Dehradun: At least 125 pilgrims have died within the first 30 days of the ongoing Char Dham Yatra in Uttarakhand. On average, according to state government officials, around 100 deaths were recorded in the entire six months’ duration of the pilgrimage (May-October) in pre-Covid times.
The alarming surge has prompted the state government to caution senior citizens with Covid history to take adequate precautions before embarking on the arduous journey to the four Hindu shrines — Yamunotri, Gangotri, Kedarnath and Badrinath — nestled in the Himalayas.
The yatra has resumed full scale this year after two years — 2020 and 2021 — of Covid-related restrictions.
The daily average footfall of pilgrims at the four Char Dham shrines currently stands at 55,000-58,000, according to state tourism department figures. This is almost 15,000 more than what was recorded over the past couple of years.
In light of the rush, Chief Minister Pushkar Singh Dhami directed two cabinet ministers — Dhan Singh Rawat and Subodh Uniyal — to supervise the yatra arrangements.
According to data provided by the state health and police departments, of the 125 people who have died so far during this year’s Char Dham pilgrimage — which began on 3 May — 75 were above 60 years of age.
While they attributed most of the deaths to cardiac arrests, state health department officials told ThePrint that the after-effects of Covid may have also played a role.
Hence, they have urged elderly pilgrims who have recovered from Covid to share their medical history with the department, and be extra careful as they scale high altitudes — where oxygen levels drop sharply, often triggering breathlessness — during the pilgrimage.
Police and government data estimate that 90 of the deaths this year have taken place in Yamunotri and Kedarnath, which are believed to have the most precarious terrains among the four shrines. Meanwhile, the Badrinath shrine area witnessed 26 deaths, while nine pilgrims died at Gangotri.
Ninety of the deceased pilgrims were men, and 35 women.
Health and tourism department officials said that, before the pandemic struck, an average of 15-17 deaths were recorded per month across the Char Dham shrine sites during pilgrimage season.
“The health of the nation has been definitely affected post-Covid. Government has not verified to what extent Covid impact is responsible for the deaths, but it has affected the oxygen-carrying capacity of the people besides lowering their immunity,” State Tourism Minister Satpal Maharaj told ThePrint.
“All four shrines are located more than 10,000 feet above sea level. People with weak lungs will find it difficult to trek in the higher Himalayas. Heavy rush of pilgrims and their non-acclimatisation to weather conditions of higher Himalayas are also responsible for rising deaths this season,” he added.
Maharaj claimed that health guidelines issued by the state government are being “ignored” by pilgrims.
“We request the people across the country to come to the pilgrimage after a thorough medical examination and proper consultations with doctors,” he said, adding that pilgrims must take breaks on the way to the shrines to get acclimatised to the weather conditions there.
‘Toll alarming despite high footfall’
According to a PTI report, around 102 pilgrims lost their lives during the yatra in 2018, while 117 died in 2017, when the footfall was 26.2 lakh and 21.9 lakh, respectively.
“The rate of pilgrim deaths is too high this season. Around 125 pilgrims have died in less than one month of the pilgrimage, as compared to around 17 in a month in the past. This rate of mortality may lead to a frightening figure of deaths at the end of the season,” a senior tourism department official said on condition of anonymity.
According to S.S. Samant, a senior research officer in the state tourism department, nearly 57,000 pilgrims are currently visiting the shrines every day.
“More than 1,30,000 have already visited the shrines within around 25 days of the pilgrimage since it started full-fledged on 6 May. This is the situation when thousands of pilgrims wait for their turn at Rishikesh and Haridwar (entry points for the pilgrimage). If this pace continues, pilgrims’ footfall figure may touch 40 lakh,” Samant told ThePrint.
‘Covid impact likely, pilgrims unwilling to share medical history’
Chief medical officers (CMOs) deployed at the Char Dham shrine sites said while Covid after-effects are not the solitary cause for pilgrim deaths, they could have added to the impact of existing ailments like hypertension, diabetes and heart problems.
“All deaths cannot be attributed to the Covid impact. In fact, relatives and companions of only a few deceased pilgrims have shared their Covid and other medical history,” said Dr M.K. Shukla, CMO of Rudraprayag district, where the Kedarnath temple is located.
The Kedarnath shrine site has witnessed the maximum number of deaths (58) so far.
“So far, five deceased (in Kedarnath), whose accomplices provided their medical details, had Covid history. However, the impact of Covid cannot be ruled out in others as it could have resulted in reduced lung efficacy,” Dr Shukla said.
Uttarkashi CMO Dr K.S. Chauhan, who is heading the health facilities at the Gangotri and Yamunotri sites, said: “We do not have proven medical reasons to attribute pilgrims’ deaths to their Covid history, but it’s an assessment that Covid infection has its long-term impacts.”
“Sadly, majority of the pilgrims are keeping their health conditions secret. Even people accompanying pilgrims who have died do not want to share their Covid details. It’s difficult to pinpoint Covid as the real cause of pilgrims’ deaths, but its impact cannot be denied as almost all the deceased suffered cardiac arrests and breathlessness,” he added.
Chamoli district CMO Dr S.P. Kuriyal said the pilgrim turnout at the Char Dham sites this year is “unprecedented”.
“Deaths of pilgrims during this period had always been there, but this time, the numbers have gone up at a greater pace. This is proportionate to the rise in pilgrim footfall. Covid history and other ailments have added to the victims’ woes,” he added.
‘Adverse cardiovascular events’
Dr Kunal Sarkar, a cardiac surgeon at Kolkata’s Medica Superspecialty Hospital said that if an individual was hospitalised for Covid treatment, the same would have had a significant impact on his/her lungs.
“By conservative estimates, as much as a fifth of the population has been infected with Covid at least once, and a fair number of them were symptomatic. If the patient was hospitalised with Covid, their lungs would have taken significant beating, even if they appear healthy right now,” he added.
“These people are now suddenly exposed to high-altitude climates. Usually, you need to give your body time to acclimatise to high altitudes, which is not done during these pilgrimages,” he added.
According to Dr Sarkar, when the air becomes more sparse at higher altitudes, our respiratory rate increases to make up for the reduced availability of oxygen. The body copes by making several secondary physiological changes, which can lead to “adverse cardiovascular events”, he said.
The risk is higher for elderly people going to such pilgrimages, he added.
“But the question we need to ask is whether there are adequate healthcare facilities and what kind of screening takes place for people. Not everyone who appears healthy is fit for the trip. Moreover, the number of devotees taking the trip after two years of Covid lockdowns may also have been more than usual. Were the authorities prepared with emergency facilities for a larger crowd?” Sarkar asked.
According to a 2021 report by researchers at the American College of Cardiology, Washington, individuals with a history of Covid infection, particularly those who were sick enough to require hospitalisation and suffered from both pulmonary and cardiac injury, may be at heightened risk of adverse events during mountainous journeys.
Dehradun-based senior government physician Dr N.S. Bisht, however, is of the opinion that while people with Covid history may have problems travelling in the higher reaches, it cannot lead to their death.
“High mortality rate due to Covid past is not possible because we are still in the initial stage of the Covid impact. Long-term studies have not been done. I believe the main cause of deaths is rising pilgrims,” he said.
“The footfall this year is much higher compared to that of the past. A number of elderly people had been eagerly waiting to visit Char Dham shrines. It’s also true that people often ignore their health during pilgrimage. Most of the deaths have occurred due to their existing ischemic heart problems owing to high blood pressure and diabetes. I feel the current hue and cry on deaths of the pilgrims is irrelevant,” added Bisht.
Health facilities available for pilgrims at Char Dham sites
According to health department officials, apart from the permanent health centres located en route to the Char Dham shrines, they have also set up 19 special medical relief posts (MRPs), where 11 first medical respondents (FMRs) have been deployed.
Life-support systems, a fleet of special ambulances and helicopter services are also available at the MRPs, they told ThePrint.
“Apart from this, 133 medical officers, including 24 specially trained physicians and orthopaedic surgeons, have also been deployed along the Char Dham routes. MRPs have been equipped with life-support systems,” state Director General of Health Dr Shailja Bhatt said.
Pilgrims who need additional oxygen services, she added, “are also provided disposable oxygen cylinders on the recommendations of doctors”. “Seriously ill pilgrims are airlifted to AIIMS Rishikesh. We have also deployed around 50 additional ambulances on the Char Dham route,” she said.
(Edited by Gitanjali Das)