Undoubtedly staying at home for this long is very very difficult, but what if you had to be at your work 24*7? Not being able to meet your families, unable to hug your kids, and tend to your family’s needs during this time?
As hard as it seems, some of our heroes, working on the frontline have been living this life for weeks now and who knows how long will it go.
As promulgated by the WHO, the recommended doctor-patient ratio is 1:1000. Unfortunately, India still lags in achieving the desirable ratio. According to a survey by the economic times in 2019, India has a shortage of an estimated 600,000 doctors and 2 million nurses. The shortage of medical professionals, nurses, staff, etc. is the basic problem in India.
Fortunately, India is not among the worst-hit countries, but its under-funded and patchy public health system, with huge variations between different states, poses special challenges for the country’s disease containment strategy.
Now wonder what could happen if the already poor ratio of health-care providers to patients falls further? Not very surprisingly, this is already happening.
According to the WHO, personal protective equipment (PPE) is essential for doctors, nurses, and health professionals attending to Covid-19 patients or screening suspected cases. PPE includes masks, goggles, gloves, and face shields. Shortages of PPEs are leaving doctors, nurses, and other frontline workers dangerously ill-equipped to care for Covid-19 patients.
Earlier, a Mohalla Clinic doctor tested positive in Delhi after exposure to a Covid-19 patient, which led to quarantining up to 1,000 people.
Similar reports of doctors and other health professionals testing positive or having exposure to Covid-19 patients have come from Rajasthan, Karnataka, Uttar Pradesh, Bihar, and Kerala among other states.
In Rajasthan, a doctor who tested positive attended to patients admitted to the intensive care unit of a Bhilwara hospital. Some of the ICU patients later tested positive for novel coronavirus.
In Bihar, the situation is critical. Some of the doctors attended to a COVID-19 Positive patient in regular protective gear and not the kind recommended for treating novel coronavirus cases, which led to some of them showing symptoms and about 83 of them share the same mess. Rest, you can wonder.
Given the long stay of novel coronavirus patients at hospitals, India will need millions of PPEs until the time the novel coronavirus pandemic eases out.
COVID 19 treatment is currently focused on government hospitals. In most parts of the country, these hospitals are underfunded, not patronized by the rich and powerful; their staff demoralized. This does not change overnight.
An overstretched public health-care system forces millions of Indians to turn to the unregulated private health-care sector. The Indian government’s expenditure on health as a percentage of GDP still hovers around 1·5%, one of the lowest in the world. For around 52% of households in urban areas, and 44% of households in rural areas, the private sector is the main source of health care when they are sick, according to government data.
Over the past few weeks, there have been several reported instances of patients trying to flee isolation wards in government hospitals and hide travel history. Many with exposure to suspected cases of COVID-19 and infected persons have also tried to dodge the mandatory home quarantine.
According to India’s latest containment plan, a 20-page document, which specifically talks about “non-pharmaceutical interventions”. “Quarantine and isolation are important mainstay of ‘cluster containment,” the document states.
Quarantine refers to the separation of individuals who are not yet ill but have been exposed to COVID-19 and therefore have the potential to become ill. Isolation refers to the separation of individuals who are ill, suspected, or confirmed COVID-19 cases. Despite so many guidelines, there have been reports of people fleeing the isolation wards and crossing borders because local MLAs are overruling the respective officials and allowing them to do so. How can you expect this pandemic to get controlled in a country with so many loopholes?
Now let’s ponder on what the doctors are receiving after working in these conditions.
After completing their MBBS, medicos are sent on a one-year rotatory internship to get hands-on experience in the field during which a stipend is paid to them by the respective governments.
Despite facing a slew of hardships due to the coronavirus pandemic and working for more than 10 hours daily to screen and survey people in remote areas, a meager stipend of little over Rs 230 per day has left MBBS interns in government medical colleges of Rajasthan and Uttar Pradesh fuming with the budding doctors launching a social media campaign demanding a hike in the allowance.
Nearly 8,000 resident doctors in Karnataka have raised their voice over the low monthly stipend they get and the exorbitant fees that they have to shell out, in the state’s government colleges and universities.
Fighting on the frontlines of the COVID-19 pandemic, the doctors said that they risk their lives on a daily basis, only to have just a few thousand rupees left every month from the stipend that they receive.
International experiences have shown that 5-10% of patients need ventilator support to survive. India’s ventilator inventory is estimated to be a mere 40,000, clearly inadequate given the scale and reach of the coronavirus.
As of on 28th March, the donations pledged to PM-CARES fund had crossed over 6500 crores rupees. Since it has been set up, there have been controversies over creating a different relief fund while the PMNRF already exists. Also, when there have been hundreds of crores being donated already, why is there still no improvement in what we are providing to our health care staff?
Why is there still a lack of PPE kits and ventilators?
Why still the doctors and nurses are getting infected?
The virus pandemic is eating its way through the weak spine that the health care system of India is, and unless the funds don’t plaster up the weakened links, it’ll be successful and break the nation in one go.
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