It’s 4:30 a.m., and I get three frantic calls from M, my friend. I know what it is, and even before I text her back, I’m calling hospitals to see if they have beds available. I wake up friends, co-workers and other helpers I know — it’s 8 a.m. but we have a bed if M moves fast.

Indians are in collective mourning, and we all know someone who is sick or dying. Everyone is reeling from a deadly, heartbreaking second COVID-19 wave.

For the past two weeks, every time I scroll through social media, a flood of grief and helplessness overwhelms me.

“#SOS, my aunt needs oxygen in Delhi.”

“Chennai Twitter: Please help, there are no ambulances, my cousin is breathless.”

“Mumbai: We lost him. #RIP”

Desperate pleas for help and medical attention are shared and retweeted in hopes of finding someone, anyone, who can help. There are everyday obituaries on our timelines. The authorities remain flabbergasted, as citizens — who are anything but ordinary — step up to create frantic fundraisers and organize help in any way possible.

But let’s back up a little. India, like the rest of the world, already had a pandemic in 2020, so why is this wave worse?

Let’s break it down.

1. We thought it was over: Until this surge, it was thought that India had done remarkably well given its population density. Despite Indian public health experts’ warnings, authorities didn’t take the idea of a second wave seriously and so didn’t plan enough.
2. New variants: There is growing evidence that some new variants — like the one that originated in the United Kingdom — are more transmissible. We are awaiting more data on the newer mutations in India that are likely behind the spike and the greater rate of infections compared to 2020.
3. Super spreader events:  Election rallies, weddings and religious mass gatherings coupled with a failure of the political leadership to follow COVID-19 protocol.
4. Lack of transparent data: Some states have not been reporting or testing adequately and misrepresenting figures, creating a false sense of security. Current case and death numbers are also underreported. 
5. Unplanned curbs: Lastly, the restrictions were put in place much too late, although hopefully, we will see their effect soon.

——

My phone pings with texts from resident doctors in Mumbai and Delhi, two of the worst-hit cities by official numbers.

“It’s too young an age to be seeing so much death and being so helpless.” 

“So many death certificates filled, those faces haunt us, we couldn’t do anything.” 

“We’re having breakdowns every day.”

Resident doctors, the unsung heroes of the pandemic, are buckling under the strain of another round.

“It’s heartbreaking to turn patients away, but we have no more beds or supplies,” says a resident doctor from a government facility who preferred to be anonymous for fear of backlash from their institution. Swapneil Parikh, an internal medicine specialist in Mumbai, told me that while there is definite mismanagement, “No hospital system in the world can handle this kind of rise in numbers.”

Our health systems are overwhelmed. Not enough beds or oxygen or medical supplies. Heartbreakingly, in India’s second wave, Indians are not dying from COVID-19 as much as from a lack of resources — missing not from a lack of funding, but a lack of planning. 

Delhi, the nation’s capital, is gasping for air in a major oxygen crunch. On April 23, Sir Ganga Ram Hospital, a large hospital, ran out of oxygen and 25 critical patients died. On May 1, 12 patients died due to a lack of oxygen at Delhi’s Batra Hospital. 

That these tragedies are unfolding in a country that produces enough oxygen, is horrifying and “unacceptable,” said Sumit Ray — a critical care specialist and medical superintendent at Holy Family Hospital, a 345-bed facility in New Delhi that has been converted into a fully COVID hospital. Uttar Pradesh, one of the most populous states, is suffering from deaths due to no oxygen and threats to those who complain. 

From a failure to listen to scientific advice to mismanagement of a current crisis, India is currently reeling from multiple hits.

——

There is a guilt that I now feel, two weeks into a national crisis, on having my close family safe so far — the guilt of surviving as our crematoriums are overflowing.

So, to find a ray of hope, I look at Mumbai and states like Kerala — reeling from high numbers but steadying through transparent reporting, clear communication and reinforced health systems.

I think about how the “global” in global health is especially crucial in times of crisis. 

For example, while earlier the world watched India and offered words of support — and some instances of acute help — persistent activism by the global health community pushed Western leaders to offer more long-term help. On May 5, the Biden administration supported the proposal to waive intellectual property protections for COVID-19 vaccines that can enable poor nations to accelerate their vaccination programs. In a globalized world we owe it to each other to step in and help — especially in a health crisis. Besides, India is one of the largest economies and manufacturers of vaccines — but it can’t export to other countries right now. This impacts other nations’ immunization programs and overall health care — and the possibility of more infection and variants as well.

Helping India in our current crisis is therefore not just an economic decision, but a humanitarian responsibility to protect global health. We’re not over the pandemic until we’re all over it, and I urge the larger Yale community to reinforce its commitment to public health to help avoid future mismanaged pandemics.

There’s still a long road to recovery, and hopefully, Indians don’t have to walk it alone.

Please help by donating to verified fundraisers.

Editor’s note: This current version of this piece was edited to include links to fundraisers.