- فيكاس بندی
- BBC News – Delhi
Most hospitals in Delhi and many other cities in India have run out of beds, forcing people to find ways to get treatment for the sick at home. But even that is a difficult task with the high prices of oxygen cylinders, capacitors and basic medicines on the black market.
Here are some of the stories I learned about.
Find an oxygen cylinder
Ancho Priya spent most of her Sundays looking for an oxygen cylinder as her fever continued to worsen. She did not find any beds in a hospital in Delhi or the suburb of Noida. Her search for an oxygen cylinder in the stores did not succeed, so she was forced to turn to the black market.
Ancho Priya paid a whopping 50,000 rupees ($ 670) to buy a black market cylinder, which in normal times costs just 6,000 rupees.
Her mother-in-law is also struggling to breathe, and Anshu is worried about her now. It says it may not be able to purchase another disc on the black market.
The BBC contacted several suppliers of oxygen cylinders and most of them asked for at least 10 times the normal price.
And Ancho’s difficulties are not unique. Hospitals have run out of beds in many cities, including Delhi, Noida, Lucknow, Allahabad and Indore, which has made families dependent on makeshift home arrangements.
The situation has become dire, especially in Delhi, where there is no longer a single intensive care bed. Affordable families hire nurses and see doctors remotely to keep their loved ones breathing.
India has reported more than 300,000 cases within days, setting new world daily records. Monday, the largest number of cases of Coronavirus infection was recorded for the fifth consecutive day, as it reported 353,991 new infections, and 2,812 other deaths in the previous 24-hour period.
Indians also struggle to get blood tests for loved ones, CT scans or X-rays.
And the laboratories were exhausted due to the increase in the number of cases, and it took about three days for the results of the tests to appear. This makes it difficult for doctors to assess disease progression. Doctors also use CT scans to evaluate a patient’s condition, but it takes days to get an appointment for an examination.
Doctors say this delay puts many patients at risk. There are many patients who found beds but were not accepted because they had no report of COVID-19.
Remdisfer from the black market
This is the story of another patient.
Anuj Tiwari hired the services of a nurse to help treat his brother, after they had to be treated at home, after he was refused admission to several hospitals.
Hospitals said they did not have free beds, and another said they were not receiving new patients due to their uncertainty about the arrival of oxygen supplies.
A number of patients in Delhi have died due to insufficient oxygen supply. City hospitals are becoming desperate, and some are issuing daily warnings, saying they have only a few hours of oxygen left. Then the government moves in and sends out tanks, which are often only enough to operate the hospital for a day.
A doctor in Delhi said this is the way hospitals operate and “there are real fears now of a great tragedy.”
Given what was going on in hospitals, Tiwari had to pay a hefty sum to buy a condenser, which could extract oxygen from the air, in order to keep his brother’s breathing. The doctor also asked him to bring the anti-viral drug Remdisfer, which has received approval for use in emergency situations in India, and doctors prescribe it widely to patients. The benefits of the drug, which was originally developed to treat Ebola, are still being discussed around the world.
Tiwari could not find the drug in any drugstore, and eventually turned to the black market. His brother’s condition is still critical. The treating doctor says that he may soon need to be transferred to a hospital where remdesivir can be used.
“There are no beds. What am I going to do? I can’t even take him anywhere else because I have already spent a lot of money, and I don’t have much left,” Tiwari said.
He added that “the desperate battle to save Covid patients has shifted from hospitals to homes,” and even this has become an arduous task as “we do not have ways to easily obtain oxygen.”
Remdesivir is so in short supply that families of home-treated patients are scrambling to get it. They want to have the medicine so if the patient is allowed to go to the hospital, the medicine is with him if he needs it.
The BBC spoke with a number of black market dealers, and they said that supplies were scarce, which is why they were demanding such high prices. The government allowed seven companies to manufacture remdesivir in India, and were required to increase production.
However, the government did not fulfill its promises to provide adequate supplies. Epidemiologist Lalit Kant says the decision to increase production was taken too late, and that the government should have been prepared for the second wave.
“But the drug is somehow available on the black market, so there is some leakage in the supply system, which the regulators have been unable to block,” he says.
“We didn’t learn anything from the first wave,” he said.
Another drug that is in great demand is tocilizumab. This drug is commonly used to treat arthritis, but studies have shown that it can reduce the severity of a patient’s need to use a ventilator.
Doctors often prescribe medication for severely ill patients. But the drug has disappeared from the market. India’s Cipla, which imports and sells the drug, is struggling to meet the soaring demand.
Typically, a 400 mg bottle costs around Rs 32,480. But Kamal Kumar paid 250,000 rupees to buy a single dose for his father. He said the price was “mind-boggling” but that he had no other choice but to pay.
Many in India cannot afford to pay the price, and merchants exploit their desperate desire to save loved ones. Public health expert Anant Bhan says the government should have bought the drug in huge quantities.
He adds, “Many cannot pay the official price of the drug, let alone the black market prices. This indicates the lack of planning and the government’s failure to anticipate and prepare for the wave.”
“People have been left to face their fate.”
A fake remdesivir has appeared on the black market. When the BBC interviewed a merchant about the fact that the drug he was offering appeared to be counterfeit, because the company that manufactured it was not on the list of companies licensed to produce it in India, he replied that it was “100 percent original.”
The packaging was also full of misspellings. But he shrugged and asked me to test it in any lab. The company has no online presence.
But it is this desperation that makes people willing to buy even questionable drugs. Some people have been cheated too. People are constantly exchanging phone numbers for suppliers who can provide anything from oxygen to medicines. But we were unable to verify all of these numbers.
An IT worker, who did not want to be named, said he desperately needed to buy an oxygen cylinder and remdesivir, and that he got the start of a thread from Twitter. When he contacted the person concerned, he asked him to deposit 10,000 rupees in down payment.
He added, “After sending the money, the person blocked my number, so I could not communicate with him.”
Despair drives people to trust anything in need, and this appears to be fueling the black market. Several local governments in some states promised to combat the black marketing of remdesivir, and to arrest some people. But the black market appears unperturbed.
Tiwari says people like him have no choice but to pay more.
“It seems you cannot be treated in hospitals, and now you cannot save your loved ones even at home.”