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story.lead_photo.caption An exhausted municipal worker rests after bringing the body of a person who died of COVID-19 for burial in Gauhati, India, Sunday, April 25, 2021. As India suffers a bigger, more infectious second wave with a caseload of more than 300,000 new cases a day, the country’s healthcare workers are bearing the brunt of the disaster. (AP Photo/Anupam Nath)

NEW DELHI (AP) — Since the beginning of the week, Dr. Siddharth Tara, a postgraduate medical student at New Delhi's government-run Hindu Rao Hospital, has had a fever and persistent headache. He took a COVID-19 test, but the results have been delayed as the country's health system implodes.

His hospital, overburdened and understaffed, wants him to keep working until the testing laboratory confirms he has COVID-19.

On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, behind only the United States. India's Health Ministry also reported another 2,771 deaths in the past 24 hours, with 115 Indians succumbing to the disease every hour. Experts said those figures are likely an undercount.

"I am not able to breathe. In fact, I'm more symptomatic than my patients. So how can they make me work?" Tara asked.

The challenges facing India today, as cases rise faster than anywhere else in the world, are being compounded by the fragility of its health system and its doctors.

There are 541 medical colleges in India with 36,000 post-graduate medical students, and according to doctors' unions constitute the majority at any government hospitals — they are the bulwark of the India's COVID-19 response. But for more than a year, they have been subjected to mammoth workloads, lack of pay, rampant exposure to the virus and complete academic neglect.

"We're cannon fodder, that's all," Tara said.

In five states that are being hit hardest by the surge, postgraduate doctors have held protests against what they view as administrators' callous attitude toward students like them, who urged authorities to prepare for a second wave but were ignored.

Jignesh Gengadiya, a 26-year-old postgraduate medical student, knew he'd be working 24 hours a day, seven days a week when he signed up for a residency at the Government Medical College in the city of Surat in Gujarat state. What he didn't expect was to be the only doctor taking care of 60 patients in normal circumstances, and 20 patients on duty in the intensive care unit.

"ICU patients require constant attention. If more than one patient starts collapsing, who do I attend to?" Gengadiya asked.

Hindu Rao Hospital, where Tara works, provides a snapshot of the country's dire situation. It has increased beds for virus patients, but hasn't hired any additional doctors, quadrupling the workload, Tara said. To make matters worse, senior doctors are refusing to treat virus patients.

"I get that senior doctors are older and more susceptible to the virus. But as we have seen in this wave, the virus affects old and young alike," said Tara, who suffers from asthma but has been doing regular COVID-19 duty.

The hospital has gone from zero to 200 beds for virus patients amid the surge. Two doctors used to take care of 15 beds — now they're handling 60.

Staff numbers are also falling, as students test positive at an alarming rate. Nearly 75 percent of postgraduate medical students in the surgery department tested positive for the virus in the last month, said a student from the department who spoke anonymously out of fear of retribution.

Tara, who's part of the postgraduate doctors association at Hindu Rao, said students receive each month's wages two months late. Last year, students were given four months' pending wages only after going on a hunger strike in the midst of the pandemic.

Dr. Rakesh Dogra, senior specialist at Hindu Rao, said the brunt of coronavirus care inevitably falls on postgraduate students. However, he stressed they have different roles, with postgraduate students treating patients and senior doctors supervising.

Although Hindu Rao hasn't hired any additional doctors during the second wave, Dogra said doctors from nearby municipal hospitals were temporarily posted there to help with the increased workload.

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