E-Paper
Locked down, but job not done
Experts say that this will only buy time by impeding the spread Covid-19, which could be accelerated again once the curbs are lifted.
An unprecedented nationwide lockdown is in place in India to control the coronavirus disease (Covid-19) outbreak. Experts say that this will only buy time by impeding the spread Covid-19, which could be accelerated again once the curbs are lifted. The government needs to use this time well by augmenting its health care infrastructure on a war footing to push back the virus.
1) BUILD HOSPITALS, BE BATTLE-READY
If the government relies only on the lockdown and doesn’t take immediate action to build hospitals and have more beds for its citizens, a rapid spread of Sars-Cov-2 when restrictions are lifted may knockout the health care system with surging caseloads and many needing intensive care. India’s overstretched health system is already grappling with shortages of doctors, health workers and hospital beds, especially in rural areas and densely populated states.
1.1mn registered doctors as of December 2019; only 926,000 may actually be ready at 80% availability
2.05mn registered nurses and midwives, most of whom need infection control training
669,600 hospital beds
70,000 ICU beds. India has 20% of the number of South Korea’s ICUs
1.36bn India’s estimated population
1:1,457 is the doctor-population ratio, lower than World Health Organization’s recommended norm of 1:1,000
1:10,926 is the ratio in rural areas, where citizens are entirely dependent on government facilities
GFX: FLATTENING THE CURVE (3 SMALL WORMS): Italy – Has good infra but did not lock down; China -- added makeshift infra and locked down swiftly; South Korea – Aggressively tested
LESSON: CHINA MODEL – OVERNIGHT FACILITIES
China’s Wuhan, where the global pandemic is believed to have originated, raised 16 makeshift hospitals within days, adding 13,000 beds and treating 12,000 people. By sending patients to such hospitals in addition to severe lockdown measures, officials were able to reverse the shocking numbers of daily new cases. In the last 72 hours, Wuhan added zero cases of local transmission of Covid-19.
2) VENTILATORS: KEEP THE SYSTEM BREATHING
Experts say that the number of ventilators– an urgent equipment to support the breathing of severe Covid-19 cases – in India are simply not enough. The Sars-CoV2 pathogen attacks people’s lungs, in some cases compromising their ability to breathe as they develop pneumonia. Ventilators, which deliver air to the lungs through a tube placed in the windpipe, are crucial to keep these patients alive. Training medical staff to use ventilators and ensuring there are enough skilled operators to run them 24x7 is a bigger challenge than procuring machines.
40,000 working ventilators, mostly deployed in government medical colleges and private hospitals in metros, state capitals and semi-metro towns
1,200units have been ordered after the Covid-19 outbreak, according to the government
8,510 ventilators valued at ₹444.74 crore were bought by public and private hospitals in 2019
5% Covid-19 patients require ventilator support in ICU. If these patients do not get the device, they are likely to die
LESSON: ITALY HORROR – PEOPLE LEFT GASPING
Italy, which is now the epicentre of the Covid-19 outbreak, has reported about 70,000 cases, with 600-700 people dying every day over the past week. The sickest patients are complaining of severe breathing problems but there are just not enough ventilators to go around. Reports say that in northern Italy, the orders are to not allow those over 60 access to ventilators. In a scary choice they have to make, the health care professionals have to pick younger patients with better chances of survival.
3) SAVING THE SAVIOURS: PERSONAL PROTECTIVE EQUIPMENT
A shortage of personal protective equipment (PPE), which includes masks, respirators, eye shields, gowns and gloves, is limiting health care workers’ ability to battle the Covid-19 pandemic. Doctors and nurses are forced to reuse PPE and in many cases even work without it, putting themselves and patients at high risk. Thousands of workers are reported to have been infected while trying to save others from the deadly pandemic. Doctors at the All India Institute of Medical Sciences (AIIMS) in New Delhi have flagged heavily depleted stocks of PPE, urging the administration to take immediate action to acquire more equipment.
To fight infections in just the next two months, India may need:
700,000 body overalls
10mn three-ply masks
6mn N-95 respirators
#GiveMePPE has been trending on social media amid calls by desperate health care workers
LESSON: PEOPLE DYING AT THE FRONT LINE
Thousands of doctors and nurses have contracted the disease while treating patients across the world. In Wuhan, 46 of the thousands of infected workers have died because of the lack of PPE. In Italy, just before he tested positive for Covid-19, a doctor appeared on TV, holding up a bottle of hand sanitiser and showing his face mask. He, however, said about gloves: “They have run out... We were not prepared to face this situation.” Marcello Natali died last Wednesday.
4) TEST, TEST, TEST...
Unlike the Sars pandemic in 2002-2003, Covid-19 causes mild or no symptoms in some infected people initially. This means that they are capable of spreading the virus unknowingly. Experts say that the only way to stop the disease from spreading undetected is aggressive and random testing of people. Testing has single-handedly defined the effectiveness of the response of several nations. The US government is facing public anger for the slow launch of tests. South Korea, which had the second-biggest number of cases in Asia, has managed to control the outbreak largely through testing thousands every day.
20,864 people tested in India till 10am on Tuesday
10,000/day is the capacity to test samples in India, highly underutilised
300,000+ people have been tested in South Korea, for a per-capita rate more than 40 times that of the US
50 drive-through facilities test patients while they remain in their cars in South Korea
100,000 kits per day are being currently produced in South Korea
TEST EARLY AND WIDELY, DON’T WAIT FOR CRISIS
South Korea has tested far more people than any other country. This way, it has been able to isolate and treat people soon after being infected, leading to a very low death toll. With the aggressive testing, it was also able to trace the pattern and footprints of the virus.
5) ISOLATE, TREAT, DEFEAT
Wuhan in February turned an exhibition and cultural centre into a large isolation facility, with dozens of beds. Similar centres in European countries have also been turned into isolation centres so that Covid-19 spread can be stopped and infected people can be identified early and treated. India has set up several isolation centres, with the Indian Army and the Indo-Tibetan Border Police also pitching in. But many more such centres need to come up. The government is said to be looking at dedicated Covid-19 hospitals in the country to isolate and treat patients.
LESSON: CITIZENS HAVE A BIG RESPONSIBILITY
There is currently no vaccine to prevent Covid-19. The best prevention method is to avoid being exposed to the virus. It spreads mainly from person-to-person; between people who are in close contact with one another. Social distancing is the only effective way to control the pandemic. Indians needs to follow the lockdown guidelines as much as possible. If you develop symptoms, call 1075, the national Covid-19 helpline.
