India’s Response to Covid Diplomacy by Neighbours

As the Second Wave of the COVID 19 pandemic caused unforeseen number of deaths and infections in India during the month of April 2021, geopolitics continued to feed on this tragic time. This phase of tremendous and sudden rise in the number of infections led to all kinds of shortages of medical facilities for the affected. The impact was most severely felt in the number of beds available in the hospitals and supply of medical oxygen. With cases rising in short duration, the already inadequate and poor health infrastructure wilted and soon the situation was visible to the international community.

Countries ranging from United States, Germany, Japan, Australia to China and Brazil responded with medical supplies to help India cope with the crisis. India’s neighbouring countries including Pakistan also extended support. Foreign Ministry of Pakistan offered ventilators, Bi PAP, digital X ray machines, PPEs and related items. The offer followed a message of support by PM Imran Khan. The Edhi Foundation, a non-government humanitarian organization, offered 50 ambulances and accompanying medical staff via a letter to the Indian Prime Minister. These offers of support and help were either ignored or refused by the Indian government.

The offer of help, however, by the Pakistani government through the spokesman of Foreign Ministry, was accompanied with a call to release the imprisoned Kashmiri leaders and for a meaningful dialogue between the two countries. It is notable on February 25, 2021 India and Pakistan agreed on a ceasefire on the Line of Control (LoC), the de facto border in Jammu and Kashmir. This sudden announcement of ceasefire still causes curiosity in India.

Speculations are also rife that the ceasefire might have been caused by a behind the scenes United States intervention as it grapples with a rising China in the subcontinent. With Pakistan firmly intertwined with the Chinese economy and aid, the US may weighed upon its former ally in the region, Pakistan, to effect the ceasefire. India’s rapidly increasing proximity and partnership with the US in various fields is a reality and has started to impact South Asian geopolitics.

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In these circumstances, India’s refusal to accept COVID 19 help from Pakistan indicates towards its unwavering stance on terrorist groups based in Pakistan and the linkages with ISI. US withdrawal from Afghanistan and Pakistan’s role thereafter can be a factor in the fragile peace on the LoC and hence the ceasefire. India’s stance towards Pakistan may not witness a substantial change despite these gestures of solidarity during the pandemic.

China now influences politics and events in many parts of Asia and Africa and it has a bearing on India’s neighbours. During the April COVID 19 surge in India, China immediately extended help and support to fight the pandemic. India’s initial response to the offer was lukewarm. This was perhaps reflective of its line after the events in Eastern Ladakh at the Line of Actual Control (LAC) since May 2020. India has reiterated several times that it cannot be business as usual if the situation at LAC caused by Chinese incursions is not resolved.

The Chinese, however, responded with a call to the Chinese businessmen to expedite orders of medical equipment to India. And in the first week of May 2021, President Xi Jinping offered help and support through the Chinese Embassy in New Delhi. Finally, the Chinese through the International Federation of Red Cross Societies and Red Crescent Societies provided equipment and $ 1 million in cash to the Indian Red Cross Society. Officially, however, India chose not to respond to direct offers of Covid support and help from China.

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This marks a resolute stance by New Delhi as the talks on the remaining areas of contention on the LAC are stalled after eleven rounds of talks at various levels between the two countries. Later, at the BRICS summit meeting on 31st May,2021 Chinese state councillor and Foreign Minister Wang Yi offered collective BRICS support in India’s fight against the pandemic which India accepted as a member and host recorded.

Elsewhere in the neighbourhood, Bangladesh also extended medical assistance to India during the second wave of the pandemic. Initially, 10,000 vials of the injection, Remdesivir were sent to India in the first consignment. Later, towards the end of May, more than 2500 boxes of medicines and protective equipment were sent across the border to India. India accepted both the consignments and expressed thanks through the official channels.

The surprising act, on behalf of Bangladesh, in the context of the sub-continent is the offer of a $200 million currency swap to Sri Lanka to tide over its massive debt crisis affected by the Chinese investments.

The pandemic and its second wave in India, therefore, has not impacted the geopolitics in the Indian sub-continent. Apart from the ceasefire with Pakistan, which, this time has a mysterious quality, and its longevity remains in question, there are no positives in the relationship as the support extended in the second wave of India was refused or not responded to. Similarly, with China, problems at the LAC remain despite protracted negotiations between Beijing and New Delhi. India’s diplomacy with smaller neighbours in the sub-continent has the omnipotent Chinese shadow, though there is gradual realization in the region, of the ways and means of China post the increasing credibility of reports of origins of the COVID 19 from Wuhan.

A Delhi Covid Survivor Shares His Story

While the 2nd wave of Covid-19 is mercifully behind India now, the danse macabre it brought in its wake, during March-May, will continue to haunt many citizens for a lifetime. A first-person account of a Covid survivor in Delhi brings you the situation up close:

The first symptoms showed up benignly: a mild fever of 100 degreeF (38C) and a gentle cough. But I had read enough about Covid to take these signals mildly. I isolated myself from the rest of my family, kept a bottle of sanitizer close and called the local chemist to deliver a pulse Oxy-meter and some medicines.

Warning signs came early. My calls to various pathology test labs for a swab sample to determine the infection were politely turned down. Most labs had suspended their services due to a massive surge. It was after two days that I was able to get myself tested at a hospital unit; the results took another two days.

Meanwhile, I consulted a doctor who specialized in internal medicine and treated Covid patients. I dutifully followed his prescriptions. The brands prescribed were not available at chemist shops but their generic alternatives could be managed. I read every information related to Covid-19 available on the Internet during isolation. I was sure by fifth-sixth day, things will take a positive turn.

But that was not to be.

My fever shot up to 103 degree F on the fifth day. Oxygen level, hitherto 99%, slipped to 95 intermittently. These were not happy signals. I consulted another senior doctor who added a few new medicines, including a cortico-steroid called Medrol. I was told to get back in two days if symptoms did not improve. They did not.

The new doctor advised admission to a hospital. His own facility, he apologized, was packed to capacity. He suggested in case we did not get a hospital bed that day itself, we should take an oxygen concentrator on rent. With my Oxygen levels dwindling, we arranged a concentrator. It was a good decision as by midnight, my O2 score fell off the red-mark 92.

The next day, we began the hunt for a hospital bed afresh. By afternoon, the severity of situation became clear to us. There were no beds available, leave alone a room, in either state or private hospitals across Delhi. Having called at least 50 hospitals and other leads provided by friends, little positive came out. Interestingly, I received a few calls from medical touts who promised a bed with oxygen for Rs 1 Lakh at non-descript facilities. Some offered to set up similar facilities at our place itself with an attendant for a hefty sum. I ignored the medical mafia calls.

I sought help from some of my resourceful friends. One of them posted an SOS on social media site Twitter. This was picked up by common friends and further amplified. By evening, a few windows opened. I was told the Delhi government had set up new Covid facilities and beds were available there. Friends were coordinating with officials to get me admitted there. By then, I was completely dependent on the concentrator for breathing. My family called up an ambulance to take me to any Covid facility that is finalised. My housing society, which had stored oxygen cylinders, offered them during transportation. It looked that things had begun to fall in place.

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Yamuna Sports complex, a large stadium turned into a Covid facility, was finally zeroed in on. I left home with my brother by my side, but as I stepped toward the society elevator, my vision blurred. Suddenly, there was darkness all around. When I opened my eyes again, I was sitting inside an ambulance, with a mask linked to an oxygen cylinder and people looking over me. I had blacked out and was lifted into the vehicle for oxygen feed. I realised the grim situation I was in. At the sports Complex, after some paperwork and running around, I was wheeled in to my assigned bed.

The set-up looked impressive at first sight. The hall was air-conditioned lined with foldable cots as beds, with brand new oxygen concentrators by their side. Young helpful volunteers moved around with tea, eatables and food packets. However, in an hour of my stay, I realized there were no doctors to be seen. “They would come if there is an emergency,” a fellow patient assured me. And then my oxygen concentrator blipped. Having experienced a blackout not long ago, I panicked. None of the uniformed volunteers knew how to fix the machine. Thankfully, a patient detached a tube, filled it with mineral water and re-started it. I knew the set-up was what it had been labeled: temporary.

Yamuna Sports Complex covid centre

The phone signals were weak but I managed to message my family about the ‘Covid camp’ condition. The answer was reassuring: the hunt for a proper hospital was still on. An hour before midnight, I got a call from my wife. She was on her way with an oxygen cylinder to shift me to a hospital in Noida, over 15 km from Delhi border. An editor friend had pulled all stops to get a room with oxygen facility. No ambulance was willing to cross the state border, hence she was coming with my brother.

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The guards and front staff at the hospital told us they were not taking any new patients as there were no beds; even the stretchers had been used as beds in the emergency unit. Another rounds of phone calls and an hour later, I was ushered in. In the few minutes that I took the oxygen mask off, the levels reached dangerously low again. But the expert staff managed the situation in a jiff. For once, since the blackout, I felt safe. I was told by an attendant not to take off the oxygen mask, even while using washroom. I was provided a nasal fork pipe during lunch and dinner.

The travails for the family hadn’t ended yet. They were to arrange Remdesivir injections. Each vial was being sold in black market for Rs 25-50,000 apiece. Then, there were fake injection too in circulation. Somehow these were arranged, two of them from a logistic facility in Manesar, Haryana, some 70 km from the hospital.

Five days, some 150 pills, and two dozen injections later, I was able to walk for a few minutes without the oxygen support. Although steroids fueled my appetite, I lost about 20 pounds. A deep breath took some effort, so did my visit to the attached washroom. I felt tired and my voice came out like a croak. Yes I felt lucky to have just about scraped through.

Upon my discharge after a week’s stay, with much gratitude for friends and family, I felt as if I was stepping into a new world. Travelling home with a precautionary mask on, I rolled down the window. An unseasonal drizzle had brought the temperature down and the fresh air on my face felt good. A song began to play on my lips noiselessly.

PS: During my recovery at home, I kept thinking about thousands of the unlucky ones who could not manage a bed, or arrange the elusive injections; those who stood helplessly to see their dear ones slipping away. It made me choke. I was brought up in New Delhi and was a witness to, as a patient also, its healthcare infrastructure transformed from a few stinky government-run hospitals of the 1970s to private multi-specialty facilities post-1990s. I never believed for a second that an invisible bug could bring this capital infrastructure to its knees in a matter of days. I prayed we had learnt our lessons.

The Risks of Second Covid-19 Wave

‘People Have Thrown Safeguards Out Of The Window’

Dr Abdul Samad Ansari, Director, Critical Care Services, Nanavati Super Speciality Hospital, Mumbai talks about the risks of second covid-19 wave and the need to not lower our guard

The second wave is a known entity. In fact people are now talking about the third wave too. These are but the ripple effects. The spread of a contagion depends on our social behaviour: how we maintain hygiene and how we interact. If you are meeting five to seven people in a day, it can set off a block chain of infection. If you cut down on that interaction, besides using precautionary measures such as wearing masks and sanitising, you reduce the spread potential. It is that simple.

This happened last year. In September we saw the peak. And in the subsequent months, the efforts of previous six months bore fruits. But we started celebrating prematurely. As we lowered our guard, we are now facing the consequence. People returned to their daily routine as if it was business as usual. The resurgence in Covid-19 cases is a direct result of that. April and May will show the same kind of prolonged plateau. But if we again start becoming more careful, follow strict precautionary measures, along with the vaccination, there will hopefully be a flattening of the curve in June.

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Unlike the first wave, when majority of the elderly population fell prey to the contagion, the infection is seen more in the 35-65 years bracket. This is a mobile population, who are traveling for work, going out more in public and therefore getting infected.

Thankfully, our systems are not as overwhelmed as last year and the mortality rate is also not high. But if the cases continue to grow manifold, the resources will spread out thin. The same virus with only 100 people today as compared to 1000 people tomorrow will have a different mortality scenario. It is not the virus which is causing it, but the number of cases which will impact the resources and mortality.

I can notice that the attitude of people has gone back to pre-pandemic days. Many of them have this misconception that if they didn’t get Covid for one year during its rage, it won’t happen when it is weakening down. ‘Kuch nahi hota, mujhe kuch nahi hoga, dekha jayega.’ This is the kind of Covid-apathy that is setting in, and it is dangerous.

This pandemic has brought about some kind of hygiene training and discipline among us. There is no harm in maintaining it. My message to public is: we still need to practice these hygiene precautions aggressively; unnecessary travel, gatherings, entertainment activities should be avoided or carried out with behavioural modifications such as sanitizing, scrupulous handwashing and face masks.

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I have seen 80 percent of people in public do not wear a mask properly. Mostly, these are hanging over the neck. People have also stopped meticulously washing their hands. They feel twice in a day is good enough. People are all over the places. While I don’t want to sound negative, we need to get our guards and shield back.

Frontline workers and their families have suffered for one year, we have to acknowledge those sacrifices and not lower the defence. For a year, since the onset of pandemic, my colleagues and I went home late every night, only to leave early in the morning. I could not take care of my wife, parents and children. On the contrary, I could be possibly walking in with the virus infection every day. This was a real burnout. People must realise that their careless behaviour can negate all the hard work put in by frontline worker for one year.

As told to Mamta Sharma