By Helen Regan, CNN
A severe Covid-19 wave is devastating Myanmar — a country already on its knees following February’s military coup — with people queuing for hours for oxygen in major cities and the seriously ill dying at home because they are too scared to visit understaffed, ill-equipped hospitals.
Images from the biggest city, Yangon, show families of the sick waiting at oxygen plants in the hopes of refilling tanks, crematoriums packed with mourners and coffins, and funeral workers and volunteers in white hazmat suits working non-stop at cemeteries to bury rows of shrouded bodies.
During months of bloody political turmoil, Myanmar’s security forces have killed more than 900 people, including shooting protesters dead in the streets, and laid siege to entire villages. Thousands have been detained in the ongoing crackdown, with widespread reports of torture.
Civil society has been eroded and the already-vulnerable health care system has collapsed. Doctors and other health workers, many of whom went on strike to protest the coup, have been forced into hiding to escape attacks and arrest from junta forces.
As Myanmar now faces its worst Covid-19 outbreak, doctors and volunteers who spoke to CNN accuse the military of using the pandemic as a weapon against the people. They said the military has restricted critical oxygen sales to the public and refused sick patients at military-run hospitals. Covid-19 outbreaks have also reached prisons, including the main jail, Insein, housing anti-coup protesters.
Terrified residents are choosing to self-treat at home, doctors say. When they do go to hospital they are often turned away as the facilities are running out of oxygen, treatments and beds, and there’s not enough staff to treat patients, they said.
On Wednesday, the military-controlled health ministry reported 6,093 new coronavirus cases, bringing the total confirmed to 246,663. There were also 247 reported fatalities, with the confirmed death toll from Covid-19 5,814. But doctors and volunteer groups say those numbers are woefully under-reported. A once-promising vaccine program has crumbled under junta rule, and minimal testing, a lack of official data, and widespread public distrust of the military means no one has a clear idea of the extent of the crisis.
“This is just the tip of the iceberg,” said one doctor who did not want to be identified for fear of reprisals. “We are seeing patients deteriorating and people dying everyday.”
Joy Singhal, head of the Myanmar delegation of the International Federation of Red Cross and Red Crescent Societies said the “rapid rise of Covid-19 in Myanmar is deeply concerning and in recent days around a third of people tested are positive.”
“This rise of cases has placed the entire health system under huge strain,” he said. “We urgently need greater levels of testing, contact tracing and vaccinations in all areas of the country.”
In the absence of a functioning medical system or official national Covid-19 plan, and with a public distrustful of anything linked to the military junta, a network of underground doctors and volunteer groups are trying to plug the gaps.
Desperate search for oxygen
Every day, desperate family members scour Facebook groups and encrypted apps searching for oxygen supplies for their loved ones. The words “urgent,” “emergency” and “please help me” repeated in a constant flow of desperate messages.
“My grandpa is very low in oxygen. Please help him. Is there any place where he can get oxygen?” asks one worried user on a Facebook group helping those in need of oxygen. Others offer tanks after their loved ones have died.
Snowy, 25, is part of a group of 12 in Yangon who try and deliver oxygen tanks and other supplies to those posting on social media. Each day she contacts private oxygen suppliers and delivers tanks to those in need. But the supply is never enough.
“They say, ‘save us, save us.’ But how can I save them? I’m not a doctor. I can only give them access to oxygen when I can get it. There are some people who die because we couldn’t get the oxygen in time,” she said. Snowy requested to use a pseudonym to protect her safety.
It’s not just oxygen in short supply. Snowy said she tries to source oximeters — devices used to test oxygen levels — oxygen concentrators, flow meters, ventilators and other equipment but they are expensive and scarce.
The military junta said it banned some private oxygen plants from selling to the general public to stop citizens from hoarding, according to Reuters. Charities have also been prevented from procuring oxygen by the military, according to several doctors and volunteers CNN spoke to.
“My friend, whose mother was low on oxygen levels, he queued and the military soldiers arrived with more than 50 tanks in their trucks and they sent everyone back out and filled their tanks first,” said Snowy. CNN cannot independently verify the details of the accounts.
In state media, the military at first denied there was a lack of oxygen, blaming shortages on “unscrupulous persons” spreading rumors.
“We have enough oxygen,” coup leader Gen. Min Aung Hlaing said, according to the Global New Light of Myanmar. “Some try to do negative activities while gaining political profits. They buy the oxygen cylinder and spread the rumor that the country does not have oxygen anymore.”
In recent days, however, the military-controlled health ministry said it was ramping up its coronavirus response. State media has been full of stories of oxygen deliveries to hospitals across the country, the building of Covid-19 centers and oxygen plants and more treatments being made available for coronavirus patients.
But residents say the situation on the ground is different. Kyaw Naing, not his real name, said nine members of his family in Yangon have contracted Covid-19. He said it’s almost impossible to get oxygen or be admitted to a hospital.
“We saw notices being put up saying that now they (the military) will stop giving oxygen supplies to members of the public, because the notices say they are not being stocked for use in private hospitals,” Kyaw Naing said. “On the one hand, they’re saying they are using this oxygen for private, public hospitals. At the same time, these public hospitals are not accepting or not admitting Covid-19 patients.”
CNN was unable to reach the military and military-run health ministry for comment on the outbreak and the state of oxygen supplies.
Underground doctors treat patients
The regime has also called on doctors, nurses, and other experts to volunteer at public hospitals and Covid-19 centers “due to a lack of manpower.” But doctors say the military cannot guarantee their safety and they fear arrest and possible torture.
Doctors were key drivers of the initial protest movement, and many have been arrested by the junta for their involvement.
“There have been 240 documented cases of attacks on health care facilities and health care professionals. As of last week, you have over 500 outstanding arrest warrants for doctors and nurses,” said Tom Andrews, UN special rapporteur for human rights in Myanmar. “You can’t attack Covid-19 and attack doctors and nurses and clinics at the same time. That is exactly what is making a bad situation exponentially worse in Myanmar.”
Doctors forced to go into hiding to evade arrest have set up underground networks of clinics and tele-consulation services. Each day they answer hundreds of requests from sick patients, on apps, social media, and video platforms — however they can reach the people.
“We are treating at least 150 people per day. More than half of those patients complain of fever, anosmia (lack of smell) and Covid-like symptoms,” said the doctor, who did not want to be identified. “Half of patients are severe cases.”
The doctor, who was an orthopedic surgeon before the coup, said his tele-consultation group EZ Care treated more than 1,000 patients in the past month.
“Yesterday, two patients died when we were doing the consultation because there was a lack of oxygen,” he said. “Without oxygen we can do nothing.”
Another young doctor in Yangon said six of her patients died in one day last week; the youngest was 49. She said she visits the very sick at home but feels helpless in the face of the growing crisis.
“I saw a patient at his home and it’s heartbreaking to see him struggling to breathe. It’s like he was drowning in water but he is actually drowning in air. He didn’t get oxygen in his lungs and blood. After the visit I got a phone call from his family and they said he had gone,” she said.
The young doctor, who also didn’t want to be named for safety reasons, said people are in a state of panic.
“There is a shortage of medicine and proper care, people are very panicked as they don’t know where to go or how to get treatment, so they just buy every medicine that says on online ‘this one is for Covid’,” she said.
She works all day and night, answering frantic messages on encrypted apps or giving consultations via video, but she said those at home don’t have the necessary medical knowledge to treat their loved ones.
“They don’t know how to handle oxygen concentrators, cylinders, how to assemble the lines from the concentrator to the patient, or how much oxygen to give to the patient,” she said.
The doctor, who said she was a medic during the protests and helped demonstrators who had been shot, said the military has failed the people.
“We have lost so many lives here who aren’t supposed to die this way. Some were shot, some were tortured to death, some died because they didn’t get proper treatment, some died because they didn’t get enough oxygen. These are not reasons why people should die in 2021, in the 21st century,” she said.
What is causing the rise in cases?
The latest outbreak is believed to have started about a month ago in western Chin state, which borders India, and comes as the Delta variant is hitting countries across Southeast Asia.
The doctors CNN spoke to said while there were medical staff shortages and testing was lacking, previous coronavirus waves in Myanmar were brought under control. Before the coup, Myanmar was one of the first countries in the region to procure vaccines and civilian leader Aung San Suu Kyi had planned to launch a nationwide vaccine program in April.
After the military takeover, Covid-19 testing, prevention measures and the vaccine program collapsed in the chaos of the upheaval. Several prominent medics involved in Myanmar’s pandemic response were arrested, including the former head of its vaccination campaign, Htar Htar Lin, and the head of emergency medicine at Yangon’s University of Medicine, who managed previous Covid-19 responses, Maw Maw Oo.
In recent days, the military-controlled health ministry said it is aiming to get 50% of Myanmar’s 55 million population vaccinated this year, according to state media.
“More than 1.6 million people have been vaccinated, and vaccines are constantly being imported to ensure that 100% of the population is fully vaccinated. About 750,000 vaccines from China will arrive on July 22, and more will arrive on July 23 and 24. In addition, plans are underway to receive more vaccines in the first week of August,” a statement said.
But even if those doses are procured, residents say there is deep distrust in the regime to give them a lifesaving shot, when it continues to kill and detain its citizens. Concerns are also growing for the fate of the people if the situation is left unmanaged.
“It staggers the imagination as to what will be happening just really over the next few days, this thing is out of control,” said UN special rapporteur Andrews. “This is a complete catastrophe. The entire health care system is in shambles. The number of people being infected is just going through the roof, and no one trusts this junta to provide them with information or health care or vaccines that they need to confront this pandemic.”
Snowy, the volunteer, continues to go out every day in Yangon to try and procure oxygen for the sick and desperate. She lives with her mother and grandmother but isolates when she returns home. She said she recently started to feel ill.
“I hope it’s not Covid,” she said.
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CNN’s Angus Watson, Alice Barnard and Begona Blanco Munoz contributed reporting.