With its hospitals overwhelmed, Delhi emerging as India’s coronavirus epicentre

Hospitals in Delhi, India’s national capital territory, are on the verge of collapse amid a rapid increase in coronavirus infections. With the regional government expecting total infections to explode to over half a million by the end of July, horror stories of dead bodies being abandoned in hospital wards and hallways are already emerging.

Total COVID-19 infections in Delhi reached 41,182 yesterday, after a third successive day of more than 2,000 cases, while the death toll rose to 1,327.

Both figures are likely gross underestimates. Three municipal corporations of Delhi, which maintain the records on cremations and burials at the six designated sites for COVID-19-related deaths, have said that as of June 11 last rites on 2,098 bodies had been performed as per the COVID-19 protocol.

As hospitals fill to capacity, the government is desperately seeking makeshift solutions to cope with the coming wave of COVID-19 patients. Stadiums, wedding halls and hotels are being filled with hospital beds. But it remains entirely unclear where the medical staff will come from to work in these facilities, nor how they will be equipped to provide intensive care and incubate patients. Ambarish Satwik, a vascular surgeon at Sir Ganga Ram Hospital, pointed to the chronic shortage of medical workers, telling the BBC, “You need new infrastructure, you need to ramp up capacity, not just evacuate patients and create COVID wards.”

With a population of 22 million people, Delhi is India’s largest urban agglomeration and capital city. Many people in adjacent rural states, like Uttar Pradesh and Bihar, visit Delhi for medical treatment due to the disastrous state of medical facilities in their native states. However, on June 7, as Delhi’s caseload began to rapidly increase and repeated stories of people dying of COVID-19 after being unable to gain admittance to a hospital emerged, Delhi Chief Minister Arvind Kejriwal of the Aam Aadmi Party (AAP—Common Man's Party) announced a ban on non-Delhi residents being admitted to the Capital Territories’ public and private hospitals.

After a public outcry against this reactionary order, Delhi’s Lieutenant Governor Anil Baijal, an appointee of India’s Narendra Modi-led Bharatiya Janata Party (BJP) government, reversed it, saying authorities must ensure non-Delhi residents can still access treatment.

But the AAP continues to defend its exclusivist proposal. On June 9, state deputy chief minister Manish Sisodia cited as justification unreleased government projections that he said showed that COVID-19 cases in Delhi are likely to reach 550,000 by the end of July, meaning the state will need at least 15,000 beds to tackle the situation.

If this projection is realized, Delhi will see a 13-fold increase in COVID-19 cases over the coming six weeks, and by the end of next month will have more infections than currently does India or indeed all but two countries in the world.

Kejriwal has made clear that even with the prospect of Delhi potentially becoming the world epicentre of the pandemic and the threat of tens of thousands of deaths, nothing will be done to slow the spread of the virus. “Many people are speculating whether another lockdown in Delhi is being planned,” he tweeted Monday. “There are no such plans.”

After an all-party meeting Monday, convened by Home Minister Amit Shah, Modi’s right-hand man, authorities pledged they will increase testing capacity in Delhi to 18,000 tests per day over the next five days.

For weeks, authorities in Delhi had stubbornly refused to ratchet up testing, even as the ratio of positive tests rose to over 30 percent of all tests carried out on several days. Last week, Delhi was performing 4,000-5,000 tests per day and refusing tests to people who were asymptomatic, rendering any serious contact-tracing effort impossible.

This is part of an all-India problem. According to India Spend, as of 9 AM June 12, India had tested 5.4 million people, 0.4 percent of its total 1.3 billion population. “This is the lowest testing per capita among the worst (COVID-19) affected countries, as per Our World in Data,” the web portal notes.

Home Minister Shah has also promised to provide 500 railway coaches equipped with “all facilities” to “overcome the shortage of beds” for COVID-19 patients in Delhi.

Last Friday, India's Supreme Court termed the situation in Delhi “horrific,” and said the treatment provided COVID-19 patients was “worse than (that given to) animals.” Taking suo moto notice of the reports of “mishandling” of COVID-19-infected corpses, India's highest court also stated, “Please see the deplorable conditions of people in hospitals; dead bodies are lying in the ward, dead bodies are found in the garbage.”

The Supreme Court bench comprising Justices Ashok Bhushan, S.K. Kaul and M.R. Shah issued notice to the state governments of Delhi, Maharashtra—the country's worst affected state—West Bengal, and Tamil Nadu over their “management” of the COVID-19 situation.

Writing on the Supreme Court's hearing, Bar and Bench, India's legal news website, noted that the court referred to an India TV news report aired on June 10 documenting the deplorable state of hospital wards in Delhi. “Dead bodies were found in the ward, lobby and waiting area, patients had no oxygen support, and no saline drips were shown with the bed,” the TV report observed. The particular hospital referred to is the Delhi government-run 2,000-bed Lok Nayak Jai Prakash (LNJP) hospital, which was turned into a COVID-19 hospital by the government.

These outrageous conditions are the product of the authorities’ utter failure to provide basic equipment and supplies to overstretched and overworked medical staff. The Times of India quoted one doctor at LNJP as saying, “We don't have enough orderlies … in the absence of attendants, these orderlies have to take the patients to the washroom, shift them and sometimes even give them medicines while they are wearing PPE suits.” The doctor also said that six to eight people are dying every day at the hospital.

In many hospital wards, oxygen support is provided by cylinders. Explaining the risk involved in this process, another doctor said, “In case of cylinders, it is difficult to control the oxygen flow. Also, if a cylinder is exhausted, replacing it takes time because currently there is a manpower shortage and the orderlies who have to get them take time to (get in and out of) their PPE.”

Many medical workers, including doctors, have not received their wages for the past three months. NewsClick reported on Saturday that resident doctors at two municipal hospitals, Delhi- Kasturba Hospital and Hindu Rao Hospital, threatened last Friday to resort to mass resignations if their pending salaries are not released within a week.

Health care staff at the All India Institute of Medical Science started a series of protests and agitations beginning June 1 for a number of demands. These include the implementation of uniform four-hour duty with PPE in COVID areas, a uniform rotation policy between COVID and non-COVID areas, and the establishment of a proper feedback system for health care workers.

In the midst of this horrific crisis, the BJP central government, which controls the Delhi police, is mounting a legal vendetta against students who played a prominent role in mass protests against Modi’s anti-Muslim Citizenship Amendment Act after its adoption last December. Several have been arrested, jailed and charged under India’s draconian antiterrorism laws, threatening them with lengthy prison terms and ensnaring them in a legal process in which key judicial protections are set aside.

The terrible situation developing in Delhi highlights the utter failure of both the state and central governments in dealing with the coronavirus pandemic.

Without any warning or preparation, the Modi government imposed a nationwide lockdown on March 25, ultimately extended till May 3l, that has had a calamitous economic impact on working people. At the same time, as underscored by the rapid spread of COVID-19 cases—India now has more than 330,000 confirmed cases and 9,500 deaths—it did little to dent the pandemic’s spread. This is because the government failed to organize mass testing and contact tracing and to invest massive resources in India’s ramshackle health care system.

Delhi’s ruling AAP, despite its initial populist pretentions to be a party of a “new type,” is a right-wing capitalist party that has increasingly adapted to the BJP and its Hindu supremacist agenda. Formed in 2013 by leaders of Delhi's 2011-12 anticorruption protests, it first came to power following the 2013 Legislative Assembly elections with the backing of the Congress.

Thanks to the pro-business policies of the BJP, Congress, and the AAP, Delhi, according to the ninth edition of the Hurun Global Rich List 2020, is home to 30 of India's 137 dollar billionaires. The collective wealth of these individuals is around US$76 billion. Needless to say, neither the BJP national government nor the AAP Delhi government has any intention of using any of these vast resources to tackle the desperate health care and social crisis triggered by the pandemic.