Training medics to improving infra: TN gears up for third wave

Chennai: As the second wave recedes, Tamil Nadu has begun preparing for a possible third wave of Covid-19 infections

Chennai: As the second wave recedes, Tamil Nadu has begun preparing for a possible third wave of Covid-19 infections. The state relies on experts, data and seroprevalence, adding more oxygen supported beds and oxygen storage capacity. Though the state agrees with experts who have said that there is no evidence to back the claim that a third wave may affect children more, the health department wants to improve infrastructure for paediatric care to be cautious.

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The government is preparing in three avenues- increasing infrastructure, training healthcare professionals and stocking medicines. “We are seeing to it that temporary infrastructure created for the second wave is not dismantled, and we are focussing on improving permanent infrastructure,” said health secretary J Radhakrishnan. “But, more importantly, we have to continue mass messaging to the public that they need to understand that the real prevention against a third wave or any other increase depends on behavioural change and following SOPs on permitted activities as we open up. Irrespective of the variant, for the next few months, common practices of mask compliance, hand hygiene and social distancing have to be followed.”

A 14-member task force, headed by former health secretary R Poornalingam, was set up a few days ago to advise the government on Covid-19 management. “We have told the government to prepare for a scenario where there are 50,000 new cases per day,” said a member of the committee not wishing to be named. “In the first wave, we had 7,000 cases per day, and in the second wave, the peak reached 35,000 cases per day. So, if we were to add children, we estimate that the number would be 50,000 cases in the third wave. Both government and private hospitals have to increase their oxygen supported beds.” There isn’t a consensus on the projection for a third wave.

The government has begun strengthening the paediatric facilities with oxygen support. “75% of the beds are free now across Tamil Nadu, so in view reports of a possible third, which says more of the paediatric age group will be affected,” said the director of medical education, Dr R Narayana Babu. “We are making efforts to keep our paediatricians ready, including physicians, anaesthetics and nurses. We have inspected all hospitals for a minimum of at least 100 beds in the paediatric ward to be readily supported by oxygen and ventilators. We already have 40,000 oxygenated beds in medical colleges and 60,000 regular beds.” Babu adds that he is a paediatrician. “We are doing this as a precaution. In my opinion, they (children) already have good antibody levels, and they have been less affected in the first two waves, so it may or may not affect children.”

On Wednesday, the health department opened a 40-bed paediatric ward with six ICUs in the Mayiladuthurai district. “Though certain specialists have said that there is no basis to claim that it will have more impact on children, we have been working on this area,” said Radhakrishnan.

Tamil Nadu’s oxygen needs went up to 600 MT per day while its production capacity is only 500 MT daily. Former director of public health, Dr K Kolandasamy, who is also part of the newly formed task force, said that his personal opinion is that the state should double its production capacity, and not rely on other states for allocated supply.

“Capacity to store oxygen of 5KL to 10KL should be created in districts so that they can be sufficient even if there is no supply for a week,” the member quoted above said. Tamil Nadu has already invited tenders for manufacturers to locally produce oxygen, cylinders and vaccines, and has announced a capital subsidy of 30%. “Tamil Nadu has to become a medical manufacturing hub,” said Kolandasamy. “Whatever infrastructure we build now given Covid-19 will continue to be helpful for other health issues in future after we bring the virus under control.”

Agreeing with him is Dr Jacob John, former director of ICMR’s Centre of Advanced Research in Virology, whom the state government had consulted earlier this month, along with several other experts. “The government has to make use of the fear factor of a potential third wave to build capacity in each district,” says John. “Each district is unique, so it will have to be strengthened, accordingly, which will also be useful during a non-Covid-19 period.”

Vaccination is a potent tool to protect against the virus, but Tamil Nadu has been facing a vaccine shortage, having come close to halting it twice in June. “Now, vaccine hesitancy seems to be a thing of the past. So our focus is also on rapid administration of vaccines, we are utilising whatever we receive as quickly as possible, and we keep seeking additional vaccines,” said Radhakrishnan.

Around 15 million vaccines have been utilised out of the 11 million that the state has received until Monday night.

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