Time for robust healthcare

Alongside an economic stimulus package, the Indian Government’s COVID-19 response must include measures to ensure better health and nutrition outcomes for its depressed classes

Like many parts of the world, our country too is grappling to prevent the escalation of COVID-19 to the third stage. This is a precarious situation wherein every step has to be taken cautiously with a lot of planning and care. The medical, paramedical staff and the 'safai-karamcharis' are at high risk. Several doctors and nurses have already lost their lives in China, Italy, Iran and Spain after they caught the infection while caring for the sick.

Even though flu is a common disease, sometimes it can take serious forms. The world has witnessed the influenza pandemic of 1918-1919, known as 'Spanish Flu' or 'La Grippe', which killed between 20 and 40 million people, which is more than the number of people who died during the First World War. More people died of influenza in a single year than in four years of the 'Black Death'. It has been cited as the most devastating epidemic in recorded world history. Between 17 and 18 million Indians died in this. We lost 6 per cent of our people.

But those were different times. Medical science was not as advanced as it is today. Today we have more information about the spread of diseases and their control measures. The fear, however, is that there is an increase in mobility which can be the cause for the fast spread of the infection. In India, so far, we have been spared the community spreading stage of COVID-19. But there is a lot of uncertainty in the coming days.

Keeping this in view, the government, on the advice of medical scientists, has taken certain measures including lockdown. Social distancing is an important way to prevent spread. The Johns Hopkins COVID-19 model for India points out that 'social distancing is an important step as the virus spreads through droplet infection. But a national lockdown is not productive and could cause serious economic damage, increase hunger and reduce the population resilience for handling the infection peak.' The poor people, which form more than 50 per cent of the country, may not be able to withstand this situation if some effective measures are not taken by the state.

In such situations, people look towards the state for care and help. The announced packages by the Prime Minister and subsequently by the Union Finance Minister are meagre in the wake of huge requirements for investments in the health system to provide for safety equipment, personal protective equipment (PPEs), increase of beds and other infrastructure in order to fulfil basic needs of almost 50 crore of our 54 crore strong labour force, which has been rendered jobless suddenly and has no means for livelihood due to lockdown.

The Government woke up too late and then abruptly announced the lockdown and curfew. This decision, made without adequate warning and preparation, has caused a lot of displacement among the migrant workers in different states. These people are now facing hunger and we expect them to face COVID-19 as well? When the first case was reported on January 30, many of those in responsible positions in the state assemblies and Parliament started spreading myths for the sake of image management. Scientific guidelines were totally ignored when some groups were seen taking out rallies and jostling with each other, playing various instruments with the misplaced and woefully misinformed hope that sound would kill the virus. It was even more sickening to watch the current Chief Minister of Madhya Pradesh taking an oath of office in the presence of hundreds of people, totally in contravention to medical advice.

It was good on the part of the government to announce insurance coverage to doctors for Rs 50 lakh, Rs 30 lakh for nurses and Rs 20 lakh for others in the health sector but this package once again ignores the emergency needs of health professionals, paramedics and other workers of the health system to meet the challenge. Immediate investments are required in the health sector for PPEs, masks, increasing beds in hospitals and creation of new facilities in school buildings and stadiums to meet the emergency situation of testing, segregating and quarantine of those tested positive in these places. As per estimates, our country has about 40,000 ventilators in total. The Government has decided to purchase 40,000 more. But in this global crisis, it may be difficult to get these from abroad. However, the requirement is being estimated to the tune of ten lakh if the situation worsens.

We need immediate steps to improve the nutrition level of our population. An announcement of Rs 500 per month to those with Jan Dhan accounts, many of which have already been closed, is insufficient.

In a very bold statement, senior consultant gastroenterologist and transplant hepatologist from Hyderabad, Dr Manisha Bangar, challenged the government's approach and dared the government not to waste energy on 'ghantis' and 'thalis' but care for those engaged in care of patients. She suggested that the government should ask corporates to dig into their deep pockets.

Several doctors from the organisation called Indian Doctors for Peace and Development (IDPD), who are engaged in relief work, have reported from different states the difficulties being faced by the health professionals in the absence of basic items like masks and gloves.

The Kerala government has released a relief package of Rs 20,000 crore. Punjab, Rajasthan and Delhi also have come out with economic relief packages. The US has passed CARES Act (Coronavirus Aid Relief and Economic Security) which includes cash relief, small business loans to enable payment of wages to workers, industry-specific loan guarantees that largely protects cargo industry and its workers, health care that includes free health care, an extension of the tax deadline and provision of loan holidays to students and industries. Germany, the UK and EU have aa come out with economic relief packages as well. Why is our government refraining from being liberal in announcing such a package?

What we need in the present scenario is to do a large number of tests at random because the numbers being projected may not be correct. It is also imperative to manage the stress levels of the population. A lot needs to be done to allay their fears and reduce stress level.

Views expressed are strictly personal

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