A note to my regular readers: apologies for the long gap since my last post. As you can imagine, I’ve not had much time for extracurricular writing in the past month or two. This piece is a little different to what I usually post, not to mention significantly longer, but I hope you will find it a worthwhile read.
Blessed be the Lord,
for he has wondrously shown his steadfast love to me,
when I was in a besieged city.
I am writing this in the midst of a two-week quarantine imposed by local government officials in accordance with the rules for Covid-hit households. An official notice has been pasted outside our front door warning any potential visitors that a highly contagious sickness lurks within — the very same sickness which has brought India to its knees in recent weeks, killing thousands of its people every day.
My family in Mumbai — that is, my wife, my in-laws, and myself — came through India’s first Covid-19 wave unscathed. For a whole year we avoided infection, even while the virus ravaged Mumbai in the latter half of 2020, sweeping through the homes of many of our friends. We had some close calls with D’s parents and we suffered a substantial loss of income, but our troubles were negligible compared with what some were going through. Daily-wage earners couldn’t even afford to feed themselves during the lockdown and migrant workers were fleeing the city on foot, walking unfathomable distances to reach their villages.
By the beginning of 2021 things had settled down. Covid case numbers fell to a level that healthcare providers could manage and the mortality rate was among the lowest in the world. People relaxed and many assumed that the worst of the pandemic was over — it seemed that India had weathered the storm and reached herd immunity. Restrictions on movement were lifted. In the month of February, we even managed to fit in a yacht cruise and a weekend trip to Chennai.
But then cases started to climb again and things took a dark turn in the tail-end of March. People were contracting the virus at an alarming rate. On an almost daily basis we received news about friends testing positive. Entire families were developing symptoms at once. More and more friends told us about loved ones who were in a critical condition, breathing only with the assistance of a ventilator and barely hanging on to life. Some pulled through. Others didn’t.
A few days into this catastrophic second wave India was recording hundreds of thousands of new cases per day and several thousand deaths, easily eclipsing the 2020 peak, and the numbers continued to climb steeply. But the magnitude of the crisis only really hit home for me when our church held a prayer session in the middle of one of our Sunday morning Zoom services — the chatbox was quickly flooded with prayer requests for Covid-infected relatives and friends, many of whom were critical. The pastor went through the requests one-by-one and by the time he’d finished he’d used up about half of the time slot usually set aside for the sermon.
The country’s healthcare infrastructure soon began to unravel, especially in metros like Mumbai and Delhi, which were once again bearing the brunt of the outbreak. Social media users began sharing information about where oxygen cylinders could be procured and which hospitals had beds available, a disturbing change from the usual stream of banalities.
Before long, the international press was exhaustively covering the crisis. The world became familiar with the grim images of cremation grounds cluttered with makeshift pyres and patients laid out on stretchers in the parking lots of overcrowded hospitals and haggard healthcare workers toiling in busy wards.
A new Covid variant known as B.1.617.2 was said to be largely responsible for the chaos. Media reports said that the variant, which originated in India, was more contagious and possibly more deadly than other strains. Even people in their thirties with no pre-existing conditions were now losing their lives to the virus. What’s more, Covid tests appeared to be turning up a lot of false negatives and experts feared that cases were being severely undercounted. A well-informed friend of ours messaged us when his wife began to receive treatment for Covid despite testing negative: “there is a pure evil going around,” he said, “please don’t take it lightly.”
And then, in early April, D developed symptoms — a mild fever, body ache, fatigue, and loss of smell. She took some paracetamol and spent a couple of days in bed, after which she felt better. We booked a Covid test but, due to high demand, we had to wait a couple of days for someone to come over and take swab samples. By the time the samples were collected she had recovered her sense of smell and mostly shaken off the other symptoms. The following day the test result came back — Covid RNA had not been detected.
That very night I too was struck with fever. I tossed and turned in bed with a creeping headache and rising body temperature. In the morning my thermometer reading was slightly above the normal range. I spent the day in bed trying to sleep off a raging headache while heavy drilling and hammering in the flat two floors down made the entire building tremble — the owners had for some reason chosen to embark on a major remodelling project in the middle of a public health emergency.
Headaches and temperature fluctuations persisted for a couple of days but my symptoms were not debilitating. I frequently took to my reading corner with a copy of Solzhenitsyn’s Cancer Ward in hand and a thermometer in my mouth. I drank lots of electrolytes and took vitamin and zinc supplements. I was confident that I’d bounce back quickly thanks to a fairly robust immune system. And then, all of a sudden, my sense of smell completely abandoned me — a strong indicator of Covid.
We booked another RT-PCR test and again we had to wait a few days for someone to collect swab samples. In the meantime, my fever broke. But my sense of smell did not return. I would walk around the house sniffing perfumes, scented candles, and kitchen spices — cardamoms, cloves, star anise, cumin seeds — but I could not detect even a hint of a scent. I learned that I was suffering from anosmia, a condition which afflicts a large number of Covid patients, a small percentage of whom continue to suffer from it many months after recovering from the virus.
For a day or two I was quite morose. Anosmia may not seem like much to complain about, especially at a time when people are dying in their thousands every day for lack of oxygen, but it can be distressing. Smell is integral to one’s experience of the world — pleasant smells bring pleasure and repulsive ones warn of danger. Losing one’s ability to interact with the world via one’s olfactory system is bad enough but anosmia also compromises one’s ability to perceive flavours since smell and taste are closely linked.
By now I was fairly certain that D and I had both contracted Covid. I confined myself to the house and took care to avoid contact with delivery guys even after my test report came back negative. I wasn’t overly anxious but I did fret a little. Despite reports of an increased mortality rate among Covid victims in my age bracket, it was not death that I worried about. As strange as it sounds, I was more concerned about the possibility of long-term, or even permanent, sensory impairment.
Soon enough, though, I gained some perspective — I was grateful that I was alive and that I wasn’t laid up in an overcrowded hospital, breathing through a tube. A peace came over me — an assurance that I would be fine. I was sure that my sense of smell would return, but even if it didn’t, it wouldn’t be the worst thing that could happen.
One afternoon a taxi-van with a speaker mounted on the roof came down our street urging over-40s to go to a vaccination centre. Despite government campaigning, there has been a great deal of vaccine hesitancy here. Some are sceptical about anything being pushed by the government; some are concerned about reports of blood clotting; some are worried that they won’t be able to get the follow-up shot if supplies dry up after their first shot.
Deepika, our house help, was the only person we knew in Mumbai who had received a shot. She was keen to continue coming into work despite the surging Covid cases. But she was forced to quarantine when her husband contracted the virus. Her husband was taken away to a government-run quarantine centre as it was not possible for him to self-isolate in their small house but, thankfully, he made a full recovery and returned home after just a week.
Towards the end of April, the UK government announced that it would be restricting travel to and from India. I had not been to the UK to see my parents in over a year and a half and it looked like I would not be going anytime soon. D suggested that I hop on a flight while I still had the chance, before the restrictions came into effect. But with the way things were going in Mumbai, I knew I could not leave my wife and her folks, especially when I had no idea when I’d be able to return.
Thankfully, my parents had been vaccinated and Covid was more or less under control in the UK, so I was not too worried about their wellbeing. This made it easier for me to stay put in my adopted home city as I was once again cut off from my passport country.
And it’s just as well that I stayed, because things were about to get a whole lot worse for my family here in Mumbai.
A full week after losing my sense of smell I found that I could just about detect the scent of peppermint oil when I brought the vial right up to my nose. Although I was still a long way off being able to smell more subtle scents, I was encouraged by even the tiniest sign of improvement.
Around that same time, we got the news that D’s sister, Emmy, had come down with fever. She shrugged it off as seasonal flu but, out of concern for the wellbeing of her parents and her two kids, she left the family home to stay with a friend. She made a quick recovery and, not wanting to cause alarm, she didn’t immediately tell any of us that she had tested positive for Covid.
Days after Emmy left home, we learned that D’s mum was running a temperature. I went over to check on her while D was busy with online classes. By this time the police were restricting traffic on the roads and enforcing lockdown rules. At 11am sharp, as I was walking through a bazaar on my way to D’s parents’ place, a couple of cops showed up to order all the vegetable vendors to close up shop. Within minutes the bustling bazaar had been transformed into a quiet backstreet. When I reached my in-laws’ place I noticed a large bus parked outside which had been repurposed as an ambulance.
Mum seemed fine for the most part. Her thermometer reading was around 100 degrees Fahrenheit, but she was not experiencing any great discomfort and had no other symptoms. She was dismissive of the idea that she might have Covid and was embarrassed about being the cause of any inconvenience.
D and I were uneasy, of course, although we tried not to show it. If India’s under-40s were no longer safe from the virus, what chance did a 60-something diabetic have?
When, three days later, D’s dad and her nephew and niece also began to feel feverish, unease turned to dread. We brought her parents to our place in order to monitor them closely. We used an oximeter to measure oxygen saturation levels and heart rates and D consulted a lung specialist over the phone.
Over the coming few days, the pulmonologist would guide us through the storm with extraordinary compassion, taking D’s calls at almost any time of day even though he must have been swamped with calls from other anxious patients and their relatives. As a leading doctor in his field, his fees were usually quite high. But when D asked him about payment, he said that she should pay only what she could afford.
He prescribed medicines for Covid and advised us to get D’s parents started on them even though they had not yet been tested for the virus. In the confusion and panic of that day, we didn’t think to get the medicines delivered. The hour was late and a sense of urgency had come upon us — we felt that we wouldn’t get the prescription before the local pharmacies shut unless I went in person to collect it.
I masked up, sanitized my hands, and took extra care to keep my distance from the staff at the pharmacy and the lone customer who stood at the counter. I walked home by a slightly longer route to gather my thoughts. The streets were empty. A jaundiced moon slid between the dark tower blocks. My heart was heavy. I thought about the relentlessly rising Covid curve. I felt a great darkness as though a burial shroud had been laid over the entire city. We were under siege by an invisible enemy — an enemy with whom it was impossible to negotiate. We were at war with an all-or-nothing adversary. I felt that God was distant but I found myself praying anyway — praying for mercy for my family and for my city.
Things went from bad to worse. D and I observed a slight dip in Mum’s oxygen saturation level that night. And in the early hours of the morning, before dawn, I awoke to a thud on the bedroom door and found her on the floor in the hall in a state of disorientation. She had been making her way from her bed in the living room to the bathroom when she had collapsed. This is it, I thought, we need to get her to an emergency ward now!
But she rallied after we gave her a drink of water. Her oximeter readings were fine. She was a little frail, but that was likely because she’d been required to fast for 12 hours ahead of some blood tests which the doctor had recommended.
A medical lab employee came over around 8.30am to collect several vials of blood for the tests as well as nasal and throat swab samples for an RT-PCR test. Some time later another lab employee came to take another blood sample for a glucose test.
The RT-PCR test confirmed that Mum was Covid positive. But she had been fever-free for a few days and, despite the worrying incident during her first night at our place, her vital signs appeared to be good. She was in good spirits but very tired. She did little between mealtimes other than sleep and watch classic Goan movies. We gave her the bedroom to ensure that she was sufficiently comfortable.
D had a call from the BMC, the governing body of Mumbai. Mum was to be taken to a quarantine centre in keeping with official policy regarding Covid-positive senior citizens. This was contrary to our wishes — we did not want to let her out of our sight as long as she was in a stable condition and didn’t require hospitalisation. We waited nervously for the inevitable chime of the doorbell. I expected austere government men to come and bundle her off in a van to some unknown location while we looked on helplessly. But when a BMC worker showed up, some 24 hours later, he was extremely cordial. He made no attempt to take Mum away. He simply pasted a quarantine notice outside our door, had a word with the building security, and left.
As per the notice, we were to remain indoors until May 11th. But this was changed to May 14th when Dad tested positive for Covid.
With two Covid patients under our care, D and I were working around the clock, preparing meals, apportioning medicines, cleaning the house, sanitizing surfaces, checking oximeter levels, and so on. D was teaching online in the mornings and I had an unusually high volume of writing work coming in from clients in Singapore and the US. But I was grateful for the work — it provided a welcome distraction from the gnawing fear that permeated our days.
Each day that passed without incident felt like a minor victory. I understood that Covid patients could very suddenly take a turn for the worse. Respiratory problems did not usually show up until several days after the first symptoms appeared. So, we were on tenterhooks day after day, hoping against the odds that D’s parents would shake off the virus with good nutrition, over-the-counter pills, and bedrest. When one lives in constant dread of what the next day might bring, a strange kind of time dilation occurs. The hours become warped, elasticated by the immense gravity of fear. The fourteen days stretched out before us like a desert road whose end was lost in the heat shimmer on the horizon. It was surreal to look out the window and see people walking on the street, going about their business, while we were in full crisis mode.
We began to observe worrying fluctuations in Mum’s oxygen saturation level. The oximeter would beep urgently when the level fell below 94 percent. There were tense moments when we’d hover over the oximeter, praying that the numbers would go up and stay within a healthy range. And we experienced immense relief when they did. Friends forwarded instructions for breathing exercises that were being circulated among Covid-hit families. Some suggested home remedies such as bone broth and steam therapy. We tried these and they seemed to help to some extent.
The stress of it all was all-consuming. D and I slept in the same room as Mum, against the doctor’s advice, so that we could be on hand if something happened to her in the night. We knew that we were putting ourselves in harm’s way, but, realistically, there was little possibility of us remaining physically distant from two Covid patients within the walls of our small flat anyway. Besides, we suspected that we had developed antibodies when we’d fallen sick with Covid-like symptoms back in early April.
Three days into the official quarantine period, Mum’s condition deteriorated drastically. Late at night her oxygen saturation level plummeted below 90 percent. She was weak, her heart rate was low, and she could barely speak properly. We went through the breathing exercises and steam treatment with her. But all she wanted to do was lie down and sleep. The harrowing beep of the oximeter would not stop. I paced up and down praying fervently — the most earnest prayers I had prayed in recent memory. Cracks began to show in Dad’s usually calm, stoic demeanour. He checked his wife’s levels every few minutes, a pained and confused expression on his face.
Mum’s oxygen saturation climbed back up to a mid-90s level and D and I wept with relief, only for the oximeter to start beeping again some time later. D had put the word out about her mum’s condition on several church Whatsapp groups and was now taking calls from friends offering to help secure an oxygen cylinder or a hospital bed. Information flooded in via a group set up by church friends called “Covid Care Mumbai” — phone numbers for hospitals with available beds and individuals who could arrange cylinders. To the BMC’s credit, they were also working hard to provide us with the latest information about Covid facilities in our area.
All the city’s best-known hospitals were full to capacity. Friends were on the phone to medical establishments all over the city. One even went in person to a reputable hospital in Bandra, putting herself at risk in doing so, only to be told they were full. Emmy was also travelling from hospital to hospital making enquiries. Some had beds available but not oxygen cylinders or other equipment needed for critical patients. We would have to arrange our own oxygen supply if we took one of these beds.
Well-connected friends called up their influential contacts — politicians, police chiefs, hospital administrators — to see if they could help.
The hours wore on. It was after midnight. Mum seemed to be fading away before our eyes. Our best bet seemed to be a hospital 20 kilometres away in the outskirts of the city, but none of us had heard of it — we had no idea what the conditions would be like — and the fees were high.
D had one more recourse — a long-time friend who had authority over the management of one of the best hospitals in the city had promised to help when she’d first learned of Mum’s Covid diagnosis. But D was having trouble getting through to her on the phone. It was Ramadan and D’s friend, a practicing Muslim, was perhaps busy with religious functions.
After a few hours, D was able to get through and her friend immediately tasked an aide with making arrangements at the hospital. Arrangements were finalised just as we were on the brink of confirming a bed at our back-up hospital — I had been on the phone to the staff trying to get details but, unlike the staff at larger establishments, they spoke very little English.
Our friends were astounded that we had secured a bed at one of Mumbai’s most modern, best-equipped hospitals. Even the city’s elites were apparently failing to get beds there.
A wave of immense relief rolled over us. Under normal circumstances we are not the kind to ask favours of influential friends (even though Mumbai society runs on nepotism), but when the healthcare system is collapsing and a loved one’s life hangs in the balance principles take a back seat to raw pragmatism. Our hearts went out to the city’s poor — without money or powerful friends what hope did they have of getting proper medical care at a time like this?
We booked an ambulance via a third-party service provider and it showed up sometime after 2am. Emmy came over to help D take their mum to the hospital while I stayed back to look after Dad. As I watched them disappear into the ghostly city, I wondered if I would see Mum again.
I fetched a can of sanitizer spray and thoroughly sprayed the handrails that she had used when descending the stairs. When I got back inside, Dad was there, looking like he’d just woken up from a bad dream. I’d never seen him like that before. He shook his head and, with an air of defeat, simply said: “Corona.”
I went to bed that night sometime around 4am, the incessant beep of the oximeter’s alarm still ringing in my ears.
It turned out that Mum’s sugar level had spiked due to one of the medicines she’d been taking. A CT scan also revealed that her lungs were infected, though not to a dangerous extent. She was placed in a quiet room with two other Covid patients, ensuring that she would receive the greatest possible care, but we were charged only the rate for beds in the general Covid ward. A doctor assured D that the hospital was well stocked with oxygen and Covid-fighting drugs and equipment. They would be starting her on a course of remdesivir right away.
Over the following days, friends sent us food to save us the trouble of cooking. Several offered to help with the substantial medical costs and some immediately transferred large sums without thinking twice. We were overwhelmed by the generosity that was shown us.
But we had no time to rest. All this while Mum’s health was our biggest worry due to her pre-existing conditions. We knew Dad to be resilient and for several days after testing positive for Covid he had been fine — his oximeter levels were often even better than ours. But eventually his health also went into decline. He developed a nasty cough and it gradually got worse.
We were entering one of the hottest months of the year and the only air-conditioning unit in the house had stopped working. The heat grew unbearable even with all the windows open and all the ceiling fans on full power. But even if the AC hadn’t conked out, Dad wouldn’t have been able to enjoy it. We had already set up his bed in the living room with all the windows open for air circulation, as is recommended for Covid patients. Unfortunately, this meant that we couldn’t keep out the great clouds of dust that were being kicked up by the workers in the ground-floor apartment every day — bad news for someone grappling with respiratory issues.
D made multiple calls to the building security, the society manager, and our landlady to complain about the noise and dust issuing from said apartment, but, ultimately, there seemed to be nothing that any of them could do about it.
Dad began to feel feverish again. Emmy came to take him to a nearby clinic — double-masked and latex-gloved — for a CT scan. The scan showed that his lungs were infected — more so than Mum’s. We arranged some blood tests recommended by the pulmonologist.
The blood test reports were not very encouraging. But Dad showed no signs of discomfort, apart from the persistent cough. His oxygen saturation reading hovered at a borderline healthy level. He seemed content eating, sleeping, speaking to the grandkids on the phone, and watching the IPL, India’s largest cricket tournament, or the national news, which largely consisted of footage of Covid patients gasping for air in hospital corridors and parking lots interspersed with impassioned debates between talking heads.
And then, like a cruel case of déjà vu, we again began to experience heart-sinking moments watching the oximeter readings fluctuate. The anxiety-inducing beep of the alarm began to sound more and more frequently. But when D suggested getting him hospitalised, he was defiant: “You check yourself in, if you want. I’m not going!”
When his oxygen saturation briefly dropped below 80 percent, we knew we had another emergency on our hands. But he continued to resist hospitalisation. He paced up and down and took deep breaths to get his saturation level back up to prove that there was nothing wrong with him. And when his best efforts didn’t work, he blamed the equipment: “Your oximeter is broken,” he said.
Below the window, a pooja had started at a shrine to Sai Baba and the thick air reverberated with the sound of bells and drums.
Eventually we persuaded Dad that he needed to be hospitalised. We travelled with him on dark, empty roads to the same hospital in which his wife was being treated. This time we had no difficulty getting a bed as the staff were acquainted with D and knew that she was connected to people at the very top of the chain of command. A doctor who recognised D from her earlier visit examined Dad in the emergency ward and looked at the CT scan images we’d brought with us. He concluded that Dad would need to be put on an oxygen cylinder but that he was not in a critical condition. It was good that we’d brought him in before things got too serious, the doctor said, because the intensive care ward was full to capacity.
The main lobby seemed oddly calm — a world away from the chaotic hospital scenes in the news. The waiting area was empty, apart from two people sleeping either end, as non-patients were not permitted to hang around. We went to the payment counters to pay the deposit. The lady who served us said that her sister-in-law was also in hospital with Covid in the outer suburb where they live.
Incredibly, Dad was put in the same room his wife was in as the other two patients had been discharged and their beds had not yet been reoccupied. But, since visitors were not allowed to enter any of the wards, we said goodbye to him in the reception area before an orderly pushed him away in a wheelchair with a cannula attached to his nose.
It was Mum’s eighth day in hospital when we checked Dad in, and she had been responding well to the treatment she was being given. The following day we were able to pick her up and take her back to our place.
We showed up around 7pm and waited for about an hour outside the emergency ward for an orderly to bring Mum down. In that time three ambulances rolled up with patients who were suffering from respiratory problems. A couple were in wheelchairs and one was on a stretcher, shirtless. A man who had accompanied the latter took a paper plate of snacks to a group of child beggars who were playing outside the gate. A short distance away trains were pulling in and out of a station, their carriages seemingly empty.
Mum was in good spirits when we finally saw her. She was overjoyed about being discharged and eager to see her grandkids again. She had been through a terrible ordeal, but even at her lowest point she had not given up hope. She teared up as she described feeling the presence of Jesus with her in her hospital room. Her simple, child-like faith had not wavered.
Since I started writing this article (on the 10th day of our official quarantine period), a lot has happened. We’ve now been out of quarantine for ten days, during which time a violent cyclone has ravaged the city, uprooting trees and tearing off tin roofs.
Dad is still in the hospital. His condition deteriorated soon after admission, he required more and more supplemental oxygen to maintain a good saturation level, and he was eventually transferred to the intensive care unit. The doctor in charge of his treatment could not tell us definitively whether or not he would pull through.
Thankfully, his health picked up after a few days in the ICU, his supplemental oxygen was reduced, and he was returned to non-critical care. He has now been in the hospital for 16 days and is eager to get out. It is the first time in his life that he’s been hospitalised and he has found the experience quite disagreeable. His vital signs are good and he may be discharged any day now but, due to the severity of his lung infection, he will likely need supplemental oxygen at home for several days after being discharged.
Across India, new Covid cases appear to have peaked at around 400,000 a day and the infection rate is slowing down. But the crisis is far from over. There are still more than 20 million active cases in the country.
Some in the media have described India’s second wave as “apocalyptic”. The word is usually used to denote cataclysmic events worthy of the End of Days, but the original Greek word “apokálypsis” simply meant “revelation”. And, indeed, the events of the past few weeks have been hugely revelatory. They have, for instance, revealed what happens when a nation of 1.3 billion people spends just over one percent of GDP on healthcare; or what happens when a country’s leaders become too complacent to respond effectively to a rapidly escalating humanitarian crisis; or what happens when those same leaders place more importance on their reputations than the lives of the citizens they are supposed to be serving.
This crisis has exposed the rot at the heart of the political establishment. But it has also revealed the extraordinary acts of altruism that ordinary people are capable of. In the absence of government leadership, people have been looking after one another, sharing important updates about hospital beds and oxygen supplies, checking in on friends and neighbours, extending practical or financial support to families hit with heavy medical bills, and so on. It has also shown the tremendous debt of gratitude we owe to people often overlooked by society — garbage collectors, deliverymen, couriers, cab drivers, police officers, building watchmen, and healthcare workers have all continued doing their jobs, at considerable risk to themselves, even through the worst days of the pandemic.
On a personal level, the past few weeks have served as a reminder that God is present even in the midst of great darkness. I realise that this will ring hollow for anyone who has lost a loved one during the pandemic, but I have a renewed conviction that it is the case. I could attempt to explain why suffering is rife in a world created by a loving God, but now is not the time for theodicies.
My own faith is a feeble thing — never anything more than a guttering flame in a storm of doubt, even at the best of times. But I’ve seen divine providence reach into the bleakest of circumstances. We are not always spared trouble, but, in my experience, God has always given me what I need to get through whatever situation I’m in.
Tomorrow will bring new challenges. Some Covid patients are at risk of blood clotting even after recovering from the virus. Some are at risk of infection by a deadly black fungus. We will need to remain vigilant. Sooner or later a third Covid wave will hit India. But today I am thankful for health and life. I am thankful for the air in my lungs and for the smells, both pleasant and foul, that I am once again able to perceive.