Residents blame state government and bureaucracy for Meerut’s deadly second wave of COVID-19

On 5 May 2021, relatives of COVID-19 patients refill oxygen cylinders from a facility in Uttar Pradesh’s Meerut city. The Bharatiya Janata Party-led state government has consistently insisted that Uttar Pradesh set “a great example of COVID management” but hundreds of news reports from the ground contradict the state’s assertions. PTI

“The government is doing work only on paper. It’s all pretend,” Surendra Singh, a resident of Rampur Pawti village in Uttar Pradesh’s Meerut district, told me on 23 May. Residents across rural and urban areas of the district said that unlike the first wave of COVID-19, the second wave had ripped through the region, and the primary cause was the panchayat elections held from 15 to 29 April. There was immense anger against the state government and the bureaucracy, and village after village reported that they had received no help. In most villages it was civil-society members and residents who pooled resources to help provide aid and access to medical care—tests, medicines, oxygen, and in one case, even makeshift medical facilities.

Residents across the board complained that the government hospitals never had beds, and if they did have space, there was no staff to attend to patients and no medicines or oxygen. Several reported how they had been asked by hospitals, public and private, to procure oxygen, injections and medicines on their own, despite constant claims by the government that there were no shortages of anything. All the villages reported that their COVID-19 death toll was far higher than official numbers. A major concern was the loss of livelihood and savings due to the pandemic, and the expenses families were incurring for basic healthcare. Complaints of overcharging and the black-marketing of supplies were a recurring theme. There was a massive amount of misinformation regarding the disease and rumours about vaccines were rampant.

The narratives from the villages are a severe indictment of the management of the public-healthcare system and the pandemic in general by the state government, led by the BJP’s Ajay Singh Bisht and his administration. As several reports in The Caravan have highlighted, the district of Meerut is not an isolated case of state mismanagement of the pandemic. “The way BJP’s workers came door to door for the temple, had they come the same way to help us during corona. But they didn’t,” Kailash Chaprana, another resident of Rampur Pawti, said. “It’s all talk by the government and nothing for the people.” He added, “Now, they are doing havans”—a Hindu ritual burning of offerings—“everywhere. First, provide people the things they need so that no one has to die unnecessarily anymore.”

Every resident I spoke to said that they did not trust government hospitals primarily because there was nothing available and patients were not taken care of. Almost everyone said that the only way to get a bed was to avail of the influence of senior officers or local politicians. The condition of government hospitals was so bad that the general consensus was that it was better to recover at home than go to a public hospital and risk dying. This had spawned a few conspiracy theories that COVID-19 patients going to hospitals were dying and people became increasingly wary of testing positive.

Ankush Prajapati is a 24-year-old resident of Sakoti village. He lost his father, Kiran Pal Prajapati, to COVID-19 on 4 May. Pal was the vice president of the BJP’s Meerut Mandal, an administrative division that includes six districts of the region. The 48-year-old owned a dairy business. “My father initially had mild fever, so we did not take it seriously and treated him at home.” Ankush said that his condition worsened around the first week of May and his oxygen levels had decreased. “We tried many hospitals but there was no place. We finally admitted him to a private hospital on 4 May.” Ankush said that his father was not taken care of and the hospital even told them to arrange oxygen on their own. “We somehow got the oxygen but even then they would not come and check him.” He said that they then made the decision to shift him to one of Meerut’s biggest public hospitals—the Lala Lajpat Rai Memorial Medical College, commonly referred to as Medical.

Ankush said that his father died within hours of shifting him there. “We spoke to him a few times and first he said he was good and then he said he was not doing very well. And two hours later, he was gone. We don’t even know what happened. And in all that time, my father said that no one had come to even check on him.” The family believed that Pal had needed oxygen and a ventilator and was provided neither by the hospital. “Even today, I regret that we made such a big mistake and admitted him to a government hospital,” Ankush said as he wondered how he would take care of his sick mother and complete his studies. Almost all the residents I spoke to who had to avail of services at Medical were highly critical of the hospital’s functioning. They also criticised the fact that the administration’s constantly changing guidelines for medical care were often arbitrary, did not keep patients and accessibility in mind and were not effective.

Vishu Aggarwal is a resident of Meerut City and his maternal uncle, 63-year-old Subhash Chandra, was admitted at Medical on 22 May. He told me that Chandra, who has a business dealing with industrial oxygen, fell sick around 8 May and then started showing symptoms of Black Fungus or Mucormycosis. “We first took him to the Anand Hospital and got him admitted in a COVID-19 ward. But his antigen test was negative, so they shifted him. Then they diagnosed him with Black Fungus.” As of 28 May, Meerut had 147 cases of Black Fungus. On 22 May, the rising number of Black Fungus cases in UP prompted the state government to issue new guidelines regarding the management and treatment of the disease. The guidelines were meant to streamline the availability of relevant drugs and cut down on black marketing.

It is unclear how these new guidelines have helped. Aggarwal said that staff at Anand Hospital told him that if he could procure the injections for black fungus himself, they would treat Chandra there itself. If not, he would have to take Chandra to a public facility. “But there are no injections available in Meerut via the administration. And there are several counterfeit injections floating in the market and so much black marketing also.” He said that they searched for the injections in Delhi, Noida and Gurgaon but the price was too high, far higher than the usual retail price, and even then there was no guarantee that it was the original drug. “We had no option but to take him to Medical.”

Aggarwal said that Medical first said it had no beds. “We used sifarish”—a recommendation, usually from a person in authority or power—“and only then did they give us a bed.” He told me it had been two days but Chandra had not been given any treatment since all reports were delayed, even the RT-PCR. “His situation is critical but no one has even come to see him, even after he got admitted by sifarish.” He added, “This second wave has been devastating and scary, so many are dying. The first was nothing.”

The pervasive complaint of the lack of medical equipment, medicines, oxygen and beds has led to residents and civil society stepping into the fray. In some villages, the situation was so acute that if the residents had not provided for themselves, things would have been far worse. Sakoti was one such village. I spoke to Shailendra Kumar, who is the husband of the newly-elected pradhan, or chief, of the village, Ekta. “Nothing happened in the village in the first wave. But the second wave was bad, really bad.” Shailendra said that from 15 April to 6 May there had been 32 deaths in his village, of which 24 were COVID-19 deaths.

Shailendra said that after so many deaths, “there was an atmosphere of fear in the whole village.” He added, “We did not get any help or any facilities from the government.” He told me that because of this the residents consulted a local doctor on their own who told them to open a small facility themselves. “So, we opened a small hospital in the primary school of the village. We have six ASHA and six Anganwadi workers, so we deployed them there. We got oximeters, thermometers, steam etc.” Shailendra said that with the help of the doctor they made their own protocols. “We took down the information of all the people in the village and gave them information about the disease. Whoever fell sick, we got them all tested for corona—antigen and RT-PCR both. We even arranged oxygen for critical cases.” He added, “This whole arrangement was done by the people of the village.”

Shailendra said there were no beds available anywhere in the period following the elections. “[People got beds] only if an MLA or a minister called. Despite that people were getting fleeced.” He mentioned the case of a private hospital—he refused to name it, since his family had used sifarish to get a space there for a relative—that charged a minimum amount of one lakh per day as a pre-condition to a COVID-19 admittance. He, too, described how people in his village did not want to go to Medical, or most other public hospitals for that matter, after two residents of the village had been admitted at the COVID-19 ward there and both had died within days. “There was no help from the government and if we had waited for them, the whole village would have suffered.” When I spoke to him on 23 May, Shailendra said the village had two active cases of COVID-19.

Gopal Khatri lives in Ghaziabad and works as a builder. He hails from Sakoti village and is a part of a group, along with a few others, which got together to help the village. He told me that on 4 May, he saw a Facebook post of one of his friends about how “30 people had died of COVID-19 in Sakoti.” He said that this prompted him to reach out to a few other people from Sakoti who live outside the village. “Four of us got together initially and then more people joined in.” Khatri’s teenage son, Adarsh, also helped him out.

Adarsh told me that “the first day, 5 May, we held a meeting with the village to figure and decide what all was needed and had to be done. We also had to decide where to set up the distribution centre.” The group Adarsh worked with had helped source basic and critical-care medicines and oxygen cylinders. It also helped with access to COVID-19 tests. They told me that on the first day itself, 60 people from the village were tested, of whom 12 turned out to be positive. The teenager said, “This epidemic is a once in a century occurrence. If we are capable, we should help others.” He added, “I do not know what the village would have done if people had not helped.”

Shailendra squarely blamed the second wave on the panchayat elections. “They had time before the second wave but they did nothing. They pretended the disease was no big deal. They said they will give all facilities but there is nothing.” He said that all the COVID-19 deaths in his village in the second wave happened within nine days after the election. “People from up to Ghaziabad participated in it. This is a big election, in which almost all villages are involved. All the villages of our district panchayat fell sick. But our village was one of the worst-affected ones.”

Shailendra said that the state government was severely undercounting even legitimate COVID-19 deaths. “On 3 May, I was at Medical for hours as a friend of mine died of COVID-19. The next day, the newspaper said that there were three COVID-19 deaths at Medical that day.” He said this was a lie. “I myself saw at least nine bodies of COVID-19 patients being taken away in the time I was there. The newspapers are lying, the deaths are far higher.” He then narrated his tussle with the local administration over his village’s COVID-19 deaths. “The Block Development Officer said ‘give five thousand rupees to those who have died of corona in your village. When the oath-taking of the pradhan is done, it will be sent to your account.’ I said 24 died.” Shailendra continued, “But the BDO said that ‘according to our figures, four dead, so you give Rs 20,000.’” Shailendra said he was told “You can give at your own discretion.” He added that he refused. “We know that 24 people have died from Corona here. Now, you can understand what their figures mean.”

Shailendra also mentioned that his village had had just one vaccination drive. “About 200 people got the shot.” But, he said, four of the vaccinated people had died of COVID-19 and this had led to rumours. “A misconception has spread in the village that people are dying after getting the vaccines. Some believe that the vaccines are deliberately meant to cause impotency.”

Chaprana, the resident of Rampur Pawti, also mentioned that there was significant fear regarding the vaccine in his village. “And in addition, 80 percent don’t know how to register online and maximum don’t have smartphones.” Chaprana said, “And it’s not just the vaccine, it’s everything about the disease.” He explained, “There was no fear in our village in the first wave. But this time people got sick in every house from village to village, so many died, especially those who had gone to election duty.” He added, “In the first ten days of May, there was no oxygen when I was taking people to the hospitals. There were five deaths due to corona in my village and their family members are still admitted. And then there was Black fungus, white fungus.” He said because of this it reached a point “where no one was ready to see a doctor.”

Singh, also from Rampur Pawti, echoed Chaprana. “Everyone was being treated at home. The condition in government hospitals was so bad that people were even afraid to get the corona test done.” When I spoke to Singh on 23 May, he was far more concerned about his financial condition. He is 55 years old and used to work as a ward boy in the Jindal Hospital, a private hospital in Meerut but lost his job during the lockdowns that accompanied the second wave.

“Whatever work there was, it has all stopped. There is no daily-wage or hard-labour work either, everything has ended,” Singh said. He told me that he was struggling to even provide food for his family. “There was some accumulated capital, but we had to spend it all for food and treatment. Prices are rising daily. How will a man survive if everything is closed but everything is still getting expensive?” Singh added, “In the second wave, the financial condition of everyone in the village has become precarious. This government has crushed the poor man completely.”

Another complaint of several residents was that in the chaos of COVID-19 management, non-COVID patients were also suffering. Sanjay Kumar is a resident of the Badhala Kaithwara village. His mother, 48-year-old Usha Devi, has been admitted at Medical since around 6 May due to ill health. She was tested for COVID-19 twice and was negative both times. “Three days ago, my mother was on a ventilator and it stopped and not a single doctor was willing to come check on her. When we asked, we were told that they did not have enough staff who knew how to operate a ventilator. Sometimes, I have to give her medicines on my own, let alone food.” He added, “She is so critical that she won’t make it from here to the door and now they want to discharge her saying that she has been here for 17 days. She’s on a ventilator and they want to discharge her.” 

Dr Anil Nausran is a pathologist and former secretary of the Indian Medical Association’s Meerut chapter. “The preparation that needed to be done for both the waves was never done,” he said, scathing in his criticism of the state government’s response to the pandemic. “The fear and misconceptions that people have, there are many reasons for that.” Nausran explained, “We have so many medicine systems in our country. But we have high illiteracy and people like Ramdev, who mislead people in the name of our religion and exploit them. They exploit them financially.”

Nausran said that exploitation of the people was leading to doctors being painted as the villains. “Oxygen supplies were not in the hands of the doctor, it is in the hands of the administration. Arrangement of beds is not in the hands of the doctor, it is the responsibility of the administration.” Nausran said that doctors were being made into scapegoats for the administration’s incompetence. “The doctor’s job is to treat, not to look after the supply of oxygen or beds.” He added, “And here, the administration failed completely. It is not that there was a shortage—there was mismanagement, there was black marketing.”

Nausran blamed the state government for the black marketing. “When the demand for something increased, they stopped its supply—for them crisis means increased rates.” Chaprana alleged that local BJP workers had been complicit in the hoarding and black marketing. Nausran said that for the administration, hospitals have become the point of business. “There are 250 small and big hospitals inside Meerut. The government has also issued licences to the corporate sector to open hospitals. They only see profits in medicines, in beds. And what the public sees is that doctors are looting them.”

According to Nausran, the “politicians and bureaucrats are running the system their way.” He added, “But this is a medical war, a medical emergency, and they never take inputs from senior doctors, they never sought doctors’ cooperation. That is what caused the damage in the second wave.” Nausran was furious. “They haven’t even figured out how to get proper testing done till now.”

It all boiled down to the need to develop the health system, Nausran told me. “It’s not as if we don’t have the infrastructure, we do. But it needs to be activated properly. It has to start at the level of the primary health centre. There should be a provision of beds and oxygen, at least ten beds, in each village.” He added, “The government has to correct the problem at the village level itself. Otherwise, there will be terrible consequences in the time to come.”