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Delhi citizens grapple with crippling medical deficiencies amid second wave of pandemic

Scarce and overpriced medical supplies, non-availability of oxygen and exorbitantly priced ambulances to take those seriously ill or dying to far flung corners of the national capital; these are some of the outstanding features that constitute life in the metro today

May 06, 2021 / 08:39 PM IST
People awaiting their turn to get the jab at a COVID-19 vaccination centre in Delhi

People awaiting their turn to get the jab at a COVID-19 vaccination centre in Delhi

In Delhi's Dilshad Garden, the availability of vaccines and stock of common medicines are inversely proportional.

"The vaccines for corona are very strong in nature, so many people fall sick for a couple of days after taking them. The government has told nurses administering the vaccine to inform patients that they should keep general medicines like Paracetamol for fever reduction handy," says Ram Prakash, a compounder at Aggarwal Medicos located near the busy GT Road roundabout.

But with desperate people on the knife’s edge, stocks of all anti-viral medicines such as Paracetamol, Crocin and Calpol are dwindling, he adds.

In the neighbouring urban district of Shahdara, a large swathe of cramped, low income neighbourhoods on Delhi's north eastern end, an interesting pattern of urban strife has emerged after vaccination opened up for the below-45 population.

As vaccine hesitancy ran high in these lower-middle-income colonies over the past week, the area saw a large number of vaccination centres with a requisite stock of doses, being relatively empty.


COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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This was quickly spotted by residents from across East Delhi, who have flocked there to get their jabs. This has led to irritation, with local residents complaining about the relatively wealthier outsiders buying up the medicines after taking their vaccine doses.

Thirty-year-old corporate accountant Anand Sharma, who travelled 14 km to Shahdara from his residence in the comfortable middle-class enclave of Vivek Vihar, says: "There isn't a single slot anywhere in a 10-km radius from my home, despite the presence of more than a dozen vaccination centres. I didn't want to travel this far during the pandemic, especially to an urban slum, but you have to take the vaccine as a priority, right? I will also have to pick up some medicines, which are much cheaper here, for my mother who has been keeping unwell."

Buying in black

Many medicines, including the relatively costlier and specialized Favipiravir, Ivermectin, Dexamethasone and Fabiflu, currently being prescribed for staving off COVID-19, have almost completely disappeared off the shelves in market places.

In April, Delhi saw 4.86 lakh reported COVID-19 cases while health experts say undetected cases could be as high, if not higher. As a result, the price of medicine is determined by the dynamics of demand and supply.

"We have received dozens of complaints from modern medicine chains to small neighbourhood stores, where many people are asking for rates above the maximum retail price (MRP). It's a well-known fact, but for something as basic and widespread as over-the-counter or prescription drugs, it is difficult to enforce the law," admitted a member of the Delhi Chamber of Commerce and Industry.

The story of medical supplies is, however, less about the price and more about availability. The Delhi Police have received dozens of complaints of profiteering over N95 masks, many shipments of which have disappeared from the market, only to emerge periodically in the black market. Reports of spurious, locally made masks, which do little to protect against airborne viruses, have come out of the blue.

That, however, is the buyers’ story. The sellers say they are being targeted. "People think we are hoarding and selling below the counter and I've had the police called to my shop once. Now, we are forced to sell as much as anyone demands. But it’s the people who are complaining, they are ones who are running a racket, making a profit by selling goods through intermediaries," R P Singh, the secretary of the Medicinal Items Sellers Association in Chandni Chowk, said.

Lack of air and ambulance

In a city already known for its ostentatious attitudes, the latest status symbol is the oxygen cylinder. In a bizarre twist of fate and irony,  however, it is the poor who are better placed to secure it.

The Delhi government does not maintain a public database of oxygen suppliers or dealers. But as the oxygen crisis gained momentum, armed with resources compiled on Twitter and Facebook, people have begun making the rounds of oxygen filling stations.

The majority of these are scattered throughout industrial estates on the edge of the city, such as Bawana, Okhla, Naraina and Badarpur. And it is in the unauthorised colonies around these clusters where poor residents are finding it simpler to procure oxygen, simply because they live close by.

Says Sadique, a helper at a welding shop in Badarpur: ``in the initial days, we used to get many calls to deliver oxygen cylinders to posh colonies in Kalkaji and Saket. But as the situation worsened, many oxygen refillers refused. Just imagine dragging out a 47-litre cylinder and loading it in a van in front of hundreds of people who have been waiting for at least half a day to get it filled."

“Now,” he adds with a smirk, ``we hear the rich are struggling. Let them come and stand in line.’’

However, the smaller shops complain of being harassed by the police on a daily basis, who routinely come and forcefully fill and take away large cylinders. The locals say that many of these are cops on VIP protection duty, who ferry cylinders for the families of the people they are supposed to guard.

Hassled and badly rattled patients in the National Capital Region (NCR) have also had to undergo severe fleecing by the city's private ambulance operators. Such operators in Gurugram have gone on strike after the Haryana government imposed a cap on ambulance fares while private operators in Delhi are also charging massive amounts from desperate patients.

Private ambulances' ambush

Across the country, transporting patients and the mounting number of COVID casualties is proving to be a challenge for family members as private ambulance drivers are charging anything between Rs 10,000 and Rs 14,000 to head to the nearest hospitals, burial grounds and crematoriums, no matter if they are located just a few km away.

Even though the municipal corporations of most major cities are claiming that they have enough ambulances to deal with the ongoing crisis, patients are often left on hold or waiting for even up to an hour to book an ambulance from the government helpline.

“We tried government helpline ‘108’ for hours on May 4, but could not connect as the number would invariably be busy,” said Praveen Aggarwal, a resident of Sarita Vihar in Delhi, who wanted to book an ambulance for his daughter Nikita, to be taken to Jasola Apollo, barely 2 km away. He had no choice because private ambulance operators demanded Rs 10,000 for the journey!

“We looked up private ambulance operators online and they were asking for Rs 10,000 for an ambulance without an oxygen cylinder and said if we want one with an oxygen cylinder, it would cost more,” he told Moneycontrol.

Penalties imposed

The Haryana government attempted to set a fare-cap on private ambulances. It has directed regional transport authorities to slap a “minimum Rs 50,000 penalty” on private ambulance drivers or owners found charging more than the fixed price.

The state government instructed that advance life support ambulances can be hired at the rate of Rs 15/km and basic life support ambulances cannot charge more than Rs7/km for transporting patients in any kind of emergency, including accidents.

A day later, the Private Ambulance Welfare Association, Gurgaon, submitted a memorandum to the Deputy Commissioner’s office, announcing their inability to run the vehicles as per the rates fixed.

“In the last two days we have seen a rise in patients showing up in critical conditions at our emergency. They have turned up breathless, fainted, being carried by their loved ones, unresponsive and most families are complaining that ambulances are not available anymore,” a doctor working at Park Hospital in Gurugram said.

He added that patients in critical conditions are being brought in private vehicles, taxis and autos, which are leading to further complications in their treatment. In a country where VIPs are the only ones safe and well protected, it would be ambitious to expect anything else for the hoi polloi.
Subhayan Chakraborty
Yaruqhullah Khan

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