On April 4th, three days after the commencement of the Kumbh Mela, during which millions of Hindu pilgrims converged in the town of Haridwar to bathe in the Ganges, servers at one of India’s most popular online health services registered an uptick in searches that displayed an alarming pattern. The site, myUpchar, is a destination for residents of India’s smaller cities and towns, where doctors and health-care providers have long been in short supply. Each day, more people arrived at the site with questions about COVID-19.
As the virus’s second wave washed over India, and hospital beds and oxygen grew scarce, visitors to the site frantically hunted for medicines rumored to treat the disease: Fabiflu, remdesivir, azithromycin, ivermectin, doxycycline. Then, on April 28th, those search terms were all overshadowed—by a factor of three—by queries for an obscure homeopathic nasal spray. The popularity of the treatment baffled Manuj Garg, the site’s co-founder, who had never heard of it. Then he saw a viral WhatsApp clip of a sickly old man lying on his side, his finger in an oximeter. A caregiver seated beside him made a specious claim: the nasal spray was a miracle cure that obviated the need for oxygen. “We gave him the spray five minutes ago. That’s how fast this is,” the person promised. “Anyone, anyone whose oxygen levels are falling, go and get this spray. You won’t need to run around for an oxygen cylinder.” When Garg looked up where the online queries were coming from, he saw that they spanned the country. “This is a sign of desperation,” Garg told me. “When there’s no information, bad information finds a way.”
At the onset of the pandemic, Indians relied on briefings by the Ministry of Health and Family Welfare to make sense of where the virus was headed. But officials rarely gave reporters a chance to ask questions—or get meaningful answers. “The briefings weren’t designed to be useful,” Anoo Bhuyan, a health reporter at IndiaSpend, a data-journalism nonprofit, recalled. “It was theatre. It was frustrating.” Officials presented PowerPoint slides of self-serving government talking points, and tried to blame the outbreak on a gathering of Muslims in Delhi. “There was denialism, and a resistance to share information and be transparent,” Bhuyan said.
As the virus has spread, the chief minister of the state where the Kumbh Mela was held said that “Maa Ganga’s blessings are there in the flow. So, there should be no corona.” A legislator in another state claimed that the purifying properties of cow urine and dung would combat the virus. The chief minister of Uttar Pradesh, India’s most populous state, said that a fit mind and yoga were effective preventative measures. Harsh Vardhan, India’s health minister, attended the product launch of “the first evidence-based medicine for COVID-19,” which, according to the event’s organizers, had been sanctioned by the World Health Organization. (The W.H.O. immediately denied the claim.) And, in one of his monthly addresses to the nation, Prime Minister Narendra Modi played images from a viral video, in which a doctor suggested that a nebulizer was a viable alternative to an oxygen machine. After an outcry from medical experts, the government removed the images from its coronavirus materials.
As confusion spread, desperate patients began taking drugs of any kind. “Indians are self-prescribing steroids,” Sakshi Pandit, a molecular biologist, told me. Some physicians have peddled false elixirs as well. “Doctors seem to be prescribing everything under the sun,” Pandit said. “My dad was given azithromycin ‘just to be on the safe side.’ And don’t even get me started on plasma transfusions. People are taking cancer drugs. They’re running around taking antivirals and antibiotics right now. What if they stop being effective? I don’t know what’s happening. Nobody is being held accountable.”
At first, as COVID-19 overwhelmed other nations, it seemed to miss India, giving rise to theories about the superior immunity of its citizens, the secret advantages of its climate, and the effectiveness of its leaders. In January, as daily cases remained low, Modi declared that India had “saved humanity from a big disaster by containing corona effectively.” Soon after, election officials announced that state-assembly elections would take place in March and April, including eight phases of voting in West Bengal—with an estimated population of a hundred million. (A judge later assailed the move, telling election-commission officials that they “should be put up on murder charges.”) Campaigning in the state proceeded. In April, as the second wave grew, Modi held a rally for his supporters and told them, “Today, I see people in every direction. It’s the first time I’ve seen such a crowd. You have shown such strength that wherever I look I can see people. You have done something wonderful.”
In a matter of weeks, the coronavirus has torn through the country’s social safety net. It has seemingly spread everywhere, to every family; the wealthy flew abroad, the rest of us hunkered down in fear. Each of the fourteen people I interviewed for this article knew someone who had been infected. I asked one source when a particular acquaintance had died. He replied with one date, then corrected himself: “Wait, last Saturday was another friend. She died the previous week.”
Twitter became a stream of S.O.S.s. Someone’s wife’s father needed plasma, someone needed oxygen, someone else medicines, another an ambulance. Hospital administrators tweeted appeals for oxygen. On the morning of April 29th, administrators at a children’s hospital in Delhi posted that the facility had less than twenty minutes’ worth of liquid oxygen left. Help arrived. Three days later, officials at the same hospital tweeted that their supply was again nearly exhausted. Twelve hours later, they announced that the hospital would no longer accept patients who required oxygen, “due to inconsistent liquid oxygen supply.” On April 28th, seven patients died when hospitals in Uttar Pradesh ran out of oxygen. Three days later, twelve patients died when a hospital in New Delhi did as well. Dr. Prashant Mishra, a senior administrator at a hospital in Lucknow, told me that doctors were rationing oxygen. “Now everybody wants oxygen. I’m working in the capital of a state and here we have managed those things, but in the interior there would have been an issue, because no one was prepared for such a massive outbreak,” he said. “We’re trying to manage the maximum patients with the available resources.” He told me that, on average, he received forty to fifty calls a night from COVID-19 patients or their families.
News of one Gujarati family’s experience spread rapidly online, exacerbating fears of poor care and hidden COVID deaths. According to press reports, Rupal Thakkar, a forty-eight-year-old mother of a toddler, grew weak and her condition began to deteriorate. Days before, her husband had tested positive for the coronavirus. Her family began searching for hospital beds and found one in a private hospital. After she was admitted on April 16th, hospital officials told her family that Thakkar’s oxygen levels were dropping and that the family should move her to a facility with more resources. Several hours later, a doctor called to say that her heart had stopped. (A hospital spokesperson told a local news outlet that Thakkar “was admitted in the hospital within time and proper treatment was given to her by the medical team.”) The death certificate issued by the hospital listed “sudden cardiac death” as the cause. A document issued by a crematorium described her cause of death as an “attack.” After Indian newspapers began looking into Thakkar’s case, the hospital issued a new death certificate, which described COVID-19 as a contributing cause.
Across India, journalists have reported that COVID-19 deaths are being undercounted. Recently, in Gujarat, so many mourners crowded crematoriums that police threatened to beat them if they did not disperse. One reporter likened the Indian government’s response to that of Soviet officials during the Chernobyl disaster, calling it a “Soviet system where you hide one number, and then cover up another number to hide the first. And then you create policy based on the fake number.”
As India’s recorded death count surpasses the two-hundred-thousand mark, and its daily official case count rises above three hundred thousand, pressure on Modi is growing. Judges have ordered the government to insure that Delhi is supplied with the oxygen it needs. Longtime critics of Modi have called for the Prime Minister to resign or, at least, to answer growing questions about the oxygen shortages, a troubled immunization policy, and his role in encouraging superspreader events. In response, the Prime Minister’s aides assure citizens, on a regular basis, that he is personally looking into the “oxygen situation.” The country’s foreign minister, according to a local news report, urged Indian diplomats to counter a “one-sided narrative” being spread by international media about the country’s management of the pandemic. The Ministry of Information and Broadcasting hosted a workshop to help civil servants better convey “information that concerns the government’s efforts to manage and address the ongoing Covid pandemic.” Indians will have more information, just not the kind they need.
