The region around Varanasi, one of the holiest cities in the world for Hindus, is among the worst affected by the second wave of coronavirus sweeping India. Many angry citizens of the region, in the northern state of Uttar Pradesh, are now asking where their MP, Narendra Modi - India's prime minister - is in their hour of need. India's devastating second wave has pushed the country's total number of infections to 20 million and the death toll to more than 220,000. In Varanasi, with the health infrastructure swamped, patients can no longer find hospital beds, oxygen, or ambulances, and getting a Covid test can take up to a week. In the past 10 days, most pharmacies have run out of basic medicines like vitamins, zinc and paracetamol. "We are inundated with calls saying help us get a bed or oxygen," said a local medical professional, who did not want to be named. "With the most basic medicines in short supply, people are even taking expired drugs," he said. "They say it's a little less effective, but at least it's something." What caused the virus spread? City residents say the first signs of trouble became visible in March. As cases spiked in Delhi and Mumbai and authorities there began imposing restrictions, migrant workers began returning home to their villages in and around Varanasi on overcrowded trains, buses and trucks. Many came home for the Holi festival on 29 March or to vote in the village council elections on 18 April - held against advice from experts. Reports say more than 700 teachers on poll duty died in the state and the elections helped spread the virus. Varanasi's hospitals were soon overwhelmed and people left to fend for themselves. Rishabh Jain, a 25-year-old businessman based in the city, told the BBC that when his 55-year-old aunt fell sick he had to drive 19 miles (30km) every day to queue for up to five hours to refill an oxygen cylinder. "We panicked when her oxygen levels fell below 80," he said. "We couldn't find a hospital bed so the family started phone bashing to find an oxygen cylinder. We tried 25 numbers for 12 to 13 hours and finally with help from social media and the district administration, we managed to get a cylinder. She's recovering now." Alarmed by the situation, the Allahabad high court on 19 April ordered a week's lockdown in Varanasi and four other cities in the state, saying the pandemic had "virtually incapacitated our medical infrastructure". The state refused to enforce it and challenged the order in the Supreme Court, arguing it had to "protect both lives and livelihoods". Critics now say the government has failed to do either. With the district administration imposing intermittent weekend curfews and with most businesses and shops shut from fear, thousands are losing their livelihoods and the virus is still spreading.