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Personal Perspectives on the COVID-19 Crisis in India

University students and staff and faculty members with direct links to the nation, which is struggling with a massive second wave of coronavirus infections, shed light on the situation.

Hargun Kaur, a junior studying nursing who hails from Punjab, India, is anxious about picking up her phone each time it rings or chimes with a new message. Although she desperately wants to hear from her family members in India, the tragedies of the recent COVID-19 surge are often too overwhelming for her and some extended family members living in the United States.

“They don’t want to hear who else is in the hospital or who has died because of COVID-19,” she said, adding that her Instagram feed from friends in India is devastating. “It’s very hard to see.”

While the news images of people struggling to breathe or family members desperately searching for oxygen canisters are difficult for anyone to watch, they are even more distressing for natives of India, said students and staff and faculty members at the University of Miami with roots in the nation.

They know that their siblings, aunts, uncles, parents, or grandparents could be next. “It’s hard for everyone away from home to watch that happen and know you can’t do anything right now,” said Kaur.

Every day after her shift ends in the COVID-19 intensive care unit at UHealth Tower, nurse practitioner Sheeba Farhat logs onto a series of video calls with her family in India. She often suggests protocols they should follow to protect themselves from the virus that is ravaging the country. She does her best to calm their fears.

“Most of the time, they are concerned about the shortage of medical supplies at hospitals and are worried that if they should contract the virus, there wouldn’t be enough oxygen,” she said.

Farhat hopes the crisis in India will subside, but that hope faces adversity. With the world’s second largest population, India’s 1.3 billion residents are experiencing one of the globe’s most severe outbreaks of COVID-19 since the pandemic began. The country has been reporting more than 300,000 daily cases of COVID-19 in the past three weeks, with total deaths exceeding 250,000.

And although the nation stemmed the spread at the beginning—by imposing a stringent national lockdown—after just a few weeks, India reopened for business. This was a hasty decision, though, according to some natives.

“India is a very, very crowded country. So, once people go out, and transportation, offices, and shops are open, isolation is practically impossible,” said Dilip Sarkar, a computer science associate professor whose family lives on the outskirts of New Delhi. “All of the buses and trains are jam-packed.”

Each State Decides Restraints

Faculty members and students noted that the national government likely has not reimposed the harsh restrictions because of the economic fallout created by the first lockdown. Today, India’s national leadership is leaving COVID-19 restrictions up to the leaders of its 28 states, to impose whatever quarantine measures they see fit. Yet, these leaders face a tough choice since many of India’s poorest residents rely on their daily income to eat and to pay rent, as well as to send money to their families in rural villages. Therefore, if these people cannot work because of a shutdown, they and their families could starve or lose their homes.

“It’s a helpless situation,” Kaur said. “The world can’t stop for those who are dying; otherwise, many of those who are living will die because they can’t feed themselves.”

Still, the country’s extensive health care system is buckling under the weight of the massive second wave, with hospitals running low on beds, medical supplies, and especially oxygen.

“India has a very robust health care system in both the private and public sector, it’s just the sheer number and magnitude of the surge that has overwhelmed the system,” said Dr. Dipen J. Parekh, chief operating officer of UHealth and chair of the Miller School of Medicine’s Department of Urology. He grew up in India and his parents and brother live in the massive city of Mumbai, one of the areas hardest hit in the recent surge.

Jyotika Ramaprasad, a journalism professor in the School of Communication, has a sister, Vandana Patel, in the western city of Vadodara. Patel, who is an obstetrician, owns and operates two hospitals for women. Although the obstetrician already contracted COVID-19 last spring, Ramaprasad is concerned that her sister, niece, and nephew—who are all obstetricians and sometimes deliver babies from mothers who are infected with COVID-19—could be reinfected.

Sarkar is also in touch with friends and extended family in cities across India, and he  has learned of people being infected with COVID-19 a second time. He also has heard from loved ones in the cities of Kolkata and Mumbai that some who have been vaccinated are now testing positive for COVID-19. “I’m not a doctor, but this worries me,” he said.

The associate professor’s brother and his 88-year-old mother share an apartment just outside of New Delhi. Fortunately, so far, everyone is healthy. And, Sarkar said, the adults were vaccinated, but they haven’t left the apartment in a long time.

The situation is so dire that because four families in the apartment complex got COVID-19 recently, a team of government security guards are now patrolling the entrance. So, none of the residents can leave, and visitors cannot enter. According to Sarkar, the guards bring the family’s food deliveries upstairs and drop them at the door.

Large Scale Events Fueled Spread

Some wish India’s federal government had imposed more lockdowns when the second surge began in early March. Sumita Chatterjee—a lecturer of South Asian history, as well as gender and sexuality studies—grew up in Lucknow, a large city in northern India, where her siblings still live. Chatterjee said that she believes the latest outbreak escalated so quickly because several states in India held elections recently; and in the weeks leading up to it, many crowded in-person rallies occurred. In addition, she pointed out, the government allowed a Hindu religious festival to be held in person, attracting millions of people.

“The government was overconfident they had beaten COVID-19, and then continued on as if the pandemic was over, when it wasn’t,” Chatterjee said. “Now, they need to stop and listen to the scientific and medical knowledge available in India and to follow the directions. I am hoping the government responds to this like it is a military emergency, because the capabilities are there.”

Latha Chandran, the Miller School of Medicine’s executive dean for education and policy, grew up in the state of Kerala, along India’s southwestern coast. Her mother, brother, sister, and extended family still live there. Chandran said it is a tragedy that this is happening to a nation that is a training ground for medical professionals, herself included.

She is also surprised that in India—which produces 70 percent of the world’s vaccines—just 2 percent of the population is vaccinated against COVID-19.  “The logistics and distribution of the COVID-19 vaccines is not commensurate with the need,” she said. “It shows there is a huge struggle.”

While her family members have received one dose of the two-shot vaccine, Chandran still worries about them and talks to her family at least once a week. She also messages with friends from medical school on WhatsApp. “I don’t know of anyone who hasn’t had COVID-19 touch them in the second wave,” she said.

Air Pollution May be a Contributor

But Naresh Kumar, an associate professor of environmental health at the Miller School of Medicine, said there may be other reasons for the swiftness of the latest wave. Kumar, who works in the Department of Public Health Sciences, said India’s air pollution is “well above acceptable standards established by the World Health Organization.” According to a recent study in The Lancet, air pollution could be blamed for more than 1.6 million deaths in India during 2019.

“Some people who are chronically exposed to that pollution and then get COVID-19 most likely already have weakened immune systems,” said Kumar, who also has several relatives in India. “So, their chances of having a favorable outcome are greatly diminished.”

Although he is grateful that the case numbers in India are starting to trickle down, Parekh is regularly in touch with Indian doctors he has trained through the Miller School’s fellowship program. He believes that the most useful things that the United States and other nations can offer India are medical support and expertise, as well as supplies, like oxygen and vaccines.

While India has vaccinated more than 100 million people, it needs a larger supply to make an impact because the population is so immense, Parekh pointed out, so ramping up vaccinations could be the most effective way to end the surge.

“There are so many unutilized vaccines around the world that could be sent there to help,” he said. “And if the world works to help India, they are helping themselves. Because this is a global crisis.”

Despite his anxiety, Pratim Biswas, dean of the College of Engineering , who specializes in aerosol science, is also looking for ways he can use his expertise to help curb the crisis in his native country. Biswas’ 90-year-old mother lives in Mumbai. In fact, a new variant of COVID-19 (called B.1.617) which many believe is fueling the current Indian outbreak, may have originated just outside of Mumbai in a smaller city called Amravati in February, news reports indicate.

Working with scientists at the Indian Institute of Technology (IIT), Bombay, Biswas is refining some innovative strategies to detect the novel coronavirus and designing systems to control the spread in indoor environments, along with designs for some more effective face masks. Some of his colleagues at IIT are even working on producing medical oxygen that could help ease the shortage for coronavirus patients in India and beyond. Tested successfully at the IIT, the method converts a pressure swing adsorption (PSA) nitrogen unit into PSA oxygen unit.

“While the process doesn’t produce 100 percent oxygen, like cryogenic techniques, it can generate up to 60 percent oxygen, which can be good for a patient in dire need,” said Biswas, who is building a partnership with colleagues at IIT in environmental engineering science and chemical engineering.

India’s many nitrogen-producing facilities, which take air from the atmosphere as raw material, could be potentially converted into oxygen-generating industrial plants to help ramp up the supply of medical oxygen, Biswas noted.

Meanwhile, Biswas is continuing his National Institutes of Health-funded research to develop remote sensors that could be used in health care settings to detect COVID-19 aerosols. He is glad that the United States is starting to send help to India and hopes that the situation will improve.

“The United States and other countries are helping, and that’s good because this is a global pandemic,” he said. “Public health experts are on the ground in India, but they can get advice on best practices from the experts here. And we can collaborate to come up with the best solutions to prevent dramatic surges in the pandemic.”

Chatterjee is also hopeful that India will expand its vaccine distribution efforts and recover soon.

“I’m keeping my fingers crossed because things are alive and changing,” she said. “The health system, as well as the knowledge and skills, are there. We just need to get people vaccinated in a proper manner, and India did this with smallpox. So, it can do it, but it just needs proper management.”

If you would like to send donations to India, https://covid.giveindia.org/ is recommended by students and faculty members. There are some other non-governmental organizations working at local levels to address the COVID-19 spread in India.

Written by Janette Neuwahl Tannen and Robert C. Jones Jr.
Ashley A. Williams contributed to this report. 
Published on May 13, 2021