Vinay Srivastava’s death shows UP’s healthcare system has collapsed

“They didn’t admit him for want of a document,” an exasperated Harshit Srivastava said over the phone from Lucknow, Uttar Pradesh. He had lost his father, Vinay Srivastava, to Covid a few hours earlier. His voice quivered with emotion and anger. It was April 17, and tweets posted by Vinay less than 24 hours before had gone viral.

In a series of tweets, Vinay, 65, a journalist of 35 years, noted that his oxygen level was falling precipitously and begged for help to get admitted in a hospital, including from chief minister Adityanath. The help never came and he soon died. His death, almost live tweeted, exposed the collapse of UP’s healthcare system and the callousness of its functionaries.

For several weeks now, India has been in the grip of a brutal new wave of the coronavirus pandemic. It reported 2,95,158 infections on April 20 and 2,023 deaths. Uttar Pradesh, with 162 deaths, is relatively less affected, but the Adityanath government is widely suspected to be grossly underreporting the numbers. Indeed, reports from across the state indicate a collapsing healthcare system, overflowing crematoriums, and mishandling of the crisis by the government.

Vinay’s tragic death is illustrative. He could not be admitted to hospital because he failed to obtain permission from the chief medical officer. The Adityanath government had mandated that no hospital would admit a patient for Covid treatment unless they obtained a letter from the CMO. The rationale apparently was that this would ensure better coordination and oversight, but critics allege this was done to keep the numbers down.

Vinay had sent the first SOS after three facilities – Jagrani Hospital, Regency Superspecialty Hospital, and Balrampur Hospital – refused to admit him. “Non availability of beds and mandatory requirement of a letter from the CMO confirming the patient is suffering from Covid,” Harshit explained. “Both these reasons are responsible for my father’s death.”

Several private doctors Harshit called refused to see his father as well. “We got his RTPCR result today,” he said on April 19, after his father had died. “And doctors wouldn’t entertain us without this report.”

He had also called nearly 40 private vendors for an oxygen cylinder, Harshit said, but to no avail.

By evening on April 17, Vinay’s oxygen saturation was down to a dangerously low 57 percent – hospitalisation is recommended if it falls below 90-92 percent – and Harshit frantically called every government helpline he could find. No response.

A few hours later, his oxygen saturation had plummeted to 31 percent and he was soon gone.

“The situation is dire,” Harshit said, angirly. “The time spent by this government building a temple in Ayodhya could have been used to set up hospitals.”

His father might have seconded him. A fortnight before he died, Vinay had questioned the rationale of organising election rallies amid a pandemic.

‘Hospital ran out of oxygen’

Vinay and Harshit’s ultimately futile struggle to find a hospital bed moved many journalists to lash out at the UP government. Some narrated their own ordeals.

Rajiv Srivastava, an independent journalist in Lucknow, who lost his mother in similar circumstances on April 16, blamed “fudged data and a leadership that’s unaware of ground realities”.

“It takes four days for the RTPCR test result to come so we requested this private hospital in Gomti Nagar to admit my mother as she was having trouble breathing,” Rajiv said.

Her oxygen level was 78 when she was admitted on April 12. “On the night of April 16 the hospital ran out of oxygen and there was no back up. A vehicle that was supposed to bring oxygen cylinders punctured a tyre so there was no oxygen supply for over an hour,” Rajiv added.

By the time the oxygen supply was restored, his mother had died.

But why did the hospital suddenly run out of oxygen? “Usually the hospital needs 18-20 cylinders a day but with an increasing number of Covid patients, the demand has gone upto 150-200 cylinders,” he explained.

Abhishek Pandey, a reporter with Bharat Samachar TV channel, has been covering the pandemic in Lucknow since it began. It’s a “dire situation” in the city now, he said, caused by “the failure of the system”. “I am approached by people almost daily, some with folded hands and crying, asking if I could help find them hospital beds,” he said.

In UP, hospital beds and ambulances are supposed to be allocated by the Integrated Command Control Centre, a centralised system set up by the Adityanath government in March 2020, based on referral letters from the CMO and RTPCR results. As infections have spiked, however, the ICCC has been getting up to 6,000 a days, clogging the lines. When Abhishek recently raised concerns about the functioning of the ICCC with one CMO, he was told there were “calls from VIPs adding to the pressure”.

Asked what he meant by “the failure of the system”, Abhishek pointed out that once vaccines were rolled out in the country, the Adityanath government took the revamping of healthcare infrastructure off its agenda. “An oxygen plant was set up at the Sanjay Gandhi Post Graduate Institute of Medical Sciences a few days ago. It could have been installed much earlier,” he added, by way of an example.

‘I saw bodies in washroom’

Ashish Kumar Singh, 38, Lucknow correspondent for Jantantra TV, was admitted to L2 ward of the Lok Bandhu Hospital in the first week of April, with Covid. The government has categorised Covid wards as L1 for non-critical patients, L2 and L3 for critical and complicated ones.

For the four days he was in the hospital, Ashish said “it was total mayhem”. “My family brought food at 9.30 am and I would get it at 2.30 pm because the staff supposed to deliver it to L2 had to wear PPE kits and in between shifts there was no clarity on who would do it and when.”

Ashish was in a ward with three beds and a single washroom.

“The hospital staff were so callous,” he alleged, “they would keep dead bodies in the washroom until they were taken to the mortuary.”

Hemant Tiwari, president of the UP Accredited Journalists Association, has lately been inundated with calls for help from fellow journalists. Since the last week of March, he said, 50 journalists in the capital city alone have tested positive for coronavirus.

Ajay Srivastava, former vice president of the association, is one of them. When he got sick, Hemant said he called the CMO and the district magistrate but didn’t get a response for almost a day. “For 10 hours he was kept at a hospital owned by a trust. Finally, when I managed to get through to the magistrate, I asked him to tell CMO to take my call and issue the referral letter,” he added.

Brijendra Patel, a reporter in Agra, called Hemant last week when he couldn’t find a bed. “He was standing outside the medical college and asked if I could help get him admitted,” Hemant said, adding that he immediately called the district magistrate, “but there was no response”.

Brijendra, 45, eventually found a bed but succumbed to Covid seven days later. As did Tavishi Srivastava, a political reporter with the Pioneer. She had desperately called around for help, but it never came. She was in her 70s.

“She was the first woman journalist to venture into political reporting in UP about three decades ago,” Hemant recalled. “She couldn’t get treatment on time.”

Tavishi had managed to get a bed after her friends in Delhi intervened, Hemant said, but it was too late.

“Imagine if this is happening to journalists who still have some access, what would be the condition of the common man?” he asked.

Hemant assigned some of the blame for the dire situation to the media. If they had done a better job of holding the government accountable, he said, Uttar Pradesh might not have been facing disaster. “I have never seen such a harrowing condition of the healthcare system in the 36 years of my career,” Hemant said.

Martand Singh is a journalist in Lucknow.