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Covid-19 cases in India have reached their lowest numbers in a year and a half as leaders are celebrating the administration of 1 billion doses of vaccine, a striking change in developments since the virus caused tens of thousands of deaths earlier this year. Since the peak of Covid-19 cases in May 2021, Direct Relief has been involved with multiple airlifts of medical aid to the country as it has battled the pandemic, infusing the country’s medical system with financial support, oxygen delivery and infrastructure, PPE, medications and more.
A Growing threat
When Covid-19 initially hit India, the country appeared to be withstanding the pandemic relatively well. A lockdown was initiated, and the virus seemed to be largely controlled, peaking in mid-September of 2020. But then, in February 2021, after massive crowds had attended political rallies, religious festivals, and large-scale weddings, a second wave began with case numbers quickly tracking upwards. Both urban and rural areas were hit hard as the life-threatening disease spread outwards from the north to the south and east and from cities to more isolated and remote areas and communities.
By April, many hospitals had run out of bed spaces, particularly in urban communities in the north. Intensive care units were filled, and the lack of beds, combined with inadequate oxygen access – the demand for which had tripled due to the increase and severity of cases – led to many patients being turned away and family members racing against time to find or fill oxygen cylinders on their own. India’s daily Covid-19 death toll hit a number of record highs in May, with the World Health Organization stating that the country accounted for half of the total reported cases globally and 30 percent of global deaths.
Direct Relief had already been supporting facilities in India as part of its extensive Covid-19 global response efforts, but additional international assistance with the provision of personal protective equipment (PPE), medical material resources including oxygen devices and intensive care mediations, and financial assistance was clearly needed to protect healthcare providers and effectively treat patients. With support from generous donors, Direct Relief significantly augmented its assistance efforts to help address the enormous increase in cases, hospitalizations, and demand for oxygen.
Supporting the response
With the situation drastically deteriorating in India, Direct Relief prepared a number of large emergency donations and, since April 2021, has delivered 750 tons of aid with a total wholesale value of $601.6 million through the provision of 334 shipments containing:
• 6,665 oxygen concentration units • 29.6 million defined daily doses (DDDs) of Covid-19 ancillary medications such as antibiotics, vasopressors, sedatives, immune suppressants, and albuterol inhalers • 7,610,788 million units of PPE including masks, gowns, gloves, goggles, and face shields
In addition, Direct Relief provided cash grants designed to increase the capacity of medical institutions to safely and effectively treat patients with Covid-19, as well as to strengthen their resilience so that they are better prepared to manage infectious disease outbreaks in the future.
Emergency shipments containing oxygen concentrators, medical products, and PPE were packed at Direct Relief’s warehouse in California, transported by air freight, and delivered to health facilities caring for Covid-19 patients throughout the country.
The emergency shipments were transported with the support of FedEx, which provided three entire 777 aircraft to deliver the bulk of the goods. Direct Relief also mobilized multiple commercial deliveries of oxygen devices, medicines, consumable and durable supplies, PPE, and other medical aid to India.
In order to combat the national spread of Covid-19, PPE and medical goods had to be provided to healthcare facilities in urban centers as well as distributed throughout affected states and regions to ensure aid was getting to the places it needed to reach. The medical goods contained in these emergency shipments were delivered to 29 partners – hospitals, local health departments, state ministries of health, and other healthcare organizations. A number of these partners further distributed a portion of the donated goods to additional facilities throughout the country that were caring for Covid-affected populations and communities.
In addition to displaying information about Direct Relief’s emergency shipments, details can be seen on the redistribution of the medical products received by partner Tata Memorial Centre facilities in Mumbai and Delhi and the delivery of oxygen concentrators via ACT Grants. Tata Memorial Centre is a hospital and cancer research institute in Mumbai that served as consignee and distributor of the Covid-19-related PPE, medications, ventilators, and oxygen concentrators contained in each of the three FedEx humanitarian flights coming from the U.S. These products, including 3,426 oxygen concentrators and more than 250,000 N95 masks, were distributed to a total of 60 healthcare partners.
Direct Relief also supported ACT Grants to facilitate the purchase and transport of oxygen concentrators which, once in India, were distributed to 2,444 health facilities, organizations, and agencies. Using epidemiological and predictive analytics data, the concentrators reached hotspots including many rural districts that have far less infrastructure, resources, and visibility than urban centers. Recipient locations included India’s remote Andaman and Nicobar Islands, located in the Bay of Bengal, where Direct Relief had rebuilt local health centers following the 2004 South Asian tsunami. To date, ACT Grants has distributed 28,929 oxygen concentrators throughout India. (Direct Relief received financial contributions from US-based donors on behalf of ACT Grants to ensure compliance with Indian fiscal regulations.)
In addition to ongoing medical material support, Direct Relief has awarded grant funds to India-based partners and key projects to bolster health facilities as they continue to offer health services to Covid-19 patients and impacted communities and prepare for any future waves.
Given the critical need and shortage of oxygen during the crisis, one chief area of focus involves ensuring sustainable oxygen access through the provision of devices and the building, or rehabilitation, of oxygen generation plants. Effectively responding to the acute oxygen crisis now by augmenting capacity will simultaneously address chronic oxygen requirements and improve sustainable healthcare infrastructure that will enable the treatment of a range of respiratory illnesses.
To date, Direct Relief has identified, vetted, and supported the following facilities and organizations with $4.1 million in cash grants to enable them to respond to and recover from the Covid-19 crisis as well as to maintain ongoing healthcare services to vulnerable populations during the crisis.
Direct Relief will direct additional grant funding towards:
Safely and effectively caring for patients with Covid-19
Conducting Covid-19 educational outreach services
Improving medical grade oxygen access
Increasing partners’ capacity to handle temperature sensitive Covid-19 therapies and vaccines
Administering Covid-19 vaccinations and vaccination campaigns
Supporting the provision of essential healthcare services to at-risk communities made more vulnerable by long term lockdowns, shortages of food, socioeconomic hardship
Direct Relief also supported Deenanath Mangeshkar Hospital, a 1000-bed, multi-specialty hospital located in the city of Pune. Founded in 2001, it is one of the largest hospitals in the area, with over 800 beds, 12 operation theaters, an ICU, blood bank, digital radiology and kidney transplant units, and many state-of-the-art diagnostic, therapeutic, and intensive care services. Patients who cannot afford to pay for care on a sliding scale or at no cost.
Direct Relief has been partnering with DMH since its inception in 2001. The city of Pune was hit particularly hard by Covid-19 and since March 2020, DMH has treated more than 33,000 patients with coronavirus, which is the highest number of cases managed by any private hospital in India. Of the total cases, 19,897 were treated on an out-patient basis while 13,431 were admitted for care. The hospital has also managed many cases of post-covid complications, including serious bacterial and fungal infections.
In an effort to improve the lifesaving Covid-19 treatment delivered at the facility, Direct Relief awarded grant funding to DMH to:
Build an oxygen concentration plant inside the hospital to provide uninterrupted high-flow medical grade oxygen to the facility.
Purchase specialized equipment to enable the rapid and accurate identification of bacteria, mycobacteria and certain fungal pathogens in the clinical microbiology laboratory.
Establish and equip a Covid Center for Microbiology & Infectious Diseases to improve diagnostic and therapeutic practices for Covid-19 and other serious diseases.
The hospital has also led in providing Covid-19 vaccinations, with 175,000 people vaccinated to date.
The number of Covid-19 cases in India has significantly decreased over the past months, but variants remain a concern and there is still a possibility of a third wave hitting the country. However, thousands of Indian healthcare facilities are now much better prepared to handle another influx of cases due to the assistance received in the areas of oxygen access, availability of newer therapies and vaccinations, and additional stores of PPE and other needed supplies and equipment.