As Delhi becomes India’s coronavirus capital, its hospitals are struggling to cope

A day later, an online report confirmed he was positive.”We weren’t panicking,” says Singh’s son-in-law, Mandeep. “Since we knew the reason for his fever, we thought we would probably be able to address it.” But as Singh’s condition worsened, his family found it impossible to find a hospital that would treat him, as the city’s healthcare system buckled under the pressure of the escalating epidemic. On Wednesday, Delhi surpassed Mumbai’s Covid-19 tally — becoming India’s worst-hit city. It has so far recorded 70,390 cases of the virus and 2,365 deaths.Mandeep Singh said three private hospitals told the family they had no beds, despite an app set up by the Delhi government showing they had availability. Others did not even take the 68-year-old’s calls, including the one he was tested at. Eventually, Lakhjeet Singh went to Lok Nayak Jai Prakash Narayan (LNJP) — the biggest government hospital in Delhi. Before they set out on the 30-minute ride to the hospital, Mandeep Singh says the government app showed the hospital had 1,100 available beds. But when they arrived, Mandeep Singh claims his father-in-law was turned away by medical staff, despite government hospitals in Delhi being legally bound to not refuse emergency patients. Medics said there were no free beds.”It was very unlikely that 1,100 beds would be occupied by the time we got to LNJP hospital,” says Mandeep Singh.Outside the hospital, the elder Singh fainted. His family rushed him inside, where 10 minutes later a doctor examined him and proclaimed him dead on arrival. In a statement, LNJP expressed condolences to the Singh family and denied that he was refused admission. The hospital says he was examined by a doctor and was dead on arrival. On June 4, Lakhjeet Singh’s daughter wrote a short message on Twitter: “He is no more. The govt failed us.”The highest Covid-19 count in IndiaWhen India went into lockdown on March 25, Delhi had recorded just 606 cases of Covid-19 and 10 deaths. When the city first started easing lockdown restrictions in the third week of May in a bid to resuscitate its economy, the numbers started rising — and by June 8 it had more than 40,000 cases. A day later, the city’s Deputy Chief Minister Manish Sisodia announced the capital was expected to witness more than half a million Covid-19 cases by the end of July. Sisodia warned that Delhi would need 80,000 more hospital beds in such a scenario. Dr. Arvind Kumar, chairperson of the Centre for Chest and Lung Transplantation at Sir Ganga Ram Hospital in Delhi and founder of the LungCare Foundation, says the situation in Delhi is “frightening.” “At present, the numbers are increasing very rapidly and the problem with these infectious diseases is that as the infected pool in the society increases, the number of cross-infections occurring from that infected pool also increases and multiplies,” he says. At a press conference on Monday, Delhi Chief Minister Arvind Kejriwal said about 23,000 new Covid-19 cases had been reported in the city in the past 10 days. Last week, Delhi’s Health Minister Satyendar Jain tested positive.About 55% of the active Covid-19 cases are in home isolation, officials have said, but the rest need medical attention. As cases climbed and people scrambled to find hospital beds, in early June the city government launched the Delhi Corona App, which displays real-time information on the availability of beds at government and private hospitals. Hospitals feed the information into the platform, and government officials cross check the figures. Kejriwal said the app, which is updated twice a day, would help bridge the information gap over the status of beds and could be used to register complaints against hospitals refusing to admit infected patients.But with the app showing free hospital beds in many facilities, it appears the problem isn’t about just providing more beds: hospitals also need the staff to man them. A lack of medicsShahana Chanda, 34, was taken to at least five hospitals in early June, according to her uncle, Shahid Siddiqui, a local politician.Despite the hospital app saying beds were available, her family said she was repeatedly turned away from facilities, until finally being admitted at a reputed central government hospital in Delhi-Safdarjung Hospital.Chanda was tested for Covid-19 on admission and given a bed — but after that, her family says she was neglected.”There was nobody to look after her,” says Siddiqui. “No medicines were provided. She was left on her own, only oxygen was provided.”Chanda died on June 7. Siddiqui says she took off her oxygen supply to walk to the washroom in the ward, where she collapsed. “When she fell down, nobody came to help her. Her brother had to bring her back to the bed. When the doctors examined her, they said she’s no more,” says Siddiqui.Safdarjung Hospital said in a statement that Chanda was in a critical condition when admitted and that her family had wasted vital time by taking her to different hospitals. The hospital said Chanda initially tested negative for coronavirus. The mistreatment didn’t end there, Siddiqui said.”When she died, the brother was asked to put her in a bag, sew it and carry her to the morgue, and put her there. Nobody was there to help them,” he says.Safdarjung Hospital told CNN it would not address the allegation. Such claims of mistreatment are not isolated. On June 12, India’s Supreme Court criticized the Delhi government over its handling of Covid-19 patients and treatment of the dead, describing Indian media reports of “horrific” scenes at LNJP, where Lakhjeet Singh died. One TV report showed a man lying on the ground unclothed in a ward, with an elderly person unconscious on a bed nearby. No medical staff were on hand to assist.The Supreme Court ruling said: “The patients are in the wards and the dead bodies are also in the same wards. Dead bodies are seen also in the lobby and waiting area. The patients were not supplied with any oxygen support or any other support, no saline drips were shown with the beds and there was no one to attend the patients. Patients are crying and there is no one to attend them.”Dr. Parv Mittal, president of the Resident Doctors Association at LNJP Hospital, said the facility was overwhelmed on the day that footage was taken.”There was shortage of medical and housekeeping staff. Doctors and nurses were taking rounds but were overburdened. Many had contracted the infection due to extended work hours. The situation is much better now,” he said. “More housekeeping personnel have been employed and CCTV cameras have been set up to monitor sick patients.” The Supreme Court implored Delhi officials to increase the number of beds across the state and to “provide appropriate infrastructure and staff” for Covid-19 patients, calling the conditions “pathetic” and “improper.”Action being takenIndia Home Minister Amit Shah reviewed the situation in Delhi after the Supreme Court’s scathing report, and subsequently established a series of standard operating procedures after talks with the Delhi government.Among other measures, fees for isolation beds at private hospitals have been significantly reduced — while Delhi’s testing rate, which the Supreme Court observed as low, has been ramped up from an average of 5,000 tests daily to 18,000, according to Chief Minister Kejriwal.Officials say another 20,000 Covid-19 beds will be added there by next week. This includes a huge spiritual center which will be transformed into a specialist hospital with 10,000 beds — expected to be the biggest Covid-19 center in the world — by Friday. Furthermore, 500 old train coaches, with 8,000 beds in total, have been earmarked as isolation centers for mild cases. A spokesperson for the Delhi government said: “The government is creating multiple facilities such as hotels, banquet halls etc for treating corona patients. These facilities are being created only after arranging adequate manpower required to manage the patients. For example, around 3,000 hotel rooms are being readied in the capital.”But experts still doubt Delhi has enough manpower to operate the extra facilities.Kumar, of Sir Ganga Ram Hospital, says frontline workers are exhausted and fear getting the virus.”We don’t have enough manpower to run even our own hospital today,” he says. “We are having fights with nurses every day. They are wanting to resign, they are wanting to go away. Resident doctors are disappearing overnight … People are not willing to do duties here … There is a problem of manpower in every hospital.”