Covid in India

I have just returned from a visit to my family in India. It was hard to escape.

To get to the US from India, I needed a covid test. The Indian government has seriously restricted who can provide covid testing, treatment, and vaccination. Private doctors and hospitals that are not approved face brutal legal consequences if they provide covid treatment.

Emergency powers were centralized early last year in the hands of the Indian Prime Minister, Narendra Modi. He gave himself direct control over the bureaucrats of the states, making the local governments largely impotent and dependent on him.

Self-centeredness, apathy, a dog-eat-dog environment has come to the surface. The scavengers are out in full force.

In their supreme wisdom, the government thought that because the prefix “covid-” exists in treatment, vaccination, and testing, they must be done at the same place. For my test, I sat in a petri dish of covid, with those coming out positive sitting right next to me. Desperate, vulnerable old people who merely wanted to get their jabs sat among us. Those who were sick for reasons other than covid were among us too, for the government has required everyone sick to be first tested for covid.

A microcosm of how everything is done in India, the tests were given haphazardly, with samples getting mixed up, the nurses spending most of their time fighting among themselves, and — lacking a system of the lineup — people crowded together, pushing and breathing into the mouths of one another.

A few days earlier, the government had notified the rates of tests and further restricted where they could be done. A bribe-taking system would have been my preference to bypass government restrictions, but no such system has yet evolved. Nevertheless, corruption has exploded, and self-centeredness, apathy, a dog-eat-dog environment has come to the surface. You see this everywhere; the scavengers are out in full force.

I had gone to a private covid hospital. The situation in government hospitals is far worse, out of my capacity to handle it.

Yet the story of covid in India is hardly about covid, which is nothing more than a trigger. More than twice as many people died of the easily treatable tuberculosis in 2020 than of covid. This, instead, is a story of foolish rulers, completely hollowed out institutions, and a pathetically irrational and tribal society.

The lockdown that India declared in March 2020 was the world’s most atrocious. It was a nationwide curfew, with no one allowed to leave home, not even for grocery shopping. The police destroyed grocery shops that dared to open. It took the government a couple of days to realize that people needed to buy food — the original decision had been a shot from the hip, completely unthought through. During the four-month curfew, the police ruthlessly beat up people, particularly those who looked poor. Trains, flights, and all transportation had come to a complete, grinding halt.

This is a story of foolish rulers, completely hollowed out institutions, and a pathetically irrational and tribal society.

Allowed to restrict and abuse others, many people relished it no end, doing so by being do-gooders with the support of the law, inflicting pain on those who did not resist and taking the sorry results in stride. They then experienced an elevated, sadistic, perhaps sexual pleasure. As always, the exploiter and the exploited were two sides of the same coin, though forever interchangeable — the reason why India never finds an escape from its drudgery.

When people were allowed to go out grocery shopping, the government required shops to open for limited hours each day, as if the virus were more dangerous at other hours. This led to overcrowding — so the opening hours were further restricted! Soon the shops were instructed to open only a limited number of days each week. After a year of this policy, the government is still unsure why crowding has continued to worsen.

The country has actually been barricaded, making it look like a warzone, with many roads and highways wholly closed off. The remaining streets have only one side open for both-ways traffic leading, to many head-on collisions. The barricades are not fluorescent, a technology that Indian safety experts have yet to appreciate.

Train services are minimal, and at airports, only very limited security lineups are open. The government thinks this should have created social distancing. Wherever you can go, you must face neck-to-neck over-crowding.

With the city barricaded, it took me forever to get to the airport. To protect politicians (from covid and increasingly from angry citizens), large areas where they live have been completely closed off. Sick people cannot find a way to get to the hospital, although only those keen on dying go there.

The government required shops to open for limited hours each day. This led to overcrowding — so the opening hours were further restricted!

No hospital that is allowed covid treatment has the beds, oxygen, or medicine available. None. A single dose of critical medicine, otherwise sold for $10, is selling for as much as $1,000. I heard a price of $7,000. Oxygen cylinders, usually priced around $10, today go for as much as $1,000, if you can find them. It is worth remembering that more than 80% of Indians live on less than $2 a day.

While people are desperately looking for oxygen cylinders, those savvy enough have stocked them and medicine at home. What would have been a slight shortage has snowballed into a complete disappearance from the market. So bad is the situation that those in top political positions are pleading for them on social media. One person I know had to get the governor of his state to let his relative be given priority in cremation.

Getting an ambulance (which is no more than a broken taxi with a metallic stretcher) can, for a short ride, cost many hundreds of dollars, in some cases running into thousands. Those who haven’t lived in India may find it hard to imagine, but this is not unique to covid days. India has never had a functioning ambulance system. That’s why hundreds of thousands lacking help to get to the hospital die on the street every year.

But this is not a compassionate country. I was brought up in India, but I learned the meaning of “compassion” only when I left the country. During the past year, the police have brutalized many people in India, but not one Indian court has taken a suo motu interest in charging the police. Justice is merely some words on parchment. Early this year, when Indian covid cases were falling rapidly, there were talks about how the use of turmeric in Indian food, cow urine and dung in “treatment,” the “goodness of Indian genes,” and India’s “ancient, spiritual civilization” were behind the success. India was advertising itself as the savior of the world.

In, fact, if facts mean anything, the Indian diet is among the worst in the world, full of carbohydrates, sugar, and oil, and poor in nutrients and proteins. It’s the kind of diet that makes you susceptible to chronic diseases such as diabetes and hypertension. And a year of lockdown has seriously reduced the health of everyone. Those who could afford to sit at home gained weight, lost general immunity, and did not exercise. Poor people became much poorer, victims of massive unemployment and relatively high inflation. The beggars on the street remind one of the impoverished 1980s.

You go to an Indian hospital to die — and absolutely every Indian has stories to tell about this.

India has 0.5 hospital beds per 1,000 people, a fraction of what is required — only 5% of hospital beds are in ICUs. Even before covid hit, Indian hospitals were overflowing with patients. They occupied every single bed, often with more than one person in every bed, and the space in corridors, and between the gate and the buildings. I have never seen this any other way.

Doctors and nurses are very ill-trained, lack competencies, and are arrogant and heavy-handed. It’s natural selection; the better ones tend to leave for the West. I have never been to a hospital — not even a private one — where work flowed correctly. My earliest memory of visiting a hospital is of two nurses giggling when one had given a wrong injection to a patient.

Many years back, someone I was helping out ended up in a government hospital. The doctor wanted to amputate his hand, for it was the easiest thing to do. We had to smuggle him out by bribing the policeman to a private hospital where his bones, with some work, could be set in place. Also, many years back, my granddad died, struggling for oxygen. He had gone to a private hospital, in his scooter, for a minor checkup. They ended up doing a few operations on him. While he struggled, the two doctors argued about how the pressure difference provided oxygen and drained urine.

The Indian medical system is one big orgy of doctors exchanging commissions for cross-referring to each other and getting laboratory tests done, making it the most corrupt sector of the Indian society, worse than the government itself. Organ harvesting is not unknown. You go to an Indian hospital to die — and absolutely every Indian has stories to tell about this.

You must have government approvals to run, operate, and supply oxygen. Indian hospitals — even the big ones — do not have oxygen-producing plants.

Lacking a functioning legal system, killer hospitals and doctors face no consequences. Today, given the new rules, covid patients are removed from the sight of their families, ensuring that apathetic medical workers can do whatsoever they want.

Oxygen is very easy and cheap to produce, but even that has stayed in shortage forever. The sight of patients sitting outside hospitals with their oxygen cylinders is common and has always been. You must have government approvals to run, operate, and supply oxygen. Indian hospitals — even the big ones — do not have oxygen-producing plants.

India, of course, hasn’t a clue what crisis management is about, which is the primary reason behind today’s crisis. Covid is merely the straw that broke the camel’s back. Lacking a crisis management unit or reflective thought, “managers” miss the fact that a slight shortage of critically needed items can create massive deficits as people start hoarding the essentials. Indians who are sane are ensuring that they keep their sick relatives outside the hospital system and setting up improvised ICUs at home.

A few years back, there was a lot of talk about India providing medical tourism. Then it disappeared from the map, for those who did go to India for treatment realized that they were taking huge risks with their lives. Indian government hospitals exist only in name; Indian private hospitals are cesspits of corruption, incompetence, and utter apathy. I know no Indian who does not have a close relative who died because of the mess Indian hospitals are. But they still cost a fortune to use, making millions of Indians bankrupt every year. The covid crisis is minting money for the merchants of death, leaving millions in desperate financial situations.

Let’s do simple math. India has approximately 700,000 hospital beds, very few of which are in ICUs, and a large number of which are reserved for politically connected people. For beds that are available, oxygen supply and doctor availability have always been a problem. With 400,000 new covid cases happening every day, the system had to fall apart, regardless of the fact that only a tiny proportion of the populace required hospitalization.

The covid crisis is minting money for the merchants of death, leaving millions in desperate financial situations.

The problem isn’t the number of cases, which is negligible as a proportion of the population, but the shiver of fear that the nonexistent medical infrastructure has sent down the spine of society. The country is drowning in fear and mourning, and this crisis can hardly be blamed on covid. It must be blamed on the grotesque — almost the incomprehensible — stupidity of its rulers. The government has no plans. Worse, it is doing the exact opposite of what should be done.

Modi centralized everything in precisely the opposite way from what he should have done. After a year, he has no clue that limiting opening hours of grocery stores does not decrease crowding but increases it. Similarly, he doesn’t know that it makes no sense to send those looking for vaccination and testing to places where covid patients are. Yet, over a month ago, he declared a win over covid. He organized massive gatherings for election canvassing — just the thing to celebrate vanquishing an epidemic, right?

About 28,000 Indians die every day. These days, 3,000 people extra people die, of covid, a slight increase in overall deaths. The blame doesn’t go as much to covid for filling up India’s crematoria as it goes to lack of excess capacity. People have always waited in line for cremation. While the international media shows how packed crematoria are, this is nothing unusual, except that a 10% increase in cremations has clogged the system.

But covid is real, and its cases are everywhere. Whole families are affected. Many people my family knows have died. The death rate is guaranteed to increase as time goes by. India has stopped treating people for anything other than covid. People are dying of kidney failures, heart attacks, lack of trauma care, etc. And covid patients cannot get oxygen. Those who get into the hospitals are getting overdosed for covid by the clueless medical staff. Those who should get expensive medicine get something else instead, while what they paid for gets smuggled out by nurses — when the patients are removed from the sight of their relatives, there is no one to check on what is happening.

Those lucky enough to find a bed in a private hospital are spending at American rates. But this isn’t just the problem in covid days. This has always been a problem.

This crisis can hardly be blamed on covid. It must be blamed on the grotesque — almost the incomprehensible — stupidity of its rulers.

Over the last year, Modi spent a lot of time making noise, patted his back, and destroyed the economy, sending at least 75 million new people into desperate poverty. But he and his yesmen failed to organize such simple things as oxygen, new beds, and logistics for essential medicine. It would have made a lot more sense to quadruple beds in Indian hospitals rather than destroy at least 10% of the economy, as Modi did in 2020. He should have set up a system to make the medical profession accountable. Had he done these, the recent covid spike would have been not much of an event.

After years of a love affair with Modi, the international media have left him as rats leave a sinking ship. All fingers now point at him, as if, were he to be removed, India, the biggest democracy in the world, would change course. Alas, all this pain and suffering is nothing unusual for India. It is merely that the West is overreacting to the visible aspects of covid.

The Indian government is merely a symptom of Indian tribal culture. Indians vote on their caste, their religion, a politician’s offer of freebies, etc. They don’t have moral and social consciousness, so it is hard to believe that they can elect a government that would have it — Modi is a mere symptom.

India does not have a covid crisis. India has a government crisis. More fundamentally, it has a crisis of irrationality. There is never any planning and forward-thinking, either at the individual or at the institutional level. The nation is always at the precipice of a disaster. Over the past 73 years of so-called independence, Indians have hollowed out the institutions that the British left behind. These fragile institutions are now collapsing.

India’s population is ten times as much as it was before the British arrived. With all benefits bestowed on India by the British slowly getting neutralized, it does not take many mathematical skills to realize that eventually the Indian population will, without continual help from the West, fall to its former equilibrium, 10% of what it is today. Covid or whatever else will merely be the catalyst.