines began to be distributed, with essential workers at the front of the line, they were left off that list.
Some people collect newspapers in the little community. Some pick through dumps. Some specialize in metal. Padmavathi, who uses one name, collected hair, taking it from women’s combs and hairbrushes to later be used for wigs. She earned about US$50 a month.
It is a life along the fringes, but Padmavathi, who never went to school and whose name translates from Sanskrit as “She who emerged from the lotus,” made it work.
“She was very pushy about our education,” said her son, Gangaiah, a community health worker for a nonprofit group.
However, her eldest daughter had to drop out of school in sixth grade when Padmavathi ran out of money. Gangaiah only made it to seventh grade.
Padmavathi’s youngest is a seventh-grade daughter who earned a scholarship and lives in a private school dormitory across town.
Padmavathi shares a one-room hut made from bamboo and plastic sheeting with Gangaiah, his wife and their two children.
Gangaiah’s work in healthcare meant he could quickly get Padmavathi tested when her symptoms started on May 1. He had access to an oximeter to test his mother’s blood oxygen level.
However, when those levels began to drop, he could not get her into a hospital. Working with colleagues in the nonprofit, he began calling. Again and again he was told every bed was taken.
By the fifth day, with Padmavathi’s oxygen levels dangerously low and her breathing sometimes coming in gasps, Gangaiah’s colleagues finally found a bed.
She left the neighborhood unconcerned.
“I’ll be back soon. Don’t worry,” she told her neighbors.
The hospital had oxygen, but everyone said she needed to be in an ICU on a ventilator. That was impossible.
“It was sheer helplessness,” Gangaiah said.
THE AMROHI FAMILY, GURGAON
Ashok Amrohi thought it was just a cold when he began coughing last month. After all, the retired diplomat and his wife had been fully vaccinated against COVID-19.
A medical doctor before joining the diplomatic corps, Amrohi had traveled the world. He had been an ambassador to Algeria, Mozambique and Brunei, and had retired to Gurgaon, a city just outside the capital, to live a life of golf and piano lessons. He was a respected, highly educated member of the upper-middle class.
He was someone who, in normal times, could easily get a bed in the best hospitals.
Amrohi’s fever soon disappeared, but his breathing became labored and his oxygen levels dropped. It appeared to be COVID-19. His wife, Yamini, reached out for help. A sister who lived nearby found an oxygen cylinder.
The situation seemed manageable at first, and they treated him at home.
“I was always with him,” Yamini Amrohi said.
Regardless, his oxygen levels kept dropping.
If his condition worsened even a little more, his family would have no idea how to respond.
As Prabir Chakravorty’s condition also worsened, his family reluctantly decided he needed to be hospitalized.
First, they tried a government-run mobile app showing the city’s available beds. It was not functioning. So, Prateek Chakravorty went searching on his own.
The first three hospitals he visited were private, costly facilities built for India’s growing population of newly wealthy people. They were full.
He then went to the massive 1,200-bed public field hospital built in June last year in a leafy New Delhi neighborhood. The hospital was closed in February when cases fell in north India, and frantically reopened last month as cases surged.
Outside the hospital entrance, Prateek Chakravorty found dozens of people begging staff to admit sick family members. Some were openly offering bribes to cut the line, others were slumped on the floor, breathing from oxygen bottles.
Worried families were waiting under a nearby canopy for any news about loved ones inside. Some had not seen their relatives in weeks.
The military doctors running the facility, who were refusing the bribes, were working frantically. They had little time for patient comfort, let alone worried relatives.
Prateek Chakravorty was stunned at the scene.
“My body trembled,” he said.
Beneath the canopy, he met a sobbing young man whose father had died and been taken away for cremation.
In the chaos, ID numbers attached to some corpses had been mixed up, and the wrong body was carted off for cremation. His father’s body was lost inside the complex, where death had become mundane.
At that moment, Prateek Chakravorty decided that this hospital was not an option.
“We will do what we can at home,” he said.
Earlier this month, an ICU bed finally opened up for Padmavathi, whose condition was clearly deteriorating.
“She kept telling other people that she’d soon be fine,” Gangaiah said.
Padmavathi was a fighter, and knew how hard India could be on the least fortunate. She had grown up in a family so poor that they often did not have enough food, and she was a traveling laborer by the time she was seven. She married at 14 and raised three children alone after her husband abandoned her.
Padmavathi buried her sadness in work, her son said.
“She was a sad person, but she would hide her melancholy from us,” Gangaiah said. “She sacrificed everything she had for us. Her struggle to feed us and raise us consumed all her time.”
Joy only came when her oldest daughter and Gangaiah had children.
“She was so happy. Perhaps the only time we saw her happy in a real sense,” he said.
She was also a force in the neighborhood, helping other women with their troubles, and fighting to ban the cheap and sometimes poisonous homemade liquor that kills hundreds of poor people in India every year.
In the hospital that night, none of that mattered.
A few hours after being transferred to the ICU, amid the noise of medical machinery, Padmavathi died. She was 48 years old.
Gangaiah was waiting outside when it happened.
“I cried bitterly,” he said. “I had hardly seen my father’s love and care. She was both my parents.”
He was furious.
“We also knew from experience that the government is for rich people and the upper castes, but we always nurtured this belief that at least hospitals will cater to us in our time of need,” he said. “It turned out to be an utterly fake belief, a lie.”
At the Amrohi apartment, the former ambassador’s family was calling his medical school classmates for help. One eventually arranged a bed at a nearby hospital.
The brutal north-Indian summer was coming on by late last month. Temperatures that day reached nearly 40°C.
His wife, Yamini, and their adult son Anupam put him into the family’s car.
They arrived at about 7:30pm and parked in front of the main doors, thinking that Ashok Amrohi would be rushed inside. They were wrong. Admission paperwork had to be completed first and the staff was swamped. So they waited.
Anupam Amrohi stood in line while his mother stayed in the car with her husband, who was breathing bottled oxygen. She blasted the air-conditioning, trying to keep him cool.
An hour passed. Two hours. Someone came to swab Ashok Amrohi for a COVID-19 test. It came back positive. His breathing had grown difficult.
“I went thrice to the hospital reception for help,” she said. “I begged, pleaded and shouted at the officials, but nobody budged.”
At one point, their daughter called from London, where she lives with her family. With everyone on a video call, their four-year-old grandson asked to talk to his grandfather.
“I love you, Poppy,” the boy said.
Ashok Amrohi pulled off his oxygen mask: “Hello. Poppy loves you too.”
Three hours passed, then four hours.
Anupam Amrohi returned regularly to the car to check on his father.
“It’s almost done,” he would tell him each time. “Everything is going to be alright. Please stay with us.”
Five hours had now passed and it was a little after midnight, Ashok Amrohi grew agitated, pulling off the oxygen mask and gasping. His chest heaved. Then he went still.
“In a second he was no more,” Yamini Amrohi said.
“He was dead in my arms,” she said.
She went to the reception desk.
“You are murderers,” she told them.
Prateek Chakravorty returned from the field hospital and told his family about the nightmare there. All agreed that Prabir Chakravorty would be treated at home, in a three-story building where the brothers grew up. It is where they returned to after evenings playing soccer. It is where they spent India’s months-long lockdown last year, glad to be together.
Now it was where they had to help their father breathe.
For rich countries, oxygen is a basic medical need, like running water. Last year, Indian authorities had to order most of the country’s industrial oxygen producers to switch to medical oxygen.
It was nowhere near enough for the surge’s ferocity. Hospitals went on social media, begging the government for more oxygen. The government responded to social media criticism by ordering Twitter to take down dozens of tweets.
The Chakravorty family decided their best bet was an oxygen concentrator. Unaffordable to most Indians, with prices reaching US$5,500, concentrators remove nitrogen from the air and deliver a stream of concentrated oxygen.
They reached out to friends, relatives and business colleagues in their efforts to find one. This is how things now work now in India. With the formal medical system barely functioning, tight networks of family, friends and colleagues, and sometimes the generosity of complete strangers, often save many from death.
Informal volunteer networks have germinated to reuse medical equipment and look for hospital beds. The black market thrives, charging astronomical prices.
A friend responded to their the family’s plea. Sougata Roy knew someone in Chandigarh, a city in the Himalayan foothills about a five-hour drive away, who had a machine and was not using it. He offered to get it.
Roy arrived on April 27 with the machine and instructions. On April 29, the family found someone to care for their father. He was not a trained nurse, but had experience treating COVID-19 patients at home.
Prabir Chakravorty’s signs of improvement were slow, but the family grasped at them, overjoyed when he could eat a little boiled chicken. They celebrated quietly each time his oxygen levels were good, knowing they were lucky to have the resources to treat him at home.
“It was hell,” Prateek Chakravorty said, remembering the worst two weeks. Slowly, though, the family’s optimism grew.
May 7 was Prateek Chakravorty’s birthday. Prabir Chakravorty looked brighter, and the relieved family decided to celebrate. They ordered chocolate cake from a nearby bakery.
Prabir Chakravorty did not want any, but for the first time in weeks, he was craving something sweet. He settled for a cookie.
The horror did not end with the ambassador’s death.
Ashok Amrohi’s body, sealed in a plastic bag, was taken by ambulance the next morning to an outdoor cremation ground.
Cremations are deeply important in Hinduism, a way to free a person’s soul so it can be reborn elsewhere. A priest normally oversees the rites. Family and friends gather. The eldest son traditionally lights the funeral pyre.
However, when the Amrohi family arrived at the cremation ground, a long line of ambulances was in front of them. Beyond the gate, nine funeral pyres were blazing. Finally, Anupam Amrohi was called to light his father’s pyre.
Normally, families wait as the fire burns down, paying their respects and waiting for the ashes, but immense fires burned around the Amrohi family. The heat was crushing. Ashes filled the air.
“I have never seen a scene like that,” Yamini Amrohi said. “We couldn’t stand it.”
They returned to their car, waited until they were told the body had been cremated, and drove away.
Anupam Amrohi returned the next morning to collect his father’s ashes.
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