Featured Story

2021; Volume 22, No 8, August

Photo by Gerd Altmann, Pixabay.

Each Wave of COVID Had A Vastly Different Impact in India,
and Vaccination May Spare Further Global Devastation

By Sushma Bhatnagar, MD
Chairperson, COVID Care Centre
National Cancer Institute, All India Institute of Medical Sciences; and
IAHPC Advocacy Focal Point for India

A casual stroll through any lane in New Delhi, our national capital, or any other city in India, would paint a picture of places blooming with hope and normalcy. A closer look, however, reveals a lurking—yet strong—undercurrent of anxiety, desperation, gloom, and uncertainty: What if the pandemic unleashes a third wave? If so, how severe will it be?

Dr. Sushma Bhatnagar

People have not yet overcome the brutal destruction left behind by the second wave of the COVID-19 pandemic. We know for certain that there was loss, grief, fear, hunger, poverty, unemployment, and so on; however, the true magnitude of the destruction has yet to be assessed.

The second wave spared no one. The grief from losing a dear one, a relative, a colleague, or a friend gets no special mention. Hundreds of children and the elderly have been orphaned and thousands have lost their families, their livelihood, their opportunity for education, and their social support systems. We are still recovering from our savage encounter with the second wave.

I have been the chairperson of the COVID Care Centre, at National Cancer Institute, All India Institute of Medical Sciences, since the pandemic began in India. I am unable to yet accept or digest the situation that has unfolded.

The terrible impact
of the unexpected

The impacts and destruction of the first and the second waves in India have been entirely different.

Imposing a nationwide lockdown while the first wave was still setting in gave us crucial time to prepare for and efficiently manage it, resulting in a fewer emergencies and mortality rates that were lower than expected.

The second wave was sudden, unexpected, and brought with it a more virulent and lethal virus in comparison to the virus mutation in the first wave. The second wave did not spare even the young and healthy. Hundreds succumbed to death in our hospitals before we could do anything, snatching away any opportunity we could have had to treat them. Within hours, numerous people breathed their last, without having a chance to say goodbye to their loved ones. The second wave laid bare the deficiencies of our health system, and brought to the forefront the critical need to strengthen our capacity to deliver basic services across the country.

I am still unable to find meaning for these unexpected events and deaths. I continue to ask myself the same question: Why?

Limited resources hampered PC, but
the government aided access to scrip

Health care professionals and volunteers fought day and night to save lives and mobilize help. They worked selflessly, despite the trauma of witnessing agonizing deaths and extended working hours, and the despair of staying away from family.

The pandemic also imposed several challenges on the palliative care community. Palliative care patients fell through the gaps and were not prioritized due to limited resources in an already stretched health care system. Additionally, the nationwide and state-wide lockdowns restricted the provision of home cares services and limited access to essential medicines. This left our patients distressed and with a compromised quality of life. We are grateful to our national government for allowing and making valid prescriptions sent via email and Whatsapp. Palliative care practitioners from across the country displayed resilience as we resorted to embracing telemedicine consultations, couriering medicines to patients in remote areas, continuing palliative care training programs via virtual platforms, and by resuming the delivery of home care services with staff wearing PPE kits and following necessary COVID safety protocols.

Watching our health care professionals and volunteers being overburdened, helpless, and without adequate resources during the second wave created myriad emotions among the public, including panic, hysteria, anger, and guilt.

It is heartbreaking to share that hundreds of our frontline health care professionals and volunteers lost their lives while in the line of duty. The Indian Medical Association, the national body of doctors in India, reports that 513 doctors sacrificed their lives during the second wave alone. Those who survived are devastated, both physically and emotionally. The mental health and psychological issues of these frontline workers have yet to be reported or analyzed.

A vaccinated community
pays tribute to lives lost

Statistics released by India’s Ministry of Health and Family Welfare reports that only 2,224 new cases and 507 deaths were recorded on July 22, 2021. These numbers provide our health care professionals a small window to catch their breath. Our vaccination rates are rising steadily: at least one-third of our 1.4 billion population has had a first dose. Our experience with the second wave keeps us cautious, however, as fewer than 100 cases per day were being reported in several states just before its sudden surge.

Burdened with a huge population and an already strained health care infrastructure, I shudder to think what a third wave will impose on us, if there is one.

I earnestly ask the global community to get vaccinated and follow COVID-appropriate behavior, in tribute to the lives lost due the pandemic. I strongly believe that only a responsible and conscious community can save the world from this relentless pandemic.

Dr. Sushma Bhatnagar, a former IAHPC Board Member and a current IAHPC member, is Professor and Head, Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Learn more about All India Institute of Medical Sciences in the IAHPC Global Directory of Palliative Care Institutions and Organizations.

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