India’s Fight Against Corona

Analysing how the country’s health care system is punching above its weight amidst this pandemic

“Our greatest glory is not in never falling, but in rising every time we fall”.

This famous quote by Confucius for me epitomizes how India has been at the forefront against fighting this virus when the Western world(Italy, Germany, Belgium, Sweden, the UK, the USA to name a few) with more advanced economies and health care systems has been struggling to contain the same enemy.

It was predicted way back in March that nearly 60% of India’s 1.3 billion population would be infected with the virus by so-called experts (epidemiologists to be precise). Several experts had predicted the collapse of India’s health care system and unprecedented loss of life, due to our high population density (the second largest population in the world) and poverty, where around half of the population struggles to survive with minimum substance for living.

What the West didn’t anticipate and didn’t take into account in their calculations, was our people-centred approach when it came to battling this virus. Primary and Community Health Centres in several states came up overnight for the population that lives Below the Poverty Line. Most of these were Govt. funded completely free of cost.

To say that everything is hunky-dory would also be a lie. There are thaluk level and district level referral and specialty hospitals run by the Government on minimal payment even for the general population before the pandemic. However, their numbers are just not enough considering the population of the country. Not only the lack of infrastructure but the number of doctors and medical and paramedical staff strength is also an alarming issue.

This is an established handicap of Indian system known to the International community as well. This pandemic has not only made an impact on the lives of every Indian citizen but has changed the perspective of the public towards the country’s health care system.

A glimpse of India’s response

Flattening the curve of the spread of Covid-19 has been the priority for the establishment following public health protocol. Even though the sudden nationwide lockdown created panic among the general public and uncertainty among the poor section of the population, this preventive social measure proved effective to curtail the social spread.

This stringent social lockdown that made the nation motionless gave us space and time to devise a plan of action and rearranging temporary medical care when developed countries tried to project it as a miscalculation. Police, civil servants, medical, paramedical forces joined hands to establish Standard Operating Procedures (SOPs) to put in place this Covid action plan. Trained social volunteers came forward to lend their hands in this battle.

National Initiatives mooted for facing the Pandemic

Existing inadequacies in the public health care system forced the Govt at the Centre as well as the States to take stock of the situation and save the lives of citizens as well as the quality of life of the citizens. This had to be achieved within limited means (access to space, infrastructure and human resource).

Several hospitals and PHC in various states turned into Covid-19 treatment hospitals. Early in the pandemic, the healthy patients were segregated from suspected and Covid-positive patients. As early as March, a state like Kerala had made provisions for a second-line of Covid isolation and care centres by utilizing big college hostels and convention centres. This was done to face any sudden spread or unforeseen increase beyond the capacity of hospitals in the worst crisis and was later implemented in several states across the country.

Amidst the pandemic, Ministry of Health and Welfare in collaboration with NITI Aayog released Telemedicine Practice Guidelines enabling Registered Medical Practitioners to provide healthcare in remote settings using telemedicine. The Govt. of India initiated immediate steps to manufacture all essential PPE kits, ventilator and testing kits. It also approved ₹15,000 crores ($2 billion) for an India COVID-19 Emergency Response and Health System Preparedness Package.

At the beginning of June, Centre and States had designated 958 Covid hospitals across the country, as well as 2,313 Covid Health Centers (for those who don’t need too much medical support) and 7,525 Covid Care Centers (for those with mild infections who can’t isolate themselves at home). National Center for Disease Control (NCDC) developed ‘The Cobas 6800’ testing machine for further increasing the testing capacity for COVID-19. Presently the testing capacity at NCDC is about 300–350 tests per day. With Cobas 6800, which is a high throughput machine with the capacity to test around 1,200 samples in 24 hours.

The Path Ahead

Lack of convergence of appropriate medical infrastructure is a root cause for the apathy in India’s public health care system. While the National Health Policy is periodically modified by the Union Govt., public health as a subject falls under the State List, according to the Indian constitution. Even though health care expenditure should be a priority of the state government as per our federal system, the disparity in the financial allocation to the public health care sector by State governments has made it a big challenge to maintain a balanced health care infrastructure and service system.

This led to setting up the National Rural Health Mission and financial support was provided to the states based on its population. This has helped the State governments to improve the health care facility as per national guidelines. By introducing a health insurance scheme for the poor, the public health sector has made tremendous improvement during the last 15 years.
However, the improvement has not been uniform as it was projected. We do not have much impressive rural and primary health care system when we look into the national level. But when we take into the stock of some states like Kerala, we certainly have impressive stories to discuss. The insufficient number of doctors, nurses and paramedical staff in public health service has been a roadblock in our systematic service delivery. Globally, our country ranked 145 among 195 in terms of the calibre of health care services.

Final Thoughts

Even we discuss the action plans undertaken and the societal preparedness to save lives against this virus and other challenges, the life of people as well their economic well being is in a grim state of affairs. This will surely affect negatively the life of 130 crore population, but there is a bright ray of hope due to the paradigm shift in the concept of the life of the entire societies on life which will shed their greed and frustration. Hopefully, this pandemic leads to larger allocations to the medical infrastructure in this country. May it spur on and inspire the next generation of frontline warriors (healthcare workers, civil servants and public administration).