India Covid surge: Hospitals send SOS as record deaths registered

Indian hospitals say their patients are dying because of a shortage of oxygen as Covid case numbers and deaths set new records for a third day running.

India has recorded nearly a million infections in three days, with 346,786 new cases overnight into Saturday.

At the Jaipur Golden Hospital in Delhi, 20 people died overnight because of a lack of oxygen, an official said.

The government says it is deploying trains and the air force to transport supplies to hard-hit areas.

The number of deaths across India rose by 2,624 in the 24 hours to Saturday, up from 2,263 on Friday.

The World Health Organization (WHO) said the situation in India was a "devastating reminder" of what the coronavirus could do.

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Earlier this year, the Indian government believed it had beaten the virus. New cases fell to 11,000 by mid-February, vaccines were being exported, and in March the health minister said India was "in the endgame" of the pandemic.

However, since then, a new surge has erupted, driven by the emergence of new variants, as well as mass gatherings, such as the Kumbh Mela festival, where millions of pilgrims gathered earlier this month.

'Patients will die'
Hospitals in Delhi have warned they are at breaking point. At the Holy Family Hospital, intensive care units are full and there is no room for any more beds.

"Almost every hospital is on the edge. If oxygen runs out, there is no leeway for many patients," Dr Sumit Ray told the BBC.

"They will die. Within minutes, they will die. You can see these patients: they're on ventilators, they require high-flow oxygen. If the oxygen stops, most of them will die,"

Another hospital put out an SOS message for oxygen, saying it was down to 30 minutes' supply. The Moolchand Hospital, which has 135 Covid patients on life support, said all the hospitals in the area were in a similar situation.

"We have retained all our night staff to make sure we save as many lives as we can," Moolchand's medical director Madhu Handa told the NDTV news network.

"We hope the supply comes in time but we're keeping our fingers crossed, and this is a never-ending thing: it happens every day."

On Friday, Delhi's Chief Minister Arvind Kejriwal pleaded for oxygen supplies on live TV, Reuters news agency reported.

"All of the country's oxygen plants should immediately be taken over by the government through the army," he said.

Desperate families have been appealing for oxygen on social media. The BBC's Soutik Biswas was among those receiving appeals.

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A virologist at the Christian Medical College in the city of Vellore in southern India, Gagandeep Kang, told the BBC more action was needed to stop the spread of the virus.

"We need to ensure that there are no non-essential activities taking place. You know what Indian weddings are like, and restricting the size of gatherings, whether it is for family reasons, other social reasons or for business or for political rallies. All of that really needs to stop," she told the BBC.

"I don't think a national lockdown is required, but I think that in places that are showing a rise in cases, we do need to intervene with greater stringency than we have done in the past."

Twenty-five families in India's capital Delhi woke up to the news on Friday morning that someone they loved had died in the city's Sir Ganga Ram hospital, reportedly because coronavirus patients could not get enough oxygen.

The hospital's medical director said a severe shortfall had slowed the flow of oxygen to 25 of the sickest patients, who needed a high pressure, stable supply.

The tragedy came at the end of a week where several major hospitals in Delhi have repeatedly come close to running out of oxygen, which can help patients with the virus who need support with their breathing stay alive.

On Tuesday, it took a desperate public plea from the chief minister and an intervention from the high court for the Indian central government to organise a late night refill.

An oxygen tanker eventually arrived at Sir Ganga Ram hospital on Friday morning, shortly after a dire warning that 60 more patients were on the verge of death.

But India's rising wave of cases is pushing its healthcare system to the brink - from the country's richest cities to its remotest corners.

A battle for breath
Maharashtra and Gujarat in the west, Haryana in the north, and Madhya Pradesh in central India are all facing an oxygen shortage.

In the northern state of Uttar Pradesh, some hospitals have put "oxygen out of stock" boards outside, and in the state capital Lucknow hospitals have asked patients to move elsewhere.

Smaller hospitals and nursing homes in Delhi are doing the same. Desperate relatives in several cities are lining up outside oxygen refilling centres. One plant in the southern city of Hyderabad hired bouncers to manage the crowd.

Many stricken with coronavirus are dying while they wait. Hospitals are struggling to accommodate breathless patients, or even keep alive those who were lucky enough to find a bed. Social media feeds and WhatsApp groups are full of frantic pleas for oxygen cylinders.

For a week, India has been reliving this nightmare on repeat, waiting for the terrifying moment when there is no oxygen left at all.

For anyone who has watched the pandemic unfold here - from doctors to officials to journalists - this feels like déjà vu. Seven months ago, the country had grappled with a similar oxygen shortage amid a rapid surge in case numbers. But this time, it's much worse.

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Typically, healthcare facilities consume about 15% of oxygen supply, leaving the rest for industrial use. But amid India's second wave nearly 90% of the country's oxygen supply - 7,500 metric tonnes daily - is being diverted for medical use, according to Rajesh Bhushan, a senior health official.

That's nearly three times higher than was consumed every day at the peak of the first wave in mid-September last year.

Then, India was adding about 90,000 cases daily. Just two weeks ago, in early April, the single-day spike was around 144,000. Now, the daily caseload has more than doubled to well more than 300,000.

"The situation is so bad that we had to treat some patients in a cardiac ambulance for 12 hours until they could get an ICU bed," said Dr Siddheshwar Shinde, who runs a Covid hospital in Pune, a western district with India's second-highest active caseload and third-highest death toll from the virus.

Last week, when there were no ventilators left, Dr Shinde began moving patients to other cities - unheard of in Pune, where patients usually arrive from nearby districts seeking treatment.

The state of Maharashtra, where Pune is located, is among the worst-affected parts of India, and currently accounts for more than a third of active cases. The state is producing about 1,200 metric tonnes of oxygen daily but all of it is already being used for Covid patients.

And demand is rising along with cases, and outstripping supply. It shows no signs of letting up.

"Usually hospitals like ours were able to have enough oxygen supply. But in the past fortnight, keeping people breathing has become a task. Patients as young as 22 need oxygen support," said Dr Shinde.

Doctors and epidemiologists believe the deluge of cases is delaying tests and consultation, leading to many people being admitted to hospital when their condition is severe. So the demand for high-flow oxygen - and therefore more oxygen - is higher than it was during the last wave.

"Nobody knows when this is going to end," Dr Shinde said. "I think even the government did not foresee this."
A scramble to find supply
Some governments did. The southern state of Kerala increased supply by monitoring demand closely and planning for a rise in cases. Kerala now has surplus oxygen that it is sending to other states.

But Delhi and some other states do not have their own oxygen plants and are relying on imports.

The Supreme Court has weighed in, asking Prime Minister Narendra Mo