‘Beg, borrow, steal’: the fight for oxygen among New Delhi’s hospitals

By Devjyot Ghoshal and Aditya Kalra

NEW DELHI (Reuters) – Pankaj Solanki, a doctor and the director of a small hospital in New Delhi, rushed to an oxygen vendor earlier this week to secure enough cylinders to keep 10 COVID-19 patients on the ICU ward breathing.

His supplies would only last until Thursday night, and so he has sent a driver out to try to find more.

“It is mental agony. I can’t bear it any more. What if something happens to the patients?” he told Reuters.

The last-minute scramble for oxygen at Dharamveer Solanki Hospital is playing out across the city and the country, which is facing the world’s largest surge in COVID-19 cases.

Hospitals in India’s capital, renowned for some of the best medical care in the country, are unable to guarantee basic services and thousands of lives hang in the balance – a stark warning of how India’s healthcare system is buckling amid the pandemic.

Big private hospital chains have not been spared.

This week in New Delhi, which has been hit particularly hard by the coronavirus, seven Max Healthcare hospitals treating more than 1,400 COVID-19 patients were down to between 2 and 18 hours of oxygen left.

Staff at a major facility of the Apollo group had a harrowing night wondering if oxygen to 200 patients would run out. A tanker arrived at around 3 a.m., just in time, a source at the hospital said.

As panic breaks out at hospitals unable to admit some people with severe COVID-19 symptoms, police are being deployed to secure oxygen. In court, judges are challenging the central government to do more to address shortages.

In a late-night court hearing on Wednesday, Delhi justices called on Prime Minister Narendra Modi’s government to “beg, borrow, steal or import” to meet the city’s needs. Officials said they were arranging supplies, but the judges weren’t convinced.

The state “cannot say ‘we can provide only this much and no more’, so if people die, let them die; that cannot be an answer by a responsible sovereign state,” said Justice Vipin Sanghi.

OXYGEN EMERGENCY

Demand for medical oxygen has soared. India recorded 314,835 new COVID-19 infections on Thursday, the highest tally anywhere during the pandemic. In Delhi alone, the daily rise is around 25,000.

Modi and Delhi Chief Minister Arvind Kejriwal have been criticized for failing to plan for the upsurge in cases.

On April 13, when Delhi recorded 13,000 new cases, Kejriwal told a news channel there was “no shortage of oxygen”. Five days later, he tweeted, “OXYGEN HAS BECOME AN EMERGENCY”.

“It is poor forecasting. Maybe they are not able to understand the gravity of the situation,” said Anant Bhan, an independent researcher of global health and bioethics.

“This is a reminder again – we should have extra reserves of oxygen. It shows poor planning.”

A senior gas industry source directly involved in supplying oxygen to Delhi hospitals said the city had moved too slowly in recent days in liaising with authorities and suppliers.

The city has few production units nearby and transportation is a challenge.

The Delhi government and federal health ministry did not respond to Reuters questions for this story.

At an INOX gas plant in the state of Uttar Pradesh, around an hour’s drive from Delhi, 12 trucks from cities across northern India were waiting to load oxygen on Thursday.

Six drivers told Reuters they had faced long delays, as surging demand from hospitals in the capital and elsewhere outstripped supply.

“We have been waiting for three days,” said Bhure Singh, one of the drivers. “Demand has increased and there is no gas.”

The plant has been visited by government officials and police, some carrying assault rifles. An Uttar Pradesh police officer said they had been given orders to escort trucks in some instances to make sure they reached their destination.

LAWYERS’ BARBS

At one Max facility in west Delhi treating 285 COVID-19 patients, oxygen supplies this week ran dry as authorities diverted their tanker to another hospital, the healthcare group wrote in a letter to Delhi’s health minister.

Staff had to borrow cylinders from another facility.

The medical superintendent at the Shanti Mukund Hospital, Kulwinder Singh, told Reuters on Thursday they were asking families of 85 patients who needed high-flow oxygen to make other arrangements because they had only two hours’ worth of supply.

Some hospitals in Delhi have run out of oxygen altogether, putting lives at risk, the city’s deputy chief minister Manish Sisodia said in a televised address. “After some time, saving lives would be difficult,” he warned.

In the capital, the fight for oxygen has reached the High Court, where judges convened late on Wednesday night to hear a plea from Max hospitals.

For around two hours, lawyers for Delhi and the federal government traded barbs over transportation challenges and supplies. Other lawyers shared real-time updates on oxygen tanks reaching hospitals in the city, and a judge took notes on demand and supply statistics for the capital.

The Supreme Court also intervened, saying Modi’s administration should draw up a plan to address shortages of oxygen and critical supplies.

“The situation is alarming,” the court said.

(Additional reporting by Alasdair Pal in Yusufpur and Danish Siddiqui in New Delhi; Editing by Mike Collett-White)

Exclusive: Nurses at Mexico hospital hit by coronavirus say they were told to avoid masks

MONTERREY, Mexico (Reuters) – Nurses at a public hospital hit by Mexico’s worst coronavirus outbreak were told by their managers not to wear protective masks at the start of the epidemic to avoid sowing panic among patients, nurses and other medical workers said.

Two doctors and a hospital administrator have died and at least 51 staff members have been infected since the new coronavirus was detected at the IMSS General Hospital in Monclova in the northern state of Coahuila in late March, the state health department said.

The hospital became Mexico’s first hot spot for the COVID-19 illness caused by the coronavirus.

At least four of the infected workers are currently hospitalized as a result of the outbreak, which has fed concerns that Mexico’s underfunded healthcare system is ill prepared to cope with a major epidemic in the nation of nearly 130 million people.

At the beginning of the outbreak, managers “said that protective equipment wasn’t necessary,” said nurse Charly Escobedo Gonzalez who works at the Monclova hospital.

Answering questions from Reuters about the reports that hospital management told staff not to wear masks, a senior official at Mexico’s main public health service IMSS which runs the hospital said that the health workers should be believed, but he did not confirm details of the reports.

“Specifically, if they are saying that then of course we have to believe it,” said the IMSS official, Raul Pena Viveros. He said there can be misunderstandings inside a hospital about where it is appropriate to wear protective equipment.

“Not all of the workers have to wear the same equipment inside the hospital. And when this type of equipment is used badly…it runs out more quickly and they put workers who are in contact with patients at risk,” he said.

Mexico has registered 4,661 people with the coronavirus and 296 deaths, a fraction of the figures in the neighboring United States, but the coronavirus arrived weeks later in the Latin American country.

The Monclova hospital became a coronavirus focal point in the third week of March, highlighting a lack of masks and even soap and bleach there, staff said.

As staff began to fall ill, hospital floor managers instructed healthcare workers not to use facemasks, which some had bought for themselves due to the lack of hospital equipment, seven workers told Reuters.

Pena Viveros said the hospital had been short of protective equipment as well as other materials to fight the coronavirus in March.

Health officials have not given a detailed explanation of why so many Monclova healthcare workers became infected.

Hospital workers are at greater risk of contracting the coronavirus if they do not wear protective equipment like facemasks and gloves. The N95 respiratory masks offer more protection from other people who are infected while more simple surgical masks help the wearer avoid spreading the virus.

Due to a lack of proper N95 masks, some staff at the hospital were also wearing inappropriate industrial-style masks that were donated to them, Pena Viveros said.

The lack of N95 masks was later resolved, said Pena Viveros, who was sent by the head of the IMSS from Mexico City to investigate the Monclova hospital and spent a week there in early April. Staff say the hospital has more protective equipment now but that they still lack gear such as masks.

Three nurses said that while some colleagues chose not to wear facemasks after being told by managers or supervisors that they were not necessary, other staff kept wearing them.

NO “PANIC”

On the night of March 22, one of the heads of the nursing staff told a group of doctors and nurses gathered in the emergency room to take off their N95 masks because they were not necessary, according to a nurse who heard the order.

Another nurse, surnamed Hernandez Perez, was given a similar order by a deputy head of nursing a few days earlier.

“In a morning clinical class, the sub-head told us not to create panic…that we shouldn’t wear facemasks because we were going to create a psychosis,” said Hernandez Perez, who did not want her full name used. She is now at home sick and has tested positive for the COVID-19 respiratory illness caused by the coronavirus. A second nurse confirmed Hernandez Perez’s account.

Reuters was unable to speak to two of the nursing managers who nurses say spoke at that meeting.

After media accusations that the Monclova hospital badly lacked equipment to deal with the virus, the head of the IMSS, Zoe Robledo, announced in early April that the director of the hospital had been temporarily replaced.

Neither the suspended hospital manager, Ulises Mendoza, nor the current hospital director answered repeated requests from Reuters for comment.

One nurse, who asked that her name not be used for fear of retaliation, said that during the second half of March she was repeatedly told by superiors not to wear a facemask while working in high-risk areas such as on the ground floor of the hospital, where the emergency room is located.

As well as the 51 confirmed cases, Pena Viveros said more than 300 other workers were temporarily sent home as the hospital scrambled to contain the outbreak.

He said the hospital contracted nurses and doctors from other facilities to address the personnel shortage, nevertheless the hospital’s ability to care for patients has been impeded, some staff said.

(Editing by Frank Jack Daniel, Daniel Flynn and Alistair Bell)

Indonesia issues tsunami alert after powerful quake causes panic

Indonesia issues tsunami alert after powerful quake causes panic
JAKARTA (Reuters) – Indonesia issued a tsunami alert on Thursday after a powerful earthquake struck in the sea near the Moluccas, prompting panicked islanders to flee to higher ground, according to residents and a media report.

The quake had a magnitude of 7.1 and struck 139 km (86 miles) northwest of the city of Ternate at a depth of 45 km, according to the U.S. Geological Survey. Earlier, the agency put the magnitude at 7.4.

“Most likely it (a tsunami) won’t hit the land, but we still need to be on alert,” Rahmat Triyono, an official at Indonesia’s geophysics agency, told Kompas TV. He said there had been no reports of damage so far.

The quake was also felt strongly on the island of Sulawesi, to the west of the epicenter.

Indah Lengkong, a resident of port city of Bitung in North Sulawesi, said by text message: “The house was visibly shaking.”

People in her neighborhood had initially panicked, she said, adding: “The quake was very strong and lasted for a while. We can still feel tremors but weaker.”

Twitter user @inritaehyungie, who lives in Tondano in North Sulawesi, also felt the quake strongly.

“The earth was literally shaking so hard,” she said.

Metro TV said some residents had fled to higher ground in the North Moluccas.

(Reporting by Jakarta bureau; Writing by David Evans and Ed Davies; Editing by Catherine Evans)

Kitchen devices resembling bombs cause havoc for New York commuters

New York City police officers are seen as police said they were investigating two suspicious packages at the Fulton St. subway station in Manhattan, New York, U.S. August 16, 2019. REUTERS/Catherine Koppel

By Peter Szekely

NEW YORK (Reuters) – Kitchen appliances resembling pressure cookers were left in two Manhattan locations on Friday, disrupting automobile and subway travel during the morning rush hour before police deemed them harmless and began investigating the possibility of a hoax.

The discoveries of the devices, which the city’s chief counterterrorism officer called “rice cookers that could be mistaken for pressure cookers,” raised concern because of the latter’s previous use as makeshift bombs in New York and Boston.

Surveillance video shows a dark-haired man in his 20s or 30s with a shopping cart placing the devices at two locations inside the busy downtown Fulton Street subway station, said John Miller, the New York Police Department’s deputy commissioner of intelligence and counterterrorism.

“Because of the timing and the placement and items we’re carrying this right now as a hoax device,” Miller told reporters at the scene. “That’s the investigative category.”

The unidentified man is “not a suspect but certainly someone we’d want to interview,” he said. Police posted two photographs on social media of the cookers at Fulton Street.

Officials said they had not determined whether the discovery about an hour later of a third implement resembling a pressure cooker next to a garbage can on a street corner in the borough’s Chelsea neighborhood was related, Miller said.

Miller noted that in September 2016 the so-called “Chelsea Bomber,” Ahmad Khan Rahimi, wounded 30 people using a device made from a pressure cooker and a cellphone timer that exploded on Manhattan’s West 23rd Street. Another pressure cooker bomb was left nearby but did not explode.

Rahimi was sentenced last year to life in prison.

There was also an explosion in Midtown Manhattan in December 2017 when a Bangladeshi man, Akayed Ullah, detonated a homemade bomb in a pedestrian tunnel connecting two subway lines and a bus terminal. Three people were wounded.

Pressure cookers were turned into bombs by a pair of ethnic Chechen brothers when they killed three people and injured more than 200 at the 2013 Boston Marathon.

The discoveries, which were first reported at about 7 a.m. EDT (1100 GMT) created havoc for thousands of motorists and commuters on the numerous subway lines that converge at Fulton Street as police and bomb squad vehicles swarmed to the scene.

Even after police deemed the devices harmless at the Fulton Street station complex, which is close to the World Trade Center, officials warned of residual delays for commuters.

(Reporting by Peter Szekely; Editing by Daniel Wallis and Steve Orlofsky)