#SOS: Indians lean on one another

A second wave of Covid-19 infections sweeping through India is pushing the healthcare system to the brink and overwhelming central and state governments. As authorities struggle to cope with the soaring number of cases and fatalities, Indians have started to lean on one another, taking to Twitter with desperate cries for help.

Pleas for oxygen, hospital beds, ventilators, access to intensive care units and even Covid-19 tests have inundated the Twitter feeds of Indian users since the crisis worsened in April. All of the essentials for fighting the pandemic have been in short supply across the country, with the shortage particularly acute in the capital city New Delhi.

A 30-minute window into Twitter usage in India on April 27 illustrates just how critical the situation has become, with the flood of requests seemingly unrelenting. In the short period between 4:00 and 4:30 p.m. local time (1030 to 1100 GMT), there was on average one tweet every 30 seconds with the #SOS hashtag or mentioning the word “urgent”, relating to the Covid-19 crisis.

The pleas on Twitter only provide a small glimpse into what is happening in the world’s second-most populous nation, where Prime Minister Narendra Modi’s government has come under criticism for its handling of the crisis. Last week, Reuters reported that the government had not acted on early warnings from scientists about a new and more infectious strain of the virus, allowing large gatherings such as political rallies, protests and religious festivals to continue.

The roughly 20 million active accounts in India represent little over one percent of the country’s population of about 1.4 billion. Most lack the resources to seek medical help on social platforms.

Over the weekend of May 1–2, there were more than 15,600 tweets mentioning beds across six of India’s major cities, including Delhi, Mumbai, Bangalore, Chennai, Hyderabad and Kolkata. References to ICUs, ventilators, and RT-PCR Covid-19 tests were also in the thousands. Hospitals will not admit a patient without a positive test result, adding another layer of complexity to the situation. There were also more than 1,300 tweets mentioning cremation during that same period, as many locals lose their loved ones to the pandemic.

While Twitter is not as widely used as Facebook or WhatsApp in India, it is proving to be a more valuable tool during the coronavirus crisis, largely because of its re-tweet function that can quickly amplify pleas for help through users’ networks of contacts.

As requests accelerated in late April, citizens led initiatives on Twitter looking to plug the holes in the country’s failing healthcare infrastructure. The social media platform has become a marketplace for oxygen cylinders, concentrators and even medicines, all of which are scarcely available.

Lists started flooding feeds trying to align users across the country with resources.

“Twitter is having to do what the government helpline numbers should be doing,” wrote Twitter user Karanbir Singh. “We are on our own folks.”

Precious oxygen

Oxygen is a precious commodity for those suffering from severe cases of COVID-19. Critical patients require supplemental oxygenation as a dip in their oxygen saturation levels can result in the deterioration of the respiratory system.

Meeting India’s soaring demand for oxygen is a battle, with hospitals running out almost on a daily basis. The extent of the shortage has been so acute that even hospitals have turned to Twitter for help.

A snapshot of the Delhi government’s online coronavirus dashboard on May 6 at 10:35 p.m. showed that 156 of the 168 hospitals with data listed had less than 48 hours of oxygen supply left. Out of those, 126 had less than 24 hours of supply remaining and 3 hospitals only had one hour before running out of oxygen.

Medical oxygen consumption in India shot up more than eight-fold from usual levels to about 7,200 tonnes per day in April, said Moloy Banerjee of Linde Plc, the country’s biggest oxygen producer.

This rise in demand is mostly coming from western and northern India, which have limited oxygen production capacity, making it necessary to bring in the life-saving gas from India’s eastern states where it is in surplus. But a lack of advance planning and a limited fleet of oxygen tankers have made it difficult to distribute medical oxygen efficiently, often leading some states to squabble over supply and leaving patients in hospitals helpless.

India is importing around 100 cryogenic containers from abroad to transport large quantities of liquid medical oxygen from areas with surplus production to regions hardest hit by the ongoing shortage.

A patient suffering from the coronavirus waits to get admitted outside the casualty ward at Guru Teg Bahadur hospital in New Delhi, India, April 23, 2021. REUTERS/Danish Siddiqui

Because hospitals have little space and limited supplies, families are trying to treat COVID-19 patients at home, strapped to oxygen cylinders they have to find and procure on their own.

Some have been forced to queue overnight outside refilling plants in industrial estates, desperate to refill canisters and running the risk of getting infected themselves.

With resources nearly exhausted, many users turned to social media to facilitate oxygen supply. Reuters counted more than 201,000 tweets mentioning oxygen from April 22 to May 2 across six of India’s major cities.

Between April 21 and May 1, the number of tweets mentioning oxygen in New Delhi reached a peak of 1,020 over a one hour period. But the requests for help are also coming from major cities across India. Tweets analysed by Reuters show that Mumbai saw peaks of over 300 tweets per hour mentioning oxygen.

A woman with a breathing problem receives oxygen support for free inside her car at a Gurudwara (Sikh temple) in Ghaziabad, April 24. REUTERS/Danish Siddiqui

In some places, like a Sikh Gurudwara (temple) in Ghaziabad city on the outskirts of the capital Delhi, aid groups like Khalsa Help International have been providing oxygen to COVID-19 patients streaming in on cars, vans and rickshaws.

Lack of beds

In nearly every major city, critical care and hospital beds are in short supply. Cities have scaled up operations to meet growing demand for beds, by setting up temporary COVID-19 treatment facilities for example. But local governments are still struggling to keep up with the rapid infection rates, and some hospitals are having to turn away sick patients.

In New Delhi, there are available beds, but not the kind needed for critical patients.

Major cities are reporting large numbers of cremations and burials under coronavirus protocols. Some crematoriums have resorted to carrying out cremations in adjacent car parks and other open areas in order to meet demand.

The unfolding crisis on Twitter only gives us a small window into the devastation affecting the broader country, specifically those in big cities.

With no end in sight and a hobbling vaccination program, India’s crisis serves as a reminder that the pandemic isn’t over.