My journey in India with COVID-19

To memorialize my personal losses and misfortunes in the devastating second wave of COVID-19 has been a difficult task. Notwithstanding my personal distresses, I think it is more important to focus on the current situation in India and address how our nation is tackling this public health menace. The number of COVID cases had abruptly increased in April 2021, coinciding to when people resumed daily chores. Daily recorded cases have already crossed 400,000 in India with newer mutated strains evolving and posing threats to the efficacy of currently available vaccines and challenges to new vaccine development. The public as well as government officials became very concerned over the exponential increase in the number of positive cases and proportionate mortalities as Indian society was struggling to rebuild socio-economic conditions and distribute the vaccines as efficiently as possible.


The efficient distribution of vaccines in India is a critical strategy to containing the spread of the virus and reducing mortality and morbidity. The strategy initially focused on older population and healthcare professionals. Considering that the country was under economic pressure, lockdowns and containments had to be lifted so the economy could recover. The most rapidly distributed vaccine was developed by Bharat BioTech (Covaxin®) which was developed from inactivated whole SARS-CoV-2 virus. It entered phase III clinical trials utilizing 28,500 volunteers age 18 and older in February 2021 [1]. Thus far over 100 million doses of Covaxin® and Oxford-Astrazeneca developed Covishield® have been administered in India [2]. Moreover, a third COVID-19 vaccine (Russia's Sputnik V®) has been approved for use in India amid the lethal second wave, which is similar to the Oxford-AstraZeneca vaccine being made in India as Covishield® [3].


In April alone, India reported more than 6.6 million cases as the cumulative total rose to 18.76 million. Noteworthy, India entered the second wave in the third week of April, when its capital, Delhi, recorded over 25,000 daily cases [4].


Regrettably, this destructive disease affected my family as well. The shock and devastation challenged our inner strength and exposed us to life’s vulnerabilities and uncertainties. On the night of April 20, 2021, the news came as an utter shock that my elder brother with no co-morbidities, who tested positive for COVID-19 seven days previously, left us forever after succumbing to respiratory distress in a multispecialty hospital. We were in disbelief and angered when the media reported that poor healthcare conditions and lack of preparedness of this premier hospital was responsible for these unnecessary deaths. According to my younger brother’s statement it was clear that when it was coming to admitting my elder brother, they showed urgency, but after being admitted, the hospital authority did not correspond about patient’s condition on a regular basis. We provided two units of plasma, but his situation continued to deteriorate until he passed away. [5]. It was determined that the hospital and the medical system in general were undeniably negligence with regard to providing oxygen to emergency care facilities. As reported in the news, one senior doctor and administrator said he had 50 Covid beds and space for 16 ICU patients but had to refuse admissions as there was no guarantee of oxygen supply [6]. In January 2021, the state of Andhra Pradesh announced plans to develop an oxygen distribution infrastructure based on recommendations from other governmental bodies and the World Health Organization (WHO) to assure a smooth and uninterrupted supply of oxygen to the major hospitals and clinics [7]. However, as a consequence of this more recent outbreak, the lack of adequate supply of oxygen, the lack of quality control, the lack of adherence to recommended practices and in no small part the onslaught of the unusually large number of COVID-19 cases have led to the recent breakdown in India’s healthcare system and the resulting tragedy.


I was personally overcome by this outbreak. In spite of all the preventive measures I took, I fell prey to SARS-CoV-2 on April 19, 2021 while attending to funeral of my maternal uncle. Preceded by symptoms of dizziness, headache, myalgia, and congestion, loss of appetite, along with loss of taste and smell, I had mild to moderate fever for five days. I was unable to get a good nights’ sleep most evenings. My wife, family and friends were very worried as the days wore on. Knowing what was happening to people around me, my fear and anxiety increased, not just for me but my friends and family as well.


Setting aside all differences, political boundaries, people need to work together alongside the government to provide efficient, high quality medical care, as well as the vaccines in an effort to reduce the effects of this pandemic. As a citizen of the worlds’ largest democracy, I appeal to my fellow Indians and people world over to develop high quality medical infrastructures going forward, including but not necessarily limited to increasing the number of COVID- 19 beds, increasing the intensive care unit capacity, and insuring a sufficient, high quality and immediate supply of oxygen and ventilators. I hope to live in a better tomorrow facilitating and fostering the growth of science to eradicate such threats of contagion from the face of earth, so that future generations do not suffer again as did our generation.


Written By: Souvik Datta, Ph.D.


Keywords: COVID-19, pandemic, oxygen, India, Covaxin®


References

1. Rawat K, Kumari P, Saha L. COVID-19 vaccine: A recent update in pipeline vaccines, their design and development strategies. European journal of pharmacology. 2020

2. https://www.bbc.com/news/world-asia-india-55748124

3. Logunov DY, Dolzhikova IV, Shcheblyakov DV, Tukhvatulin AI, Zubkova OV, Dzharullaeva AS, Kovyrshina AV, Lubenets NL, Grousova DM, Erokhova AS, Botikov AG. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. The Lancet. 2021; 397(10275):671-81

4. World Health Organization. (2021). WHO Coronavirus Disease (COVID-19) Dashboard. (Accessed 20th April, 2021).

5. https://timesofindia.indiatimes.com/city/noida/hospital-asks-family-to-get-oxygen-for-siblings-both-die/articleshow/82189839.cms

6. https://www.bbc.com/news/world-asia-india-56940595

7. Bikkina S, Manda VK, Rao UA. Medical oxygen supply during COVID-19: A study with specific reference to State of Andhra Pradesh, India. Materials Today: Proceedings. 2021