As India’s daily COVID caseload crosses 275,000, securing ICU beds and COVID management drugs now requires clout and connections

April 20, 2021, New Delhi: With daily COVID cases growing by over 17 times within a month from 16,000 to 275,000, 2021 is turning out to be a far more difficult year than 2020. Social media is abuzz with people requesting help for COVID tests, hospital and ICU beds, COVID management drugs like Tocilizumab and Remdesivir, oxygen supplies, as shortage hits hospitals across India. This is clearly the biggest health crisis India has endured in the past century.

A COVID ICU bed is required to monitor the health of an individual infected with COVID, or may even need ventilator support for survival. As the COVID second wave intensified in parts of Maharashtra during the second week of March, the availability of ICU beds became scarce over the next 30 days, and eventually, the wave spread to many more districts of India with over 300 districts now reporting more than 500 active cases. Grim reports of people dying outside hospitals in Delhi, Lucknow, Bhopal and many other parts of the country waiting for an ICU bed have been increasing, especially over the last 2 weeks.

LocalCircles in July 2020 and late last week had alerted the Government about the black-marketing and subsequent interventions were followed. However, the shortage of these drugs is far more acute this time as compared to 2020, with many hospitals unable to supply them asking relatives of COVID patients to fetch it themselves.

There has been an increase in posts and comments on LocalCircles platform, with citizens discussing difficult times being faced by them or people in their social network when trying to secure a COVID ICU bed and COVID management drugs for their family members. Taking cognizance of the difficulties faced by citizens in many districts of India, LocalCircles conducted a survey to understand what it took for people to secure a COVID ICU bed and COVID management drugs. Over 17,000 responses were received from citizens located in 309 districts of India.

Only 13% of those who needed a COVID ICU bed were able to get it through the routine process; 55% had to use connections and clout

The first question in the survey sought to know the experience of people in their social network in regards to getting a COVID-19 ICU bed in the last 45 days. In responses, 42% said “had to use clout or connections to secure the ICU bed”, 24% said “had to follow up extensively to secure the ICU bed”, 3% said “had to escalate via social media or complain to the Government to secure the ICU bed”, and 13% said “had to do all the above 3 to secure the bed”. Breaking down the poll, only 13% said “got the ICU bed without any of the above”. Just 5% said “did not get an ICU bed”. The findings of the poll indicated that only 13% of those who needed a COVID ICU bed were able to get it through the routine process, while 55% had to use connections and clout. Beyond connections and clout, 27% used social media and complained to the Government to get the same. This question in the survey received 8,645 responses.

The findings clearly indicate that those with clout and connections may be able to secure a COVID ICU bed but those without them are likely facing a difficult situation on the ground in getting a COVID ICU bed for their loved ones. This is evident from thousands of posts that one can see daily on social media where individuals are scrambling to find a COVID ICU bed for their family and friends that are critically ill with COVID.

Only 13% of those who needed a COVID ICU bed were able to get it through the routine process; 55% had to use connections and clout

Only 13% of those who needed COVID management drugs (Tocilizumab, Remdesivir) were able to get through the routine process via the hospital; Other had to resort to clout/connections, overpayment and bribes

The first question in the survey sought to know the experience of people in their social network in regards to getting a COVID-19 ICU bed in the last 45 days. In responses, 42% said “had to use clout or connections to secure the ICU bed”, 24% said “had to follow up extensively to secure the ICU bed”, 3% said “had to escalate via social media or complain to the Government to secure the ICU bed”, and 13% said “had to do all the above 3 to secure the bed”. Breaking down the poll, only 13% said “got the ICU bed without any of the above”. Just 5% said “did not get an ICU bed”. The findings of the poll indicated that only 13% of those who needed a COVID ICU bed were able to get it through the routine process, while 55% had to use connections and clout. Beyond connections and clout, 37% used social media and complained to the Government to get the same. This question in the survey received 8,645 responses.

The findings clearly indicate that those with clout and connections may be able to secure a COVID ICU bed but those without them are likely facing a difficult situation on the ground in getting a COVID ICU bed for their loved ones. This is evident from thousands of posts that one can see daily on social media where individuals are scrambling to find a COVID ICU bed for their family and friends that are critically ill with COVID.

Only 13% of those who needed COVID management drugs (Tocilizumab, Remdesivir) were able to get through the routine process via the hospital; Other had to resort to clout/connections, overpayment and bribes

Similar to the need for ICU beds, people are seeking help on social media for vials of COVID management drugs, Remdesivir and Tocilizumab. LocalCircles in July 2020 and last week as well escalated issues of black-marketing of Remdesivir per citizen complaints to the DCGI, which led to multiple interventions including alerting state drug controllers and putting a halt to the export of Remdesivir. However, that was not enough to address the immediate supply shortage. Given that, LocalCircles decided to understand the plight of the common citizens in regard to finding these drugs. The process by design is supposed to be such that these drugs are supplied by manufacturers via distributors to the hospitals directly. However, many hospitals do not have the drug and are instead asking patients to secure it if they can. This has led to widespread panic, hoarding, real and artificial shortages, and hence black-marketing is taking place rampantly. When LocalCircles asked citizens about their experience or the experience of people in their social network in sourcing these drugs, 28% said they had to use clout/connections to get them; 7% said they got it from the market by overpaying; 4% said they ended up bribing hospital officials to secure them while 20% said they could not get it at all. 28% citizens could not say what they did to secure it while only 13% said that the hospital arranged it through the normal process.

In summary, the findings of this survey indicate that due to the major shortage of COVID ICU beds and COVID management drugs (Remdesivir and Tocilizumab), by and large, only people with clout and connections are able to secure them while the common man runs from pillar to post.

Given the worsening COVID crisis with over 275,000 daily cases and new highs expected with each passing day, it is critical that the Government (both Central and States) do whatever it takes to add COVID ICU capacity in the districts with week over week case growth and 500+ active cases. Similarly, all efforts should be made to ensure that the supply of COVID management drugs like Tocilizumab and Remdesivir is only to hospitals and not to any 3rd parties. Hundreds of individuals can be found on social media claiming to be arranging Remdesivir which is not how these drugs are to be supplied.

LocalCircles will escalate the findings of this survey with key stakeholders in the Central Government and all State Governments such that timely actions can be taken on both COVID ICU beds and the supply of COVID management drugs.

Survey Demographics

17000+ responses were received from citizens residing in 309 districts of India. 68% respondents were men while 32% respondents were women. 49% respondents were from tier 1, 28% from tier 2 and 23% respondents were from tier 3, 4 and rural districts. The survey was conducted via LocalCircles platform and all participants were validated citizens who had to be registered with LocalCircles to participate in this survey.