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Disclosures: The authors report no relevant financial disclosures.
July 21, 2021
3 min read
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COVID-19 crisis in India: We can’t be silent spectators

Disclosures: The authors report no relevant financial disclosures.
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The world has looked on appalled as a humanitarian catastrophe unfolded in India due to the COVID-19 pandemic.

A record 6,148 deaths were reported on June 10 due to COVID-19 in India, the highest single day death toll in the world since the beginning of the pandemic. As of July 20, there are more than 31 million cases of COVID-19 in India and more than 400,000 — 414,482, to be precise — people have lost their lives, according to government estimates. There were more than 105,000 deaths in May alone, averaging more than 3,300 deaths every single day throughout May. In other words, 3,300 families — tens of thousands, if not hundreds of thousands of people — have lost someone they loved every day in May. No one has been left untouched. Sadly, according to numerous local and international experts, the government figures are a gross underestimate, and estimated deaths are probably in the millions, with tragedy still unfolding.

COVID-19 rates in India, as of July 20, 2021
Data were derived from the COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University.

The images of rows upon rows of funeral pyres for people who died due to a lack of oxygen, of makeshift cremation sites being set up in empty parking lots, and of bodies floating down the holy Ganges have been horrifying and haunting. What is even more horrifying is that a vast majority of these deaths were entirely preventable.

As immigrant physicians in the United States, we have witnessed the devastation that COVID-19 has caused for families in the last year. As physicians specializing in pulmonary and critical care medicine at Cleveland Clinic, we saw many patients succumb to this disease despite the best possible management by highly skilled professionals. In India, patients without basic supportive care like oxygen stand little or no chance of recovery in case of severe COVID-19 disease.

Unfortunately, while extremely saddened, we are not surprised by this current crisis.

Growing up in India, I [Abhishek Bhardwaj, MD, FACP] saw my father, a physician, work with limited resources every day. It was routine for him to ration thrombolytic therapy for patients with heart attacks, triage multiple patients to limited ICU beds and administer lifesaving treatments in the living room of our little home.

He had to make the same difficult choices every day that the world is now witnessing doctors having to make in India. My parents, multiple family members and friends in India have been infected with COVID-19. In May, there were no vacant COVID-19 hospital beds in my hometown, and many hospitals in New Delhi ran out of oxygen.

I [Bhardwaj] have had multiple deaths in the family, have spent countless hours on the phone listening to desperate family members plead for help. As I sit thousands of miles away and hear my physician friends’ horror stories, there is a sense of profound helplessness and a sense of guilt. As we go about our regular day-to-day business here in the U.S., many physicians are carrying a huge emotional burden. Most of us will mask our emotions at work and pretend that it is business as usual. It is NOT. A kind word or show of concern to your physician colleagues from throughout the world can be just the source of strength and resilience we need.

Physicians of Indian origin represent the second largest ethnic group in the U.S. health care system. These doctors and numerous other medical professionals are active members of several national and international medical societies and large U.S. health care institutions. With the support of pharmaceutical and device industries, international medical societies and large U.S. health care institutions can lend expertise, raise awareness, lobby for vaccine redistribution and arrange humanitarian trips to offload burned-out health care professionals in India.

In the end, while we know that one’s birth coordinates determine their life expectancy, what we are currently witnessing is a livestream of deaths due to global socioeconomic and health care disparities.

What is happening in India and in many other areas of the world was, and is, entirely preventable. Without massive vaccination availability and dissemination, and global support of supplies and personnel, the casualties in India and areas around the world will continue to skyrocket.

This is a race against time, and prayers alone are not enough. While these sentiments will probably resonate with every Indian in the U.S., as physicians with expertise in caring for the sick and a sense of duty to care, we should not be helpless bystanders; we need to do our part in India and globally, now.

This letter is to ever be mindful of our global responsibilities and is dedicated to the patients we could not save, and to the health care professionals at the front line of this pandemic who tried.

For more information:

Abhishek Bhardwaj, MD, FACP, can be reached at bhardwa3@ccf.org.