Wednesday, 29 September 2021

COVID-19 crisis in India: Rampant black-marketing during second wave, 70% people paid extra for ambulances, 36% for oxygen

In what could be the first assessment of quantum and scale of black-marketing which took place during the devastating second wave for health care essentials in India, Local Circles in a survey finds that 70 percent of citizens overpaid for ambulances, 36 percent for oxygen, 19 percent for medicines, and 13 percent for RT-PCR tests.

Noting the fact that we all witnessed a daily increase in COVID-19 cases causing utter chaos across hospitals hit with an acute shortage of oxygen cylinders and concentrators, ventilators & ICU beds, COVID management medicines & testing facilities, and related supplies & equipment.

An increasing number of patients laid in line for the treatment in almost every hospital that was taking COVID-19 patients. During the time of distress, while caregivers were running from pillar to post seeking aid and treatment for the patient, many became the victim of black-marketing and scamming.

Perpetrators were charging whatever premium they could for ambulance services, oxygen concentrators, oxygen cylinders, vials of Remdesivir and Tocilizumab drugs, we all inadvertently paid more to make everything available for our near-and-dear ones.

"Via a national survey, LocalCircles has attempted to find out an aggregate percentage of citizens who were overcharged for COVID-related supplies, ambulance services and medicines. It also tried to understand their experience getting RT-PCR tests during the outbreak. The survey received more than 38,000 responses from citizens across 389 districts of India. Thirty six percent of those who purchased COVID related supplies (oximeters, oxygen concentrators, cylinders, etc.) were charged over MRP during the second wave," said Sachin Taparia, CEO of LocalCircles.

The survey questioned that during the second wave when you or anyone in your family purchased COVID-related equipment/supplies (oxygen concentrators, cylinders, oximeter, other items), how did the vendor/retailer charge you?"

In response, 14 percent said "gave a discount on MRP/price", and 25 percent said, "charged at MRP/regular price". Breaking down the poll, 4 percent said they were "charged between MRP and 2 times of MRP/regular price", 14 percent were "charged up to 2-3 times of MRP/regular price", and 18 percent were "charged over 3 times of MRP/regular price."

Furthermore, 25 percent of citizens voted for "can't say", which indicates that they were unaware of the price of COVID-related equipment or supplies and is likely that they have been overcharged when they purchased it. On an aggregate basis, 36 percent of those who purchased COVID-related supplies were charged more than MRP during the 2nd wave. This question in the survey received 8,296 responses, LocalCircles in a press statement said.

The survey also noted that in some cases "citizens reported how in some cases an oximeter costing Rs 300 was sold for Rs 1,500. Similarly, oxygen concentrators that had an MRP of Rs 33,000 with a Chinese make were selling for Rs 100,000 or higher. People also reported that new oxygen cylinders and their refills were commonly being sold for a 300-400 percent higher price than their regular price. Many scams also took place where the money was paid and the supplies were never delivered."

Up to 70 percent of those who needed an ambulance service for a COVID-19 patient during the second COVID wave were overcharged; half of them paid over five times the price, the survey said.

"Ambulances were working 24/7 under extraordinary conditions. On the other hand, the pandemic became a money-minting opportunity for some perpetrators who were charging out-of-the-pocket rates to families of the patient for driving them to a hospital. Media reports were rife about ambulances charging Rs 42,000 to cover a distance of just 25 km. Later, the government of Delhi capped the rates of Patient Transport Ambulance, Basic Life Support Ambulance, and Advanced Life Support Ambulance services at Rs 1,500, Rs 2,000, and Rs 4,000 respectively, for covering up to 10 kms and Rs 100 per kms. Despite the effort, the problem persisted," the survey notes.

Up to 30 percent of the survey participants, who were also family members of then COVID-19 patients, said they were "charged at a regular price", 10 percent were charged "100-500 percent more than regular price", and 50 percent were "charged 500 percent or more than regular price". With 10 percent of citizens voting for "can't say" indicate that they were unaware of the charges for hiring an ambulance service. The findings of the survey indicate that 70 percent of those who needed an ambulance service for a COVID patient during the second wave were overcharged, and half of them paid over 5 times the charge, the survey finds. This question in the survey received 8,154 responses, said Local Circles.

Another important observation of the survey was that 19 percent of those who purchased COVID-19 related medicines (Tocilizumab, Remdesivir, Fabiflu, etc.) were charged more than MRP during the second wave.

The survey analysis of this aspect comes post-assessment of the fact that most states faced an acute shortage of COVID-related medicines (Tocilizumab, Paracetamol, Medrol, Remdesivir, Fabiflu, etc.) during the second wave. Black-marketing of those essential medicines was rampant across the country. The survey sought citizens' response if they or anyone in their family during the second wave purchased COVID-related medicines then how did the vendor or retailers charge.

In response, 30 percent said they were "given a discount on MRP/price”, and 30 percent were “charged at MRP/regular price”. Breaking down the poll, 5 percent were “charged between MRP and 2 times of MRP/Regular price”, 5 percent said “charged up to 2-3 times of MRP/regular price”, 5 percent said "charged between 3-10 times of MRP/regular price”, and 9 percent said, "charged over 10 times of MRP/regular price”. With 16 percent of citizens voting for “can’t say” indicate that they were unaware of the price of these COVID-related medicines and is likely that they have been overcharged when they purchased them. The findings of the survey indicate that 19 percent of those who purchased COVID-related medicines were charged more than MRP during the 2nd wave, the survey findings said. This question in the survey received 8,026 responses, LocalCircles said.

Overcharging for medicines like Tocilizumab and Remdesivir was rampant in north, west and central Indian states. Some other states like Karnataka, Tamil Nadu and Maharashtra handled it somewhat better by appointing the drug controllers as the custodians of these medicines. However, many ended up paying more than MRP for them, the survey findings said.

When it comes to testing and the costs, the survey post analysis found that 13 percent of citizens who got a COVID RT-PCR test done during the second wave say they were overcharged by private labs/hospitals. The basis being that "while citizens were financially overburdened with the cost of COVID treatment and COVID-related
supplies/drugs, many also had to pay extra for getting the RT-PCR test. In many states, the price ceiling was fixed by the state governments and yet citizens have written that these ceilings were violated by the labs. While testing and tracking are essential for the containment of COVID-19, India witnessed overcharging of tests along with delays in getting the results," LocalCircles said.

Taking cognisance of the issue, LocalCircles asked citizens how much did they pay for getting a COVID RT-PCR test for themselves or their family members during the second wave. In response, 9 percent said "got it done free of cost at a government facility”, 36 percent “got it done at a private lab/hospital at the price fixed by the state government”.

Breaking down the poll, 13 percent "got it done at a private lab/hospital but they were charged higher than the price fixed by the state government”. There was also 38 percent of citizens who said they used a home sample collection service and they charged additionally for the home service and the price fixed by the state government”, while 4 percent couldn’t say. The findings of the survey indicate that 13 percent of citizens who got a COVID RT-PCR test done during the second wave were overcharged by private labs/hospitals, the survey finds. This question in the survey received 13,942 responses, LocalCircles said.

The survey also assessed, in terms that what could be done or what citizens want the government to focus on to deal with the so-called and much anticipated third wave if at all it comes.

"To better prepare for the 3rd wave such that this level of rampant black marketing does not take place again, citizens on the LocalCircles platform are of the opinion that the Government should come up with a better mechanism to track the supply of COVID-related drugs, oxygen cylinders and concentrators via unique identification such that the location of these products can be digitally tracked by the manufacturers and a sale/issuance requires the Aadhaar identification of the end-user. Similarly, there needs to be a mechanism in addition to the test results and personal details of the individuals undertaking RT-PCR tests, it must be made mandatory for the labs doing RT-PCR tests to upload the price charged. With such information submitted, over charging is likely to reduce," LocalCircles said.

"LocalCircles will be escalating the findings of this survey with the key stakeholders in the central government and all state chief secretaries so the feedback of the citizens can be considered in the relevant policy and enforcement interventions as well as in the preparedness for the third COVID wave," shared Taparia.

The demographics of the survey are, 38,000 responses from citizens across 389 districts of India. 67 percent of the participants were men, while 33 percent were women. 44 percent of respondents were from tier 1, 33 percent from tier 2 and 23 percent respondents were from tier 3, 4 and rural districts. The survey was conducted via the LocalCircles platform and all participants are valid citizens who had to be registered with LocalCircles to participate in this survey.



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