Covid 2nd Wave India : Covid-19 Possible Second Wave As India Unlocks; How Ready Is Healthcare System?

India is witnessing a second wave of the Covid-19 pandemic. Dr Randeep Guleria, the director of the All India Institute of Medical Sciences (AIIMS), ended speculation over the existence of a second wave of the Covid-19 pandemic.

Covid 2nd Wave India : Covid-19 Possible Second Wave As India Unlocks; How Ready Is Healthcare System?

India is witnessing a second wave of the Covid-19 pandemic. Dr Randeep Guleria, the director of the All India Institute of Medical Sciences (AIIMS), ended speculation over the existence of a second wave of the Covid-19 pandemic in an interview to India Today.

"Yes, we are seeing a resurgence of cases. We can say that we are seeing some sort of a second wave in certain parts of the country," Dr Guleria told India Today TV's Consulting Editor Rajdeep Sardesai.

This statement assumes significance in the wake of a fresh sharp jump in confirmed cases of Covid-19 from states such as Maharashtra, Delhi, Andhra Pradesh, Telangana, Kerala and Odisha, among others. The second wave is a reality at least in some parts of India.

Delhi's coronavirus situation is more pronounced with the city reporting the highest single-day spike in the number of Covid-19 cases in almost two months. The fresh spike in cases across worst-affected states has pushed the country's daily Covid-19 caseload to over 90,000 placing India on the second position in the world in terms of total recorded coronavirus infections.

Dr Randeep Guleria said the trend of rising cases indicates that the Covid-19 curve may not flatten very soon. He expects cases to rise further over the next few months and continue into early next year.

COVID-19 PLUS FINANCIAL PANDEMIC

India is a facing a dual challenge. Along with the Covid-19 pandemic, the country is also battling a financial pandemic. India's GDP has crashed at the worst rate in several decades.

Unemployment is high, which reflected in the continued worrying consumption level. Inflation has shot up. Private investment is negligible. The government does not have enough money to spend. And, it is not willing to risk increasing the fiscal deficit further.

Following the "strictest" coronavirus lockdown from March-end to early May, India has been unlocking itself as a policy response to Covid-19. The unlock policy banks on the principle that "we need to learn to live with Covid-19". Now, with Unlock-4, almost the whole of India is open. The only restricted areas are containment zones.

Under Unlock-4, the only public places shut are cinema halls, swimming pools, entertainment parks and theatres (excluding open air theatres). The new unlock phases coincides with a certain lockdown fatigue being seen among the population - people appear tired of compulsorily wearing a mask, and following social distancing and personal hygiene norms.

UNLOCK-4 MAY FUEL COVID-19 FURTHER

Such an unlock position offers fertile ground for further spread of infection during a pandemic situation. Incidentally, the second wave has come at a time when unlock phases have expanded the scope of increased public activity.

Just like the first wave, a question is being asked again: Is India's healthcare system ready to deal with the Covid-19 situation?

For record, India has a weak healthcare system despite medical tourism being one of the selling points over the past few years. The healthcare facilities in India are largely concentrated in big urban centres, and in private hands.

The problem now is the Covid-19 pandemic is spreading to rural areas of Maharashtra, Uttar Pradesh, Bihar, West Bengal, Telangana, Andhra Pradesh, Odisha and Kerala.

A health worker collecting swab sample from a homeless person in Delhi for Covid-19 test in the wake of second wave of the pandemic in the city. (Photo: PTI)

IS INDIA'S HEALTHCARE SYSTEM READY?

Based on numbers, India does not produce enough doctors. During the pre-Covid-19 era, India faced a shortage of 5 lakh doctors. The World Health Organisation (WHO) prescribes a doctor-to-patient ratio of 1:1,000. But India has a doctor-patient ratio of 1:1,596.

This means for every 1000 people seeking medical treatment there is less than one doctor (0.62). The situation is worse in rural areas.

If only government hospital doctors are included, India has one allopathic government doctor for every 10,926 people, according to the National Health Profile 2019 of the Central Bureau of Health Intelligence (CBHI).

It is estimated that about 70 per cent of all patients in India approach private doctors, clinics or private hospitals for treatment. However, private sector healthcare has not been of much help in dealing with the Covid-19 challenge, certainly not in the rural areas.

The government invoked the National Disaster Management Act of 2005 to deal with the medical situation arising out of the Covid-19 pandemic in the country. The Act empowers it to take over management of private institutions - something that several state governments did in the early phases of the spread of Covid-19. Many such private premises were later released as unlock phases progressed.

Now, there is pressure on the available healthcare infrastructure in the country to tackle the second wave of Covid-19 pandemic. In its mid-pandemic report, the Fitch Solutions Country Risk and Industry Research - a unit of the Fitch Group - warned that sudden increase in funding may not be enough to strengthen India's healthcare system.

It said, "The continued lack of medical funding and healthcare infrastructure inform out view for the potential pandemic to be worse in India if it is not adequately contained." The current state of Covid-19 pandemic in India affirms what was suspected.

THE WAY FORWARD

The strict coronavirus lockdown - which was apparently based on a now-proven erroneous theory that a complete lockdown will stop spread of the virus - was a success in itself. Economic activities came to a halt and people followed the restrictions more religiously than it was anticipated. But the lockdown only delayed the oncoming of the bigger Covid-19 crisis.

Now that India is grappling with the second Covid-19 wave experts suggest that the government should focus on three basic aspects of pandemic protocol.

One, the government should strengthen the mechanism for early detection and containment of patient and disease.

Two, healthcare capacity should be built factoring in the need for a strategic reserve of healthcare professionals, medical supplies including PPE kits and strong service delivery systems for containment zones, particularly in rural India.

Three, massive awareness campaigns should be undertaken to enforce preventive measures of wearing a mask, social distancing protocol and maintaining person hygiene, and ensure compliance at reopening public places including public transport.

Source : IndiaToday