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COVID-19 : A Commentary on the Health System of India and its Battle with the Pandemic

By Sukanya Chakraborty

The Novel Coronavirus 2019 has taken the world by a storm and brought life to a standstill.

Caused by the SARS-CoV-2 virus, the disease presents as mildly symptomatic in most afflicted individuals, with possibilities of complications in those with co-morbidities. The devastation does not end there, however. 

The socio-economic landscape of the entire world has suffered irrevocable damages, and even more so, in developing nations such as ours. With a dearth of the essential resources and an effective workforce, India has geared up at the helm of the unsteady ship to fight the storm. The spirit is indeed undeniable, yet we fear whether the ship can be rescued from the impending doom in time. 

Source : National Health Profile 2019, Central Bureau of Health Intelligence

When tackling an issue on a scale as large as this, the tried and tested methods of social distancing and national lockdowns are the measures resorted to. What we, as a country, may have struggled in establishing, is an infallible system of testing and contact tracing. The essential aim of any lockdown is to halt the chain of transmission by strict measures controlling movement of citizens and bring about an overhaul of the health system. 

It is imperative for the medical set-up of the country to cater to the demand of the day by investing utmost efforts in the infectious disease wings. Not only is extensive testing and treating indispensable, but also demarcating proper quarantine and isolation facilities. In fact, addressing patients admitted with other diseases or requirements becomes critical. The face of a hospital transforms as every aspect of treatment now has an underlying necessity to abide by the norms to prevent infectious disease spread. Routine procedures need to be conducted under jurisdiction and contamination reduced at every step. 

Source : IHME, Global Burden of Disease, 2017

Until recently, India had only 111 COVID-19 testing centres to handle a population of 1.35 billion people. The number of beds in government-run quarantine facilities across the country, meanwhile, is about 60,000. The surveillance in our country is hindered by a severe lack of awareness on the part of the nation’s denizens. Reports of patients trying to flee from isolation wards and conceal their travel history have been rampant. Lack of proper intervention on the part of hospitals have been noticed and frowned upon. In fact, what has been truly appalling is the evidence of incorrect results being released and numbers being withheld. The situation does not seem to take a turn for the better. 

Source : National Health Accounts (2016-17)

We have to pay heed to the other side of the coin as well. In a country whose foundations rely upon a major fraction of workers earning wages on a daily basis, such decisions, may spell imminent cataclysm for our economic scenario. The effects are multi-factorial. Migrants exasperated with their emotional turmoil have taken to the roads. This ordeal may exacerbate the situation by compounding chances of community transmission. Apart from the economic suffering of the already famished society, this could disseminate or spread the disease in rural areas. Information about their exposure and status of infection is extremely limited. Fear and apprehension surrounding a disease can lead to unwarranted panic and establishment of a social stigma pertaining to it. With the lack of proper scientific temper in our country, all these serve as added burdens to an already frail health system. 

It is unfortunate that most hospital facilities in our country lack state-of-the-art infrastructure to address emergencies such as this. Although by now, much of the mayhem and tumult has considerably subsided, we do need to remember that the Indian health system deserves immediate attention. A severe shortage of trained staff has rendered us helpless to contain the infection, particularly in densely populated states and low-resource regions, which India is replete in. We are highly deficient in health care services as per the recommended levels advisable by the World Health Organization. Challenges are discernible at every turn and the dream of a fruitful health order seems no less than a mirage. 

Shouldering their own Burden. Danish Siddiqui, Reuters

WHO’s Chief Scientist, Dr Soumya Swaminathan, has posited and warned that rural India may become the next coronavirus epicentre. This opportunity needs to be utilised to strengthen and improve the country’s primary health care system. Although this is an impossible feat under current time constraints, the right steps in this direction will definitely help in the future.

The coming weeks and months are challenging for India and we need to take strong measures to meet this emergency and its inevitable aftermath.

REFERENCES

[1]  Anant Kumar, K. Rajasekharan Nayar, Shaffi Fazaludeen Koya, COVID-19: Challenges and its consequences for rural health care in India, Public Health in Practice, Volume 1, 2020, 100009, ISSN 2666-5352, https://doi.org/10.1016/j.puhip.2020.100009

[2]   Bhatia S, Alexander S. 2020. ‘COVID-19 shows why we need a Healthcare Reboot for India’. LiveMint.

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