When Sushil Kumar Srivastava’s shortness of breath worsened, his family packed the 70-year-old in a car and took him to a hospital in the capital of the northern state of Uttar Pradesh in India, where he tested positive for the coronavirus.
After the private hospital dismissed the retired government official because there were no empty beds, his son Ashish brought two bottles of oxygen with him and drove his father on a hunt to a hospital that could take him in.
“All hospitals requested a referral letter from the Chief Medical Officer’s (CMO) office,” said Ashish, referring to the city’s top health officer of some 3.5 million people.
In the office, Ashish said no one was helping him. “I was chased away by the police,” he said when he tried to meet with the CMO.
Three days later, Ashish said someone from the government called to offer a bed for his father – a day after Srivastava passed away in a private clinic.
The family’s ordeal mirrors the worsening COVID-19 crisis in Uttar Pradesh, where people battle the bureaucracy along with the disease.
To get a COVID-19 bed in Lucknow, families say they need to show the result of an RT-PCR test, which is already scarce.
Then, patients must register with the CMO office, which then forwards the request to the Integrated Command Control Center for COVID management that makes the final bed assignment, a government official said.
A state government spokesman told Reuters on Wednesday that authorities planned to end the CMO referral system this week and instead appoint officials at each COVID-19 hospital to assess whether a patient should be admitted.
The cumbersome process has been criticized, including by the state’s human rights commission, which has asked the government to remove the referral rule.
“There are expert doctors in hospitals who can decide whether the patient should be admitted or not,” the committee said Tuesday. “This referral letter system is not required.”
India has already become the country most affected by the pandemic right now, having recorded more than 200,000 new COVID-19 cases every day in the past seven days, signaling the world’s strongest increase this month, and there is no sign yet that the second wave of infections will soon reach their peak.
In Uttar Pradesh, home to 200 million people, infections are on the rise with more than 22,000 cases every day, putting serious pressure on the creaking healthcare system.
The state government has said it is turning several hospitals into COVID facilities and adding more beds. It did not respond to questions from Reuters.
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At the Lucknow CMO office, next to two major hospitals, dozens of people queue up every day asking, begging, and sometimes crying for a referral letter needed for hospital admissions.
This week, local TV news channels aired images of a young man lying on the road blocking the CMO’s car in desperation to get a letter for a sick relative.
Patients must present an RT-PCR test confirming infection before receiving a referral letter.
But these tests are increasingly difficult for most patients to access, with long queues outside hospitals and clinics overloaded by the proliferation of infections.
“Getting an RT-PCR done in UP is nearly impossible,” said journalist Shreya Jai, whose family members had to wait a week to get a rapid antigen test.
Many labs in Lucknow employ less than half of their staff, the rest are sick with the virus, said a lab worker, who asked not to be named.
The state government has said nearly 230 private and state-run laboratories were used for coronavirus testing.
On Monday, the state government led by Yogi Adityanath, who is currently herself with COVID-19, was pilloried for handling the crisis by a regional court.
“It is a pity that although the government knew of the magnitude of the second wave, it never planned things in advance,” said the state’s Allahabad High Court.
In the household of Srivastava, in a middle-class neighborhood in the center of Lucknow, there is anger and grief after the cremation of the family head.
“I blame the agents sitting in air-conditioned rooms for my father’s death,” said 39-year-old Ashish, who is now a COVID-19 positive herself.
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