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Covid-19 Pandemic: Time To Act

The Covid-19 outbreak has put the spotlight on the abysmal healthcare infrastructure in the country. We need to act quickly to save the day

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Bringing down the world to a halt, including India, the Severe Acute Respiratory Syndrome associated Coronavirus (SARS-CoV), otherwise termed by the World Health Organisation as COVID-19 (acronym for Corona Virus Disease 2019) on February 11, cases in the world rise to at least 6,64,873, death toll at 30,943, as on 29 March. In India, there are over 1,024 confirmed cases, 24 death. The entire India is on the 21-day lockdown till 14 April to combat spread. The move is designed to curb the virus’s spread and keep the country’s already-fragile health system from buckling under a surge of critically ill patients.

Similarly, the central government has injected Rs 15,000 crore in the health infrastructure to fight the virus on a war footing.

Inception & Progress
In India, it started with the return of three students from Wuhan University, China — epicenter of the epidemic — to Kerala. Their infection was confirmed between 30 January  and 3 February. On 2nd March, two men—45 years old and 24 years old—with a travel history to Italy and the UAE were also reported infected with the COVID-19 by the Health Ministry. It was after a gap of few weeks that the next set of infected patients came to the fore as the medical infrastructure began detailed testing of passengers arriving from places that were reporting infectious cases in large numbers.

On 12 March, India reported first coronavirus death of a 76-year-old man in Karnataka, who had travelled to Saudi Arabia. Then the Health Ministry reported the second death of a 69-year-old woman in Delhi, subsequently rectified as she was tested negative of the COVID-19. The stats reveal that the disease is spreading at a comparatively low rate of 1.7 in India. But, in 55 days, the COVID-19 has impacted various corners of the country. As of now, Maharashtra has the maximum number of cases, however, other states like Kerala and Karnataka are trailing the list available on the Health Ministry’s website.
Testing Woes
By now, it is abundantly clear that the healthcare infrastructure is not undertaking adequate number of testing compared with other countries. In the initial three weeks, the government allowed only its own labs to undertake the testing for the COVID-19, an otherwise expensive test, virtually free. The private medical infrastructure kept pleading and offering their services for undertaking more tests. Finally, on 25 March, the Indian Council of Medical Research (ICMR) released a list of 29 approved private labs for testing Coronavirus. Although, the test costs Rs 6,500 to the government, but they have asked the private labs to charge a fixed amount of Rs 4,500 (screening test of Rs 1,500 for suspects plus Rs 3,000 for confirmation test), encouraging free and subsidised testing. Diagnosis plays a crucial role in this disease, inhibiting further spread. A Pune-based startup Mylabs has manufactured an ICMR approved COVID-19 testing kit costing nearly Rs 1,200 to supply it to private labs.
Calling Attention
According to the National Health Profile-2019, a document released by the Central Bureau of Health Intelligence under the Health Ministry, there are 7,13,986 total government hospital beds or 5.5 per 10,000 people. Of the 8-crore elderly population (above the age of 70-years and considered worst impacted by the COVID-19), there are 51 beds per 10,000. An international report on the Indian healthcare says it is estimated that by 15 May, India may need 1.1-2.2 lakh ventilators, a must to sustain, nurture and revive the COVID-19 infected patient as the respiratory system clogs (advanced stage). While there are no official numbers for ventilators in India, an assumption is that there should be around 18,000-25,000 ventilators in India. Some news reports suggest a higher number – around 35,000-40,000 ventilators. Whatever may be the numbers, the moot point is that it is not enough for even 0.5 per cent of Indian population. Ban on flights etc. may add to the woes of importing ventilators from developed countries, each of whom are also struggling with their respective infrastructure.

A ventilator cost between Rs 8 lakh – Rs 10 lakh. In the midst of the crisis, many hospitals including AIIMS Delhi states the purchase of ventilators and monitors in the last few days. But ventilator is not the only equipment needed when looked upon the number of hospital beds, one can only estimate. As the information available is just floating numbers due to the limited number of beds and other facilities in the healthcare sector.
Way Out?
The COVID-19 outbreak has exposed the gaping holes in the healthcare system everywhere, not just India alone. There are no easy solutions, only tough questions. For example: Do we need Coronavirus to realise how weak our healthcare system is? Can we ever be prepared for a pandemic like COVID-19 when we fall short in handling cases of Dengue, Malaria and respiratory ailments at different times of the year? Till when are we going to fight such menacing outbreaks ill-equipped, unprepared yet somewhere unapologetic?