On 19 April, Narayanaswamy, the head of Athreya Hospital in Anekal, a town in Bengaluru urban district, sounded an alarm with government and health officials, oxygen suppliers, and the media: his hospital was running out of oxygen. His patients, several of whom were severely ill with COVID-19, would not survive without it. “I have eight patients who are in critical condition and their family members are falling on my feet asking me to save them at any cost. But I am helpless. I can’t do anything,” Narayanaswamy, who is also the president of the Indian Medical Association in Anekal, told reporters with the Bangalore Mirror when they met him that night.
A 69-year-old COVID-19 patient overheard the doctor while he was making appeals for oxygen over the phone. Narayanaswamy recalled that he went to replenish the man’s oxygen, which was running out, he found him hugging the empty cylinder, refusing to let go. “He thought I was stealing his oxygen supply for another patient,” Narayanaswamy told me. “I had to convince him, he was not listening, even as his oxygen was dropping from 70 to 65. That’s when I broke down.”
At around noon on 20 April, about 24 hours after Narayanaswamy made his frantic calls, district health and government officials visited Athreya Hospital. They assured Narayanaswamy that they would facilitate the provision of oxygen for the hospitals in Anekal facing shortages. But, Narayanaswamy said, they were also worried about public perception. He recalled one official saying, “We are in the public, whatever is happening, we should not worry the families. We should avoid panic…even if don’t have something in our pockets, we should say our pockets are full.”
Soon after the meeting with health officials, Narayanaswamy sent a member of his administrative staff to the government-recommended supplier to get cylinders refilled. The truck going to the supplier had close to 72 empty cylinders from different hospitals in the area, including Athreya Hospital. Narayanaswamy found the suppliers resistant to refilling the cylinders and government officials, unresponsive. “Till midnight, none of them were picking up calls, I started calling again, putting messages everywhere possible, I started the same hungama”—fuss.— “When the situation was going to burst, they answered,” Narayanaswamy told me. The oxygen eventually arrived at Athreya Hospital a few hours past midnight, but for the 69-year-old patient, it was too late. He had died earlier that day. “I am honestly telling you, we didn’t have uninterrupted oxygen supply,” Narayanaswamy said, “I put my hand on my heart and tell you, there were interruptions. If it was continuously flowing, maybe he could have made it. Maybe, who knows, I am not God.”
I spoke to the 13 private and public health doctors from Bengaluru, most of them from small-to-medium-sized private hospitals. Nine among these doctors faced at least one oxygen crisis since the beginning of the surge of COVID-19 infections in April. Of these, two said that they received timely help from government officials, while the rest bought oxygen at marked-up prices, either directly from suppliers or on the black market, or got help from the medical fraternity. Most of these hospitals had either stopped admitting new patients or restricted COVID-19 admissions till they could ensure consistent oxygen supply.
“In very big hospitals…there is a liquid oxygen system and oxygenators, so an oxygen-generating system is in place,” a member from Karnataka’s COVID-19 Technical Advisory Committee, who did not want to be identified, told me. “But in smaller hospitals and nursing homes, we are finding that there is a definite shortage.”
I spoke to the head of a private hospital in the Shivajinagar locality of Bengaluru, on 24 April, who compared the situation in the city to the on-going crisis in Delhi, particularly the deaths of 25 patients at Gangaram hospital earlier that day due to an oxygen shortage. “That situation is there, it is just at the doorstep,” the doctor said. “One of the reasons it hasn’t happened is that we’ve refused a lot of admissions, and those people have already died on the street.” The head of a hospital in east Bengaluru told me, “the system is collapsing. There is a forest fire and we are trying to fight it with sprinklers.”
Karnataka has been among the worst-affected states in the rise of COVID-19 infections in March and April in India, described as the country’s second wave. On 30 April, it registered 48,296 new cases, the highest single-day rise since the beginning of the pandemic. On 1 May, the state registered 40,990 new cases, taking the number of active cases to 4,05,068. The state reported a test positivity rate—the number of positive cases among those tested—of 23.03 percent. Bengaluru Urban district alone accounted for 2,70,993 active cases, which was nearly 66 percent of the state’s case-load. By 1 May, the city had officially recorded 6,537 COVID-19 deaths since the beginning of the pandemic in March 2020.
ML Giridhar, the treasurer of Karnataka’s Private Hospitals and Nursing Homes Association and the head of Tejas Hospital in southwest Bengaluru, told me, “I think the death rate in the media is less.” According to him, it did not account for cases in which patients came to casualty wards in severe conditions, without RTPCR reports, and died. In such cases, Giridhar noted, a patient’s family was often unwilling to wait to confirm whether or not a patient was COVID-19 positive through a test, which meant that the death was attributed to another cause.