NEW DELHI — Ashish Poddar kept an ice pack on hand as he waited outside a New Delhi hospital for a black market dealer to deliver two drugs for his father, who was gasping for breath inside with COVID-19.
But the drugs never arrived, the ice that was intended to keep the medicines cool melted and his father died hours later.
As India faces a devastating surge of new coronavirus infections overwhelming its health care system, people are taking desperate measures to try to keep loved ones alive. In some cases they are turning to unproven medical treatments, in others to the black market for lifesaving medications that are in short supply.
Poddar had been told by the private hospital treating his father, Raj Kumar Poddar, that remdesivir, an antiviral, and tocilizumab, a drug that blunts human immune responses, were needed to keep the 68-year-old man alive.
Like most hospitals and pharmacies in the Indian capital, stocks had run out. Desperate, Poddar turned to a dealer who promised the medicines after taking an advance of almost $1,000.
“It’s nearby” and “coming” read some of the texts that Ashish received as he waited.
“I wish he had at least told me that he isn’t going to come. I could have searched elsewhere,” the grieving son said.
India set another global record in new virus cases Thursday with more than 379,000 new infections, putting even more pressure on the country’s overwhelmed hospitals. The country of nearly 1.4 billion people has now recorded over 18 million cases, behind only the U.S., and over 200,000 deaths — though the true number is believed to be higher.
Death is so omnipresent that burial grounds are running out of space in many cities and glowing funeral pyres blaze through the night.
The few medicines known to help treat COVID-19, such as remdesivir and steroids in hospitalized patients, are scarce. The most basic treatment — oxygen therapy — is also in short supply, leading to unnecessary deaths. Even hospital beds are scarce. There were just 14 free intensive care beds available in New Delhi, a city of 29 million people, on Thursday morning.
India’s latest treatment guidelines mirror those of the World Health Organization and the United States with a key exception: India allows mildly ill patients to be given hydroxychloroquine or ivermectin, drugs used for certain tropical diseases.
There is little evidence they work against COVID-19, and the WHO strongly recommends against hydroxychloroquine’s use for COVID-19 of any severity and against using ivermectin except in studies.
While India is a leading producer of medicine globally, its regulation of drugs was poor even before the pandemic. And mounting despair is driving people to try anything.
Dr. Anant Bhan, who researches public health and ethics in the city of Bhopal, warns there are risks in the do-it-yourself approach. Bhan said antivirals and steroids should be taken in a hospital setting due to the risk of side effects. And drugs that are lifesaving at one point could be harmful at another, depending on timing and how severe the symptoms are.
“It’s scary because these aren’t vitamin pills,” he said.
Black market prices for remdesivir, which is produced by several Indian companies, have increased up to twentyfold to about $1,000 for a single vial, said Siddhant Sarang, a volunteer with Yuva Halla Bol, a youth activist group that is helping patients find medicines and hospital beds.
With demand high, black market dealers are insisting on cash upfront, said Sarang.
“People are going to dealers with 200,000 to 300,000 rupees [$2,700 to $4,000] in a suitcase,” he said.
Stuti Bhardwaj, 37, went from one pharmacy to another in southern New Delhi this week. Her parents, both in their seventies, were not able to get tests but showed symptoms of COVID-19 and had dangerously low oxygen levels. A doctor advised a host of medications, including hydroxychloroquine.
She eventually found it and bought it, aware it was unlikely to work.
“My parents are dying,” Bhardwaj said. “I am desperate.”