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Health workers wearing personal protective equipment carry bodies outside the Guru Teg Bahadur hospital, in New Delhi on April 24, 2021.

ADNAN ABIDI/Reuters

Shirshendu Sekhar Das watched in horror at the public-health disaster unfolding in India’s biggest cities and completely overwhelming their medical infrastructure. The country had recorded the world’s highest number of COVID-19 infections four days in a row, at more than 346,000 new cases and more than 2,500 deaths a day. Mr. Das, who works as an environmentalist, realized he couldn’t waste a minute. The swelling second wave could soon swallow smaller cities like Guwahati, where he lives in the northeastern state of Assam. “We had to act now,” he said.

Together with like-minded individuals, he recently launched COVID Warriors Northeast. The grassroots group is working on a plasma donation drive and setting up a database on the availability of hospital beds, home-cooked meals and home-testing services.

“A 76-year-old patient wasn’t able to find a bed, but we managed to get him one in 10 minutes through our network,” Mr. Das said. “We are working from the minute we wake up till we fall asleep to streamline the process and avoid black marketing as it happened during the last wave.”

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Ban on flights from India leaves families scrambling

India’s COVID-19 variant of interest vs. variant of concern: What does it mean?

Last week, as it became clear the state machinery was woefully underprepared and not able to keep up with the vast outbreaks in cities such as New Delhi and Mumbai, community-led efforts such as COVID Warriors Northeast began to take root across the country.

In the worst-hit cities, groups of people organized themselves to provide whatever relief they could find, using the power of technology to crowdsource resources and raise emergency funds. Thousands of volunteers banded together to send free meals to those isolated in their homes. Others arranged for supplies of oxygen cylinders and other medical equipment, responding to pleas for help on social media.

A relative of a person who died of COVID-19 is consoled by another during cremation in Jammu, India, on April 25, 2021.

Channi Anand/The Associated Press

After a public outcry and criticism of the way the pandemic has been managed this month, India’s central and state authorities were pressed into urgent action as hospitals faced a severe shortage of oxygen, medical supplies and ICU beds, with scores of patients unable to get medical attention. A series of steps to deal with the crisis was announced on the weekend.

“We were confident, our spirits were up after successfully tackling the first wave, but this storm has shaken the nation,” Prime Minister Narendra Modi said on his monthly radio program. On Sunday, he announced that 551 oxygen-generation plants would be set up in public-health facilities. “These plants are to be made functional as soon as possible,” he said.

Basic customs duty and health taxes will be waived on oxygen and oxygen-related equipment, while COVID-19-related vaccines would be exempted from basic customs duty, said a government statement.

Meanwhile, trains began to transport medical oxygen across the country and oxygen tanks were flown in from Germany, the United Arab Emirates, Singapore and Israel. State governments set up virtual dashboards to offer real-time information on the availability of beds and medicine, and to facilitate requests for medical care.

India’s High Commissioner to Canada, Ajay Bisaria, told The Globe and Mail on Sunday that his country’s top priority is purchasing more oxygen cylinders and oxygen concentrators, and establishing more oxygen-generation plants at hospitals.

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“The biggest point of concern is the shortage of oxygenated hospital beds,” he said. “We’re looking for any quantities that we can lay our hands on.”

The Indian government has issued a global tender for 50,000 metric tonnes of liquid medical oxygen, he said. His office is making inquiries in Canada, but Mr. Bisaria said most of Canada’s supply is imported from the U.S.

Procurement Minister Anita Anand said on Friday that the federal government can provide personal protective equipment, ventilators “and any items that might be useful for the government of India.” Her office did not specify on Sunday whether Canada has a surplus of oxygen, and no time frame has been released by Ottawa on when it will formally offer support to India.

A man performs the last rites for his relative who died of COVID-19 on April 24, 2021 in New Delhi.

Anindito Mukherjee/Getty Images

Mr. Bisaria said the availability of protective gear is not as much a concern but his government will consider any offer. He said the high commission has been inundated with offers of help and any Canadians wishing to contribute should direct their donations to the Indian Red Cross Society.

India has so far administered 140 million doses of vaccine; the country’s total population is 1.4 billion. It has pinned hope on this massive vaccination rollout, which, from May 1, will be opened to everyone older than 18. However, reports of a vaccine shortage because of a delay in getting raw material from the U.S. hung like a dark cloud over the crisis.

But on Sunday, the Biden administration announced the U.S. will immediately provide India with raw materials for COVID-19 vaccines, medical equipment and protective gear.

“The United States is working around the clock to deploy available resources and supplies,” National Security Council spokeswoman Emily Horne said in a statement.

The U.S. administration had been called out for its “America first” stand; Indian-American Representative Raja Krishnamoorthi was among the many voices that urged the Biden administration to release doses of stockpiled AstraZeneca vaccines. “When people in India and elsewhere desperately need help, we can’t let vaccines sit in a warehouse; we need to get them where they’ll save lives,” he said.

Canada has purchased two million doses of the version of the AstraZeneca vaccine made by the Serum Institute of India and sold under the name Covishield. Only 500,000 doses arrived in Canada before the surge in cases in India prompted the government to stop exports. Ottawa has said it is expecting the remaining shots to be delivered by the end of June, but that is contingent on the situation in India.

A patient receives oxygen inside a car provided by a Gurdwara, a Sikh place of worship, in New Delhi on April 24, 2021.

Public-health experts in India have questioned the government’s decision to liberalize the procurement, pricing and administering of COVID-19 vaccines. Manufacturers have the right to set the price of vaccines, leading to worry about how that could hamper needy and vulnerable people from accessing them.

“There is confusion prevailing everywhere,” said Dr. J.A. Jayalal, national president of the Indian Medical Association (IMA). “This is the time to have a uniform pricing pattern; it should be done in a way that reaches all masses.”

But for now, as each day brings more grim news – cremation grounds overrun with corpses; patients collapsing waiting outside hospitals – the national emergency has spurred an all-hands-on-deck response. The IMA has set up a COVID-19 helpline managed by a doctors’ network that attends to SOS calls.

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Fearing the worst, migrant workers have begun to leave the big cities for their hometowns in rural areas. Those who have hung on have little income to get by.

In Mumbai, Neeraj Shetye, program manager at Khaana Chahiye, a food drive, had to scale up operations this month as thousands of marginalized people were out of work because of greater restrictions that shuttered many businesses. “We have distributed about 50,000 meals during the second wave of the pandemic so far,” said Mr. Shetye, who works with 18 partner organizations and more than 100 volunteers to distribute meals and food supplies to slums three times a day.

Even as the city is thrown into a state of public-health chaos, he said, the marginalized communities have bigger worries. “With no money and no jobs, they are worried about where their next meal will come from. We are also talking to them about vaccination, clearing up any doubts and offering medical help whenever necessary,” he said.

Medical staff and relatives help a patient get in a car at a hospital in New Delhi on April 24, 2021.

SAJJAD HUSSAIN/AFP/Getty Images

For Indians living overseas who are watching helplessly as the second wave implodes in India and worrying about their elderly parents, extended family and friends back home, community initiatives have come as a major relief.

Reena Bora is part of a neighbourhood COVID-19 support group of 15 volunteers in the Dwarka district of New Delhi.

She described how an elderly couple, whose children live in Canada and the U.S., were having trouble breathing. They couldn’t get a hospital bed anywhere and struggled through the night. Finally they recovered after getting oxygen in an ambulance for four hours. “That’s when we realized we need to make our own arrangements to deal with emergencies,” Ms. Bora said. Her group raised funds and within two days were able to buy an emergency equipment kit for their condominium.

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“We also check up on those who are isolated and send them home-cooked food,” she said, as she packed a lunch for a family of four sick with COVID-19. “We ensure there’s home delivery of essentials for everyone. And we make payments on behalf of elderly people who are not comfortable with digital payments. ... It’s the least we can do for our community.”

In another part of Delhi, education counsellor Aarti Natarajan Sharma decided to do her bit, too, and offered to cook for families affected by COVID-19.

“I have been having this tremendous feeling of helplessness in the last few days. My mother and I discussed what we could do to help as cases went up in the city. We decided to cater food to a few homes so that as they recover, they have one less thing to stress about,” she said. So lovingly prepared, nutritious meals go out twice a day to families who are affected by the crisis.

“My friends are coming forward and contributing groceries and cash for provisions, too. They are feeling helpless and want to pitch in,” she said. Last year, when her family contracted COVID-19 and her two-year-old son was paralyzed with a serious spinal condition, a similar gesture from her friends kept her going.

“Friends, some of whom I hadn’t heard from in years, sent us home-cooked food every day. It saved us. And now we are trying to do the same.”

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