Covid pandemic- an opportunity to augment health services in India

Monday, 10 May 2021 | Dr BKS Sanjay

As we know if one is divided by more than one, then the quotient will be less than one. This applies to all our resources as well. This message should be ingrained in the citizen’s mind that overpopulation is causing depletion of all natural and man-made resources all over the world.

Overpopulation in India is an ongoing problem which is becoming a big hurdle in the pace of all kind of developments. Overpopulation and overcrowding in any area are known to cause poor sanitation, poor personal hygiene and improper ventilation. In such an environment, if an infective agent is too virulent, then the chances of the spread of infection increase proportionately.

The common observation is that the incidence of spread of Covid-19 infection is more in the urban areas than the rural areas. Urban metropolitan cities like Mumbai, Pune, Chennai and Delhi have been hotspots for the Covid-19 infection. Though the metropolitan cities have facilities than the rest of India but still, they are not proportionately enough to even cater the current population of these cities. Due to the unevenly distributed health services in India particularly, the rural areas, there is an influx of these patients into metro cities for their medical care especially in critical condition like Covid-19 infection. This exponential influx is further compromising the already compromised health services in these metropolitan cities.

There have been the reports in the mass-media that in some cases the whole family has succumbed to Covid-19 infection. The Covid-19 strains are some times so virulent and contagious that even if one family member is infected then he may have the potential to infect the whole family. This problem becomes more so in a joint family which is still a common tradition in our country.

The world data shows that five per cent of the population of any country is being infected and one to two per cent of them die due to Covid-19. The pandemic has exposed our poor preparedness for disaster management. By April 27, 2021 more than 180 lakh people were Covid positive and nearly 2 lakh people had already died in India. I think many more are infected in our country but they are not getting tested due to various reasons like ignorance, poverty and fear of isolation.

On analysing the currently available data of Covid -19 pandemic in India, the statistics shows that the current population is almost 140 crore. Out of this, if five per cent are getting infected it means almost 7.5 crore population and 15 per cent of them– nearly one crore need some sort of supportive treatment in the hospital. Out of seven crore infected patients five per cent- almost 3.5 lakh people will need the ICU services.

The new wave of the Covid-19 pandemic has exposed our poor infrastructure like non availability of general bed, oxygen and non-availability of ICU beds which are the just the tip of the iceberg. A country maybe able to import or arrange a number of ventilators but how can we have instant supply of manpower like intensivists, nurses, ICU technicians and other paramedical staff which is not possible to generate overnight.

If we want to give all the services to the needy people then we have to develop a long term strategy to have the enough manpower and infrastructure so that the supply chain can be maintained smoothly. The data obtained from the National Statistical Office (NSO) 75th round report estimated that India has approximately 19 lakh hospital beds, 95,000 ICU beds and 48,000 ventilators. That means five per cent of the beds are allocated to the ICU ventilators. Ventilators are the main vital support for critically ill patients.

Mapping and training of the medical and paramedical staff to run the ICUs needs to be done. Currently, there are not enough ICU beds. So the number of trained medical and paramedical staff has been limited. Many private doctors and hospitals are having the capacity to buy the ventilators and other machines needed for the ICU patients at the snap of the fingers. But can they arrange or appoint medical or paramedical staff with that ease? Surely not. Our policy makers should make future policy, a stringent plan to deal with Covid-19 pandemic and other medical problems our country may face in near future with a vision to deal with them in a better way to avoid the current chaos we all are in.

As a doctor, I know that the people working in the health sector be it physician, surgeon or nurses or paramedical staff are relatively more knowledgeable and more skilled than other employees. Here I would like to suggest the government and the private hospitals to take the initiative to train the existing health workers with some short term training to run the ventilators and manage the patients at time of disaster and augment the current health services.  

However, one must understand that overpopulation is root cause of all ills in India. I feel awareness about the consequences of overpopulation needs to be re-emphasised to the public, influential policy makers and religious preachers to bring grassroots changes in the way we think about procreation. As we know if one is divided by more than one, then the quotient will be less than one. This applies to all our resources as well. This message should be ingrained in the citizen’s mind that overpopulation is causing depletion of all natural and man-made resources all over the world. The recent emergence of covid-19 pandemic has further exposed not only the health related problems but other non-health related problems too. The second surge of Covid-19 pandemic is giving nightmares to the administration to contain the Covid-19 infection. It seems that the bubble has burst and state governments are forced to keep people at home by enforcing lockdown which itself is not the cure.

The concept of one baby norm is good to control overpopulation in the subsequent generations but the drawback with one baby principle is that population will be half in each generation ultimately the population goes in negative growth. The two baby norm per couple-preferrably a girl and a boy- if enacted is sustainable and very effective way of curbing the population and maintaining the sex ratio. As our government’s policy to control the population is based on the concept of voluntary family planning, it has not given the results needed to curb the growth of the population. Our Prime Minister should take an initiative to work in this direction and once again prove the Indian dictum of “Vasudhaiva Kutumbhakam” which means the whole world is a family.

(A Padma Shri recipient, the author is an orthopaedic surgeon & member of HNB Uttarakhand Medical Education University executive council)

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