'Difference this time is the suddenness of death'

'Now you see a patient, 10 minutes later the patient is dead.'
'The second wave is definitely much more dangerous, brutal and fatal than the first wave.'
'The number of deaths and infections in India today are very, very, high; the actual numbers are not being reported.'

"Our humble suggestion to the government that whenever a patient is admitted, oxygen supply should be guaranteed; remdesivir is guaranteed. Only this guarantee will ease the situation in the hospitals now," Dr J A Jayalal, president, Indian Medical Association, tells Prasanna D Zore/Rediff.com.

• Part 1: 'People are dying. We are helpless'

What can bureaucrats do if there is no political leadership leading from the front?

It is how you (the bureaucrats) are presenting the facts (the situation on the ground to the Union government). The PM takes a decision based on the inputs shared with him (by the bureaucrats). The duty of the bureaucrats is to provide the real picture on the ground; they can't put made-up facts on the table.

If you (bureaucrats) are going to do this (hide the facts from the PM) then this is what (the mismanagement of COVID-19 pandemic) you will get.

Are you saying that the prime minister depends only upon the bureaucrats to get inputs about the ground realities?
Do you believe that given the situation the prime minister will need the bureaucrats to tell him about the realities on the ground?

I am not saying the prime minister has to depend upon the bureaucrats. I am talking about how the bureaucrats are presenting the facts to the prime minister.

If somebody is getting infected by the virus, will you hold the health minister to account? Will he be at fault? The bureaucrats and technocrats are not giving the right picture (to the prime minister).

What has been the IMA's experience of dealing with the first and second wave of the coronavirus pandemic? How are these two pandemics different?

In the first wave if there were 100 people in the ward, only 10 to 12 needed critical care. In the second wave out of 100, 60-65 people need to be given critical care including ICU beds, life-saving drugs, and oxygen supply.

The number of deaths and infections in India today are very, very, high; the actual numbers are not being reported.

The other difference this time is the suddenness of death. Now you see a patient, 10 minutes later the patient is dead.

This is the reason why the IMA has suggested that a national lockdown be imposed as quickly as the government can. That is the only way right now to break the chain and stem the spread of virus.

The second wave is definitely much more dangerous, brutal and fatal than the first wave.

How have you been your doctors dealing with the second wave?

Every single health worker in the frontline fighting the pandemic is working more than the fixed duty hours. We have lost track of time, in a way.

During the first wave there was enough of remdesivir, oxygen, ICU beds, etc. Every doctor now lives with the anxiety of whether their patients will get enough of oxygen or not.

Every few minutes I get a call from patients' relatives or doctors from private hospitals that patients don't have enough oxygen at their hospital and needs to be shifted to government hospital.

Every single doctor working in a private hospital is in a dilemma. They are not in position to admit patients because they are not sure about oxygen supply they will get.

It is a painful situation for doctors to see patients die in front of them. Not today, not yesterday or not day before yesterday. It has been happening for more than a month now that these doctors are feeling helpless as medical professionals.

There are so many reasons why oxygen is in short supply. I am not saying that this situation can be overcome easily. But there are so many patients and the need is more. But this is a situation we should have prepared for.

What would be your suggestions to the Union government and health ministry to deal with the serious situation on the ground?

Right now the most acute shortage is of oxygen supply and drugs like remdesivir.

We are saying that if these requirements are not fulfilled there will be more casualties and more pain. There is black marketing of these essentials. To stop this (black marketing), systems should be put in place to track each and every movement of these essentials.

We have asked for tracking of these essentials right from the time it leaves the source till the time it reaches its destination.

But what is happening right now is the government institutions in control of these services are unable to do this tracking. It is unpardonable that we don't have systems to stop black marketing of oxygen and life-saving medicines.

Every city, every town you will hear desperate cries for supply of oxygen.

There is no proper coordination and it is somewhat unfortunate that the Supreme Court had to intervene to correct this situation and regulate supply of oxygen.

Is this not the (health) ministry's job? Is it the job of the Supreme Court? This is happening because of technocrats and bureaucrats.

Our humble suggestion to the government that whenever a patient is admitted, oxygen supply should be guaranteed; remdesivir is guaranteed. Only this guarantee will ease the situation in the hospitals now.

Now, there is no record of the international aid we are getting; who is getting what and in what number? There are so much of oxygen concentrators and oxygen plants, but this too is not reaching where it is required.

The government should ensure that whenever such aid reaches Delhi, it should reach within two-three hours or within a day to the places where it is needed the most.