Informal collectives and access to healthcare during India's COVID-19 second wave crisis.

India was hit by a disastrous second wave of the COVID-19 pandemic that surged since February 2021. The exact magnitude of cases and deaths during this second wave remains a contentious topic, as suggested by huge differences between internal reports of the government and external reports.1 2 However, there is no dispute that, although several curbing strategies including a harsh lockdown were introduced during the early days of the pandemic in March 2020, the country now finds itself again in the midst of a crisis. Compared with last year, this time the virus has shown a much higher transmissibility rate, possibly due to a combination of newer variants, coupled with poor regulation and adherence to basic preventive public health measures. Mass gatherings in the form of massive election rallies and religious congregations were also permitted while cases had started increasing exponentially in numerous states of India, and vaccination rates continued to remain low. Health systems in major cities were overwhelmed with cases even in the first wave, where some hospital wards were dedicated to COVID-19 care, non-COVID care was almost halted3 4 and healthcare workers were stretched thin.5 The second wave now saw a collapse of the system where not just wards but entire hospitals had to be used and expanded for exclusive COVID-19 care and still remained inadequate. In addition, we witnessed the conversion of maidans (open fields), gurdwaras (Sikh religious institutions) and other places into makeshift wards and hubs for accessing oxygen. The crisis revealed the pre-existing cracks in an underprepared health system where people were left to help themselves, gasping for oxygen or drugs and scrambling for hospital beds.6 However, as with any crisis, human beings rise to find possible ways to cope or are impelled to do so from sheer desperation. It …