Help from the European Union, UK and the United States has begun arriving in India as the country battles a devastating surge of COVID-19 infections.
India recorded 323,144 new infections on Tuesday raising its total past 17.6 million, behind only the United States.
It ended a five-day streak of recording the largest single-day increases in any country throughout the pandemic, but the decline likely reflects lower weekend testing rather than the reduced spread of the virus.
The high number of cases in India has been spurred by an insidious new variant that emerged in the country. The surge has undermined the government’s premature claims of victory over the pandemic.
The health ministry also reported another 2,771 deaths in the past 24 hours, with roughly 115 Indians succumbing to the disease every hour.
The latest fatalities pushed India’s death toll to 197,894, behind the US, Brazil and Mexico. Experts say even these figures are probably an undercount.
The death toll could be a huge undercount, as suspected cases are not included, and many COVID-19 deaths are being attributed to underlying conditions.
The crisis is compounded by short supplies of oxygen with families left on their own to ferry people sick with COVID-19 from hospital to hospital in search of treatment.
On social media and in television footage, desperate relatives plead for oxygen outside hospitals or weep in the street for loved ones who died waiting for treatment.
'We are ready to support'
In response to the spiralling situation in the southeast Asian country, the European Union has activated its Civil Protection Mechanism, which is coordinating with member states to ship oxygen and medicine rapidly.
Commission chief Ursula von der Leyen earlier said she was "alarmed by the epidemiological situation in India. We are ready to support."
"The EU is pooling resources to respond rapidly to India's request for assistance," she added.
Chancellor Angela Merkel also said that Germany "stands in solidarity with India and is urgently preparing a mission of support."
"To the people of India I want to express my sympathy on the terrible suffering that COVID-19 has again brought to your communities. The fight against the pandemic is our common fight," she emphasised in a statement.
The UK on Sunday sent a first shipment of about 600 pieces of medical equipment, including ventilators and oxygen concentrators, Foreign Secretary Dominic Raab told ITV.
"There will be a series of other shipments," he added. "We need this kind of international collaboration if we're going to get through this pandemic. We're not going to be safe until we're all safe."
Foreign ministry spokesman Arindam Bagchi tweeted photos on Tuesday of the first shipment of medical aid India received from Britain. It included 100 ventilators and 95 oxygen concentrators.
Germany and Italy have, as of Monday, closed their borders to travellers from India with only their residents allowed to enter provided they present a negative test. They will also have to quarantine upon arrival. The UK also announced similar measures last week.
President Joe Biden said the U.S was also determined to help. “Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, we are determined to help India in its time of need," Biden said in a tweet.
The White House said the U.S. was “working around the clock” to deploy testing kits, ventilators and personal protective equipment, and it would seek to provide oxygen supplies as well. It said it would also make available sources of raw material urgently needed to manufacture Covishield, the Oxford-AstraZeneca vaccine made by the Serum Institute of India.
Other nations like the US, Germany, Israel, France and Pakistan have also promised medical aid to India.
The countries have said they will supply oxygen, diagnostic tests, treatments, ventilators and protective gear to help India at the time of crisis which World Health Organization’s chief Tedros Adhanom Ghebreyesus on Monday called “beyond heartbreaking.”
White House COVID-19 coordinator Jeff Zients told The Associated Press that the Biden administration was working to satisfy other “key requests” from the Indian government, namely for personal protective equipment, tests, therapeutics and supplies of oxygen and respiratory assistance devices.
Epidemiologists from the Centers for Disease Control and Prevention were also expected to soon travel to India to assist with its virus response.
'The virus is swallowing our people'
The unfolding crisis is most visceral in India's overwhelmed graveyards and crematoriums, and in heartbreaking images of gasping patients dying on their way to hospitals due to lack of oxygen.
Burial grounds in the capital New Delhi are running out of space. Bright, glowing funeral pyres light up the night sky in other badly hit cities.
In the central city of Bhopal, some crematoriums have increased their capacity from dozens of pyres to more than 50. Yet there are still hours-long waits.
At the city’s Bhadbhada Vishram Ghat crematorium, workers said they cremated more than 110 people on Saturday, even as government figures in the entire city of 1.8 million put the total number of virus deaths at just 10.
“The virus is swallowing our city’s people like a monster,” said Mamtesh Sharma, an official at the site.
The unprecedented rush of bodies has forced the crematorium to skip individual ceremonies and exhaustive rituals that Hindus believe release the soul from the cycle of rebirth.
“We are just burning bodies as they arrive,” said Sharma. “It is as if we are in the middle of a war.”
The head gravedigger at New Delhi’s largest Muslim cemetery, where 1,000 people have been buried during the pandemic, said more bodies are arriving now than last year. “I fear we will run out of space very soon,” said Mohammad Shameem.
'A matter of time'
The situation is equally grim at unbearably full hospitals, where desperate people are dying in line, sometimes on the roads outside, waiting to see doctors.
Health officials are scrambling to expand critical care units and stock up on dwindling supplies of oxygen. Hospitals and patients alike are struggling to procure scarce medical equipment that's being sold on the black market at an exponential markup.
The drama is in direct contrast with government claims that “nobody in the country was left without oxygen,” in a statement made Saturday by India’s Solicitor General Tushar Mehta before Delhi High Court.
The breakdown is a stark failure for a country whose prime minister only in January had declared victory over COVID-19, and which boasted of being the “world’s pharmacy,” a global producer of vaccines and a model for other developing nations.
Caught off-guard by the latest deadly spike, the federal government has asked industrialists to increase the production of oxygen and other life-saving drugs in short supply. But health experts say India had an entire year to prepare for the inevitable — and it didn’t.
Dr. Krutika Kuppalli, assistant professor of medicine in the division of infectious diseases at the Medical University of South Carolina, said the government should have used the last year, when the virus was more under control, to stockpile medicines and develop systems to confront the likelihood of a new surge.
“Most importantly, they should have looked at what was going on in other parts of the world and understood that it was a matter of time before they would be in a similar situation,’’ Kuppalli said.
Instead, the government’s premature declarations of victory encouraged people to relax when they should have continued strict adherence to physical distancing, wearing masks and avoiding large crowds.
Modi trying to quell criticism
Modi is facing mounting criticism for allowing Hindu festivals and attending mammoth election rallies that experts suspect accelerated the spread of infections. At one such rally on April 17, Modi expressed his delight at the huge crowd, even as experts warned that a deadly surge was inevitable with India already counting 250,000 new daily cases.
Now, with the death toll mounting, his Hindu nationalist government is trying to quell critical voices.
On Saturday, Twitter complied with the government’s request and prevented people in India from viewing more than 50 tweets that appeared to criticise the administration’s handling of the pandemic. The targeted posts include tweets from opposition ministers critical of Modi, journalists and ordinary Indians.
A Twitter spokesperson said it had powers to “withhold access to the content in India only” if the company determined the content to be “illegal in a particular jurisdiction.” The company said it had responded to an order by the government and notified people whose tweets were withheld.
India’s Information Technology Ministry did not respond to a request for comment.
Even with the targeted blocks, horrific scenes of overwhelmed hospitals and cremation grounds spread on Twitter and drew appeals for help.