Living half a world away from COVID-stricken Indian relatives, Sydney doctor Yadu Singh has beat back his frustration at being unable to help by providing lifesaving medical guidance via phone, text and video chat.
It was 4am AEST and finally, bleary-eyed, the veteran cardiologist had found a hospital bed for his niece's husband.
The patient would have to endure a gruelling eight-hour drive out of virus-swamped Delhi, but at the end of the road lay the promise of oxygen, and with it, a chance for survival.
Like many in India's millions-strong diaspora, Dr Singh has watched in abject horror as coronavirus consumes the country, infecting more than 360,000 people every day.
while deaths from COVID-19 jumped by 3,498 over the last 24 hours, according to health ministry data.
However, medical experts believe actual COVID-19 numbers may be five to 10 times greater than the official tally.
Hospitals and morgues are overwhelmed by the pandemic, medicines and oxygen in short supply and strict curbs on movement in its biggest cities.
"The last four to five days, they have been very difficult, very challenging," he told AFP from his office in a verdant Sydney suburb.
"We actually can't do much sitting 10,000 kilometres away."
The local Indian community considered trying to send medical supplies such as life-saving oxygen concentrators, but Dr Singh knew they would be tough to acquire, take a long time to arrive and would do little against the tidal wave of cases.
For Dr Singh however, thanks to his medical training and contacts, he was in a better position to help than most.
Over the last week or more, he has been working the phones and his contacts to help friends, relatives and online acquaintances across India.
He managed to WhatsApp one CT scan to a classmate who is a respiratory specialist, who in turn was able to advise a local doctor about more effective treatment.
"That medicine I believe was life-saving," said Dr Singh. "Thank God we have WhatsApp."
He has offered informal advice about temperatures, oxygen saturation levels, when to go to hospital and when to stay put and take a paracetamol.
Dr Yadu Singh, President of the Federation of Indian Associations of NSW. Source: Dr Yadu Singh
On another occasion, one morning at 3.30am he was contacted by a Twitter acquaintance living in California asking for advice about a sick aunt.
He managed to pass details of the woman to a Delhi member of parliament who was also on Twitter and could help get her treatment.
Dr Singh later received a message from the relative saying: "My aunt is doing much better. Thank you very much. You have saved her life."
'Helplessness, hopelessness’
"I can't treat people sitting in Australia," said Dr Singh. "Without seeing the patient, I can only guide them on what to do."
"That's what we can do sitting in such a faraway place. Guiding them, assisting them, giving them hope."
But sometimes, guidance and hope have not been enough.
When his niece's mother-in-law had 80 per cent oxygen saturation - 15 percentage points lower than normal levels - Dr Singh called the principal of the local hospital, a former colleague, for help.
"He said, 'I will try to help, but (there is) no bed in ICU.' And half an hour later - you can't survive with 80 per cent oxygen - she died."
"This is so painful. I knew her personally. Her brother was my classmate," he said.
"We feel helplessness, hopelessness.
"I have lost three of my circle of relatives... one passed away last night."
Dr Singh fears political mismanagement means the situation in India is only going to worsen.
"If we don't break the transmission chain, what is going to happen?" he said.
Extreme vaccine shortage
Several Indian states ran out of COVID-19 vaccines on Friday, a day before a planned widening of a nationwide inoculation drive as new infections in the crisis-hit country surged to another daily record.
India is the world's biggest producer of vaccines but does not have enough stockpiles to keep up with the second deadly COVID-19 wave, despite Prime Minister Narendra Modi's government planning to vaccinate all adults starting 1 May.
Only about 9 per cent of India's 1.4 billion people have received a vaccine dose since January.
"I registered to get a slot 28 days before, but now they are saying there are no vaccines," Twitter user Jasmin Oza said in a video post.
India had originally planned to vaccinate only 300 million of its highest-risk people by August, but widened the target due to the rise in cases.
Several Indian states have run out of COVID-19 vaccines a day before a planned widening of a nationwide inoculation drive. Source: AFP
However, its two vaccine producers were already struggling to increase capacity beyond 80 million doses a month due to a shortage of raw materials and a fire at the Serum Institute, which manufactures AstraZeneca's vaccine in India.
Inoculation centres in Mumbai will be shut for three days starting Friday because of the shortage of vaccines, authorities said.
In the southern state of Karnataka, home to the tech hub of Bengaluru, the state's health minister said Karnataka's vaccination drive for adults will not begin on 1 May.
"The state government has not received any information from companies about when they will be able to supply these vaccines," said Health Minister K Sudhakar.
In Mr Modi's home state of Gujarat, officials said vaccination for the 18-45 age group is expected to start in a fortnight, as the state expects to receive vaccines by then.
Officials in the eastern state of Odisha said they hoped to start vaccinations on Monday, if vaccine stocks arrive.
Mr Modi is scheduled to meet cabinet ministers on Friday as the wave of infections cripples the nation's health system and threatens to impact major businesses. Absenteeism in offices and industries is growing with staff falling sick or taking leave to tend to sick relatives.
World sends medical aid
World aid has started arriving in India as it struggles to combat what has been described as a humanitarian disaster.
The first US flight carrying oxygen cylinders, regulators, rapid diagnostic kits, N95 masks and pulse oximeters arrived in the Indian capital Delhi on Friday.
The United States will send more than $US100 million ($A128.7 million) in medical aid, including 1,000 oxygen cylinders, 15 million N95 masks and 1 million rapid diagnostic tests. It also has redirected its own order of AstraZeneca supplies to India, to allow it to make more than 20 million doses.
Shipments from other countries continued to pour in, with a third one from the United Kingdom reaching earlier in the day. Romania and Ireland also sent supplies late on Thursday.
Australia has also pledged to send oxygen, ventilators, masks, gloves and gowns.
India’s severe medical oxygen supply crisis is expected to ease by mid-May, a top industry executive told Reuters, with output rising by 25 per cent and transport infrastructure ready to cope with a surge in demand.
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