India's Covid-19 surge is taking its toll on mental health, even for those who don't have the virus

Every phone call brings trepidation.

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The surge has brought a teetering health care system to a collapse - hospitals have run out of beds, oxygen supplies and drugs, and although international help is arriving, there are scenes of devastation in both urban and rural areas. Crematoriums are overflowing, forcing authorities to cremate bodies in parks, car parks and even pavements.

Patients are taking to social media, posting desperate pleas for everything from coronavirus tests to a spot at a cremation ground.

But the unabated rise in cases and deaths is not just a struggle for those infected with the virus. Even those who are physically healthy are now living in fear, anxiety and a sense of foreboding that Covid-19 will reach their doorstep or that of someone they know.

Grief now, is punctuated at relief that it was not them, intermingling with the fear that it could be them next, said Sonali Gupta, a Mumbai-based clinical psychologist and author of a book on anxiety. 

She said all her sessions with patients since early April have revolved around the pandemic. "People are very fearful now. Fear, confusion, numbness, panic and anxiety, these are the top five emotions I am observing in a lot of people."

Gupta said her patients were mostly concerned about how they could protect themselves, coupled with feeling "deeply helpless" about what was happening around them.

Much of this, she added, was a direct result of the virus situation, from the realisation of their vulnerability even after vaccination to patients struggling for medical care, which was forcing people to reflect on their own well-being

"It seems to be taking a downward spiral, where we don't have any answers nor any clarity about anything," she said.

Shruti Kher, a 33-year-old owner of a marketing firm in the western Indian city of Nashik, agreed with Gupta. 

"My phone ringing is my biggest fear," she said. "My heart sinks when I get a phone call. The first thing I ask people is, all OK?"

Kher said her family members are "hyper-paranoid". They have rarely stepped out since last March and refuse to meet friends or other relatives. They even undergo Covid-19 tests once every fortnight. Yet, they still live in fear. While no one in her immediate family has contracted the virus, she has seen several deaths in her extended family and friendship circles in the last year.

Now, with the virus rampaging through their city, Kher said they are even more anxious. "We all have trouble sleeping. My mother and I often wake up, in the middle of the night, and can't fall back to sleep."

When the first wave of coronavirus infections hit India last year, the country was put under a strict lockdown to contain the spread, with cases afterwards gradually increasing to a high of 97,860 in the month of September.

But in the second wave, the country has gone from just over 12 million cases in the beginning of April to over 18 million now - a meteoric rise fuelled not just by infections in big cities but also in rural areas.

India's metropolises are seeing crowded railway stations as migrant workers rush back to their hometowns. In many states like Uttar Pradesh, this might be contributing to the sharp increase in infections.

The state on Friday saw over 35,000 new cases, with crematoriums at full capacity and the wait to cremate bodies getting longer, causing fear in many villages.

On Friday, an Uttar Pradesh man was reportedly forced to carry his wife's body on the back of his bicycle after locals refused to allow her cremation because she had died of Covid-19.

Elsewhere, hospitals have put up 'out of oxygen' signs to turn patients away and viral videos on social media show desperate relatives pleading with health authorities for medical help.

Such stories, of grief intermingling with uncertainty for the future and anxiety about loved ones, have emerged from across India.

Two days ago, my aunt, who lives in the western Indian state of Gujarat, broke down during a phone conversation. She got infected two months ago, and while she has recovered and is now fully vaccinated, she knows of at least five people who have died from the virus in the last two weeks.

She felt scared, she said, not of dying but of the gloom and the suspended grief that comes with mourning.

In India, deaths are often an occasion for family and friends of the deceased to congregate for days, ostensibly to carry out funeral rituals. Now, with such gatherings forbidden, she has not said her goodbyes and has not had closure.

In the capital New Delhi, currently India's worst-hit city, many like lawyer and researcher Arundhati R, 32, are struggling with similar questions. 

Arundhati has been holed up inside her home alone for at least three weeks now after her husband contracted the virus while on a work trip to the southern city of Bangalore.

The lawyer said her way of coping with the tragedy around her was to shut it out. "I don't watch the news nor do I check social media. I only watch sitcoms," she said. 

She has been worried about her own safety, but the recent surge in cases has made her reflect on her future.

"I keep thinking about how this disease is going to affect us emotionally," she said, adding that she does not think she would want to socialise or go out for meals even when the infections dip. 

Sitting in her home, Arundhati can "for the first time in my life" hear the constant wails of ambulance sirens as they ferry patients to hospitals. The sirens, she said, add to her feeling of being helpless. "The situation makes me feel selfish because I prefer staying home and can't go out there and help anyone." 

Gupta, the clinical psychologist, said the "trauma" of living through the current phase of the pandemic was also manifesting in psychosomatic conditions that she had observed in her patients, "from stomach aches to headaches to backaches".

"This trauma is unlikely to go away any time soon. It'll take a long time for people to process this."

This article originally appeared on the South China Morning Post (SCMP).

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