Devina Buckshee is an incoming M.P.H. student at the Yale School of Public Health. She is also a health reporter who has been monitoring the COVID-19 crisis daily from her home in Maharashtra, the second-most populous state in India. What follows is the first of several personal reports from Buckshee about the human toll of the coronavirus pandemic from the frontlines of the crisis in India. She hopes that sharing firsthand accounts of the situation in India will encourage others to support relief efforts there. This report was compiled in May. While the immediate crisis has abated, individuals and families continue to struggle with an overwhelming sense of loss.
A City in Mourning
When COVID-19 first surged in 2020, Mumbai, the most populous city in Maharashtra, was one of the hardest-hit areas in India. In April 2021, the city’s COVID-19 cases peaked again – before the rest of the country was engulfed in a devastating second wave.
But this time, despite a high number of COVID cases, Mumbai managed the crisis better, thanks to the farsighted efficiency of the man heading Mumbai municipality: Brihanmumbai Municipal Corporation (BMC) Commissioner Iqbal Singh Chahal.
Still, as we contain the crisis, the heartbreak and trauma that comes from seeing so many deaths are not easily forgotten.
“We may be better than cities with deaths from a lack of oxygen,” a resident doctor in a Mumbai government hospital says, “but it’s still grim …We will all carry this shadow with us for a long time.” The doctor spoke on the condition his name not be used, fearing backlash from his institution.
To be Numb is a Luxury
I’m so sorry.
I’m sorry for your loss.
How many times can we say something before the words lose their meaning, their impact? Condolences stumble out of my mouth again and again as I try to console friends, relatives and even strangers on the internet who are reeling from devastating COVID losses. When someone dies from a lack of oxygen, there are no words, no metaphors, that can soothe.
On May 18, I lost a colleague. The next day, a friend grew weary in the ICU. One of the worst things about this pandemic is that we grieve alone. No hugs, no shoulders to lean on, no way to touch and provide comfort to loved ones dying alone in crowded hospital wards.
How do we move on when grief is so omnipresent it becomes almost commonplace?
My mother, a social worker who helped distribute Personal Protective Equipment (PPEs), N95 masks and body bags in Mumbai last year, recently spoke with me about how she felt overwhelmed by the sense of constant urgency and seemingly endless news reports of death and personal loss. “How do you stop a tsunami?,” she asked me wearily. We both clutched bags of chips, comfort-eating, depression-eating.
But we move on, as do so many others in India, because we must. To be numb is a luxury right now.
The day after we spoke on May 25, my mother was once again on the phone from our home in lockdown, trying to arrange transport, get proper certifications, assess organizations’ needs and deliver essential supplies across multiple states. Twenty-four hours later, local officials dispatched 200 life-saving oxygen cylinders from Maharashtra to Cooch Behar in West Bengal, across five states, a 2,400-kilometre journey.
Death and Helplessness
As I write this, frontline health care workers are back in their PPEs, dealing with the latest COVID-19 surge. On May 22, Neha Dethe, a staff nurse at Jaslok Hospital in Mumbai, tells me that her shifts have been exhausting. “We see that everyone is getting affected; we are seeing more severe cases,” she said. “This gets very depressing for us, as we see how, despite our efforts, we are still losing patients. As one patient is about to die, another becomes critical; it’s traumatic and demotivating.”
Dr. Harshil Shah, a resident doctor from Mumbai who has been working in COVID-19 Intensive Care Units since early 2020, concurs, “I haven’t seen empty beds in my hospital. We’re too young to see so much death and sheer helplessness. But for us, there’s no looking back.”
Dethe adds how “it was even more stressful” given the suddenness of the surge, as equipment and staffing were hard to scale up. Still, at the end of our discussion, she asks me if I am well, if I have eaten and am resting. The kindness of our frontline workers is what we hang on to.
A Collective Trauma
While frontline health workers face the worst of this, there is a gloomy shroud of fatigue over the entire country. Everyone seems to be dealing with burnout, exhaustion, and increased depression and anxiety. It is a collective psychological trauma.
“I’m just numb,” says Fawzia Khan, a local photo editor at Elle India who is immunocompromised. She laments the lack of freely available vaccines and digs deeper into isolation. “I am just dragging myself through each day.”
A friend of mine asked me, between sniffles, who will look after her recently adopted kittens? She’s just 27. But given the deaths of young, healthy people, talk of wills and arranging personal finances has become essential.
“No single person is untouched by death,” says Dr. Ruksheda Syeda, a psychiatrist in Mumbai. “Either you are mourning or supporting those left behind.”
‘So Much Death’
Ritwik Bhalekar, a local reporter from Maharashtra, tells me of his work visiting the crematoriums in Mumbai. “The facilities were overstretched. There was so much death,” he said. The crematorium workers can’t wear PPEs because of the intense heat from the fires, so their only protection is masks. He recalled workers telling him how the priority vaccine drive for frontline staff ignored crematorium workers, despite the high risks they face daily.
“The deaths were so quick this time, by the time we rallied to help one person and arrange beds or transport they were dying,” Ritwik said. “What can we do? The only way I could help was to report.” He speaks of the need for psychological support for journalists and for all businesses to ramp up meaningful mental health care options for their employees.
Pleas for Help, Calls to Action
Social media has become a haunting reminder of desperate pleas for help, a graveyard of last words.
It’s also a dashboard with calls to action.
Volunteers across cities verify numbers of beds and available medicines to help strangers in acute need. Donating medicines from dead patients or remaining oxygen from recovered patients, we lean hard on each other. Many people who have lost family members to COVID-19 have turned to volunteering. Helping others is the only gossamer thread of hope. In isolation, we’ve become acutely aware of the comfort of community.
We sigh together.
We are the inheritors of loss; do we dare imagine a future without a mask? As some countries open up to normalcy, we must remember the pandemic is not over until it is over for everyone.