Cover photo: A 500-bed field hospital with oxygen support run by BAPS Swaminarayan Sanstha in Vadodara, India. Photo courtesy: BAPS.org.
BY APURVA GHELANI*
One of the worst nightmares for the Indian community is family hospitalized with COVID-19 back home in India. For the past 3 weeks, I have lived this nightmare. As I board the last flight out from New Delhi, I feel humbled, a bit incapacitated and thankful all at the same time.
I was very fortunate to have great friends and a support system in India and was able to fly back and see my family. They are fine for now, but for much of the trip, I thought about those of you who cannot travel anymore. What can you as an NRI with family over there do other than worrying?
I write this with the hope that it can help you:
Prepare your plan:
- Start getting information about local hospitals including (1) private, (2) trust and (3) government hospital options. Keep in mind in most cities 80% of Remdesvir supplies from municipal corporations go to government hospitals and 20% go to private, so before you judge government facilities too quickly understand that they may be a viable option. I had a wonderful experience with a trust-owned hospital that took extremely good care of our family. Private hospitals may ask you to arrange your own oxygen or Remdesvir.
- Also, at this point, it is better to go with Covid only focused facility than a multi-specialty hospital if you do get a choice as you want to go with a specialist rather than a generalist assuming all other factors being same.
- I would totally discourage buying Remdesvir from the street (Yes, it’s available illegally for Rs 15-30K per injection but a lot of them are fake so you want to be very careful).
- Consider donating to a local trust hospital (Example: https://www.bapscharities.org/usa/covid-19/). It may give you a reason to find a contact, do a good deed, and your donation will reach a destination where your family lives!
- Buy real N-95 masks from Costco and ship them to India. I noticed people use KN-95 there because N-95 masks are just not available in India. Due to heat, it may be difficult for them to wear N-95 outdoors but they can surely wear them indoors especially where exposure is higher.
- Find a lab contact that can travel to your family’s home and consider getting your household help tested as well. Many families are getting infected sitting at home through their domestic help.
- Think of the closest family friend or your street-smart person with connections that will be your go-to guy or gal for managing the “stuff” (a.k.a. Jugaad). In the middle of a lock down, curfew and chasing doctors around you need a young connected person who can maneuver quickly. Everything from getting oxygen, Remdesvir, hospital admission—you will need this person who will drive it for you. You need to know now who it will be and start giving them a heads up, because you will need them a lot.
- Be aware: Plasma is sometimes requested by hospitals for you to arrange. It can help (it surely helped us) but for that you need to have a blood bank source and usually the blood bank will ask for a replacement. So, encourage your friends and family members who have the antibodies and are potential donors to donate now and it will help them make the blood bank connection. We had to run a viral campaign on WhatsApp nothing is off table.
- If your family member is tested positive you will need a RT-PCR report, CT Scan and at some places a blood report with D-Dimmer and CRP scores. Most hospitals will ask for a single .pdf file that has these reports and the Adhaar card. Be sure to know how you will get this and where you will save it.
- Update yourself with Ayushman Bharat Yojana/PMJAY and state government schemes that cover COVID-19. If nothing else, it will shift your focus from watching news to learning new things!
- Get the contact names of the health department heads for your local municipal corporation. Unlike the past, in many cases you will be able to email them and request assistance in extreme circumstances. Put your request in writing and with a sense of urgency if it is truly urgent. NRIs messaging local officials have a different impact than locals sometimes so use your charm and cajole. Don’t assume that government and municipality heads won’t help you they are the ones sitting on stock pile and can easily direct that to a hospital.
- There can also be a decision you may have to make around home quarantine and hospital. The fact is while hospital system is overwhelmed and that’s an understatement, getting Remdesvir and other help is available to admitted patients and not for home care. Due to black marketing and illegal use, government officials will only supply items to hospital and specific patients in the hospital vs home quarantine patients. I saw patients that would go to hospital to get the Remdesvir and then go home which was ideal as you save a bed and also are technically a patient at the hospital.
- Oxygen supply is limited but what’s really limited is the transportation and the oxygen cylinders. If you are able to buy then preemptively get with your friends here and perhaps you can ship a personal oxygen concentrator which can be used by a small number of you in the pool. Chip in and ship it, worst come worst it can be used to help save a life. It’s a worthwhile effort as this ordeal is expected to last for 3 months.
- Ventilators are really short in supply and the progression for oxygen goes from cylinder/concentrator to BIPEP (pressurized oxygen) to ventilator. You should know which local facilities have ventilators and there are donors who have donated ventilators and many local suppliers do have them ready to ship in 2-3 weeks. The ventilators cost anywhere between Rs 5 to 8 lakh and nothing is off the table. Recently, I had a friend who bought a ventilator and supplied it to a private hospital with a 24-hour turnaround time to save a family member. Think about being in a war situation, nothing is off the table and no measure is extreme to save a family member.
- Be prepared your doctor will not have the time to give you updates at all so best to try and agree on a cadence especially when the doctor makes a round.
- Make sure that when Remdesvir is given, you are on Facetime and the patient is seeing Remdesvir being given. If you are providing Remdesvir to the private hospital, then be smart to store it at home and deliver one at a time daily so you are in control of your stock.
- I learned from this trip that money alone is not going to help. You will need connections and money, both, so start reconnecting with your pals that can help. It’s a country with an unreal number of selfless people that have thrown themselves to serve others in need. My experience was that so many friends did countless acts of kindness without even showing that they are doing a favor. This is a huge asset in such times.
- Start tracking exposure on Aarogya Setu app and ask your family to time their tests depending on the exposure level. Though the adoption of the app isn’t that high it’s still worthwhile to do so.
- Start helping your relatives and friends: You cannot build goodwill overnight. It takes an entire lifetime and sometimes more than one generation to build good will but you certainly can spread good karma. Start helping extended family members and friends it could be just a simple phone call to see how they are doing. If you spent your life being the black sheep or being introverted, this isn’t the time to be one!
Emotional support: Supporting your family emotionally is just as important as supporting them logistically. Many of us NRIs in my opinion tend to be very detailed oriented (comes with STEM degrees at times) and at times have the “know it all” attitude (a.k.a. NRI Gyaanis). You are not in India so calm down, you don’t know exactly what’s happening locally. Don’t spread the panic within your own family with your expert opinion on Zinc or vitamin C … please … tell a joke because they need hope and encouragement. They need to know about your plan in item 4 above and that you have their back should worse happen so they can be a bit more comfortable.
Stop watching the news: I’ll admit this may sound crazy at first. The only two sources of information you have right now are (1) the news and (2) social media. How in the world is it a smart choice to stop watching the news?
You need to understand that cremation images at a New Delhi crematorium are not going to help you right now. All they do is feed on the unknown and heighten your sense of fear. Yes, there are shortages of oxygen, Remdesvir, ICU beds etc. but how does rehashing the same problem help you in any way? Help yourself by shifting your focus from watching national news to focusing on building and preparing your plan of action (I’ll talk about this below).
Spread Hope: A well-known surgeon I follow recently drew attention to a brutal – but revealing ‘Hope Experiment’ done at Harvard in the 1950’s.
The experimenters placed rats in a pool of water to test how long they could tread water. On an average, they’d give up and sink after 15 minutes. But right before they gave up due to exhaustion, the researchers would pluck them out, dry them off, let them rest for a few minutes and put them back in for a second round.
In this second round, how long do you think they lasted? Remember, they had just swum until failure only a few short minutes ago…How long do you think? Another 15 minutes? 10 minutes? 5 minutes? No! 60 hours! That’s right! 60 hours of swimming. The conclusion drawn was that since the rats believed that they would eventually be rescued and had hope, they could push their bodies way past what they previously thought impossible.
To find hope, find stories of survival. There are more stories of survival than deaths in India right now. Talk about your friends and family members who survived and especially talk about your friends that did wonders to help others and helped save someone! Share stories about local heroes. Talk about great not-for-profits doing wonderful work in your hometown. Dig. If you dig, you will always find a small piece of good news somewhere.
Change the narrative: Indians at this time do not need the world’s pity, they need the world’s understanding and support. Sipping red wine on your comfortable couch and sharing your wisdom about what the country should do is the last thing India needs from you as an NRI.
Respect India and Indians for their resilience. India needs you as a friend that respects and supports, not a friend that judges in times of need. No country on the planet has the medical infrastructure to deal with such a crisis right now so wherever you are, note this: if the country you are residing in no matter how developed if it is hit with a variant and with the volumes India is dealing with, it’s a guaranteed collapse.
Also, discourage the use of the word “Indian variant” and start referring to it as what it really is: B.1.617. In the name of country, people see color and race and the last thing we all NRIs want is another hate campaign expanding beyond the Asian hate.
Political hate: Okay so you feel angry at the politicians and why they did Kumbh Mela and political rallies? Understandable. Your political smarts and social media posts will not save any lives as time for would have could have has passed. What is done is done so you can keep expressing anger or productively shift your focus just for now to help save lives and prepare your plan. You can always get back to trolling and cussing the politicians out later if that’s what keeps you entertained.
Protect yourself: A lesson learned from the B.1.617 variant is that letting your guard down isn’t a great idea. Get your family and yourselves vaccinated. What happened in India can happen anywhere and is already happening elsewhere. The variant spreads much faster, so mask up even if your local government does not ask you to do so.
Fly family out before the third wave: India is already talking about a third wave eventually so if travel opens up perhaps a good option is to get your family in India vaccinated and fly them to be with you if that’s feasible. Many families have already bought tickets in advance for September preempting that perhaps the travel ban may open by then.
Pray and Donate: Spread good vibes and pray for our motherland. This is a war time situation our country is in so donate and I suggest donate an amount that pinches you a bit it is truly a time to stretch out.
*Apurva Ghelani is the Founder of Winning Feathers(www.winningfeathers.com) a leading soft skills Ed-tech portal for kids. He has been a tech executive for the past 20 years at Fiserv, VeriSign and other Fortune 500 companies and is a South Asian community leader in Georgia. He has been part of several not-for-profit organizations including most recently serving as a board member of Pratham Atlanta. Email: firstname.lastname@example.org.
Disclaimer: You understand that any information and content in this article is for informational purposes only. You understand that such information is not intended nor otherwise implied to be medical advice or a substitute for medical advice, diagnosis, or treatment. Views expressed are individual opinions only.