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Coronavirus: Can India ramp up its health infrastructure swiftly to contain this pandemic?

The government is hurriedly ramping up its medical infrastructure. But how much can we stretch?

, ET Bureau|
Last Updated: Mar 29, 2020, 09.32 AM IST
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Coronavirus

COVID-19 CASES

Confirmed
182,143
Deaths
5,164
The robust healthcare infrastructure in Europe is overwhelmed. Images from the state-of-the-art hospitals in Italy and Spain — of elderly Covid-19 patients gasping for air and dying — are triggering alarm bells across the world. Italy, which has witnessed over 9,000 deaths by Saturday morning, the highest among nations, went a step further and outlawed funeral services to restrict gatherings in an effort to contain the spread of the novel coronavirus infections.

India, which has a population of 1.3 billion, wants to preempt such a situation from developing. Its fragile healthcare infrastructure will not be able to cope with such an outbreak.

So, the government decided on a two-pronged strategy: lock down the entire nation to break the infection chain and quickly ramp up its tattered healthcare facilities to face the pandemic.

Covid-19 cases in India rose to 873 (19 fatalities) as on Saturday morning. The measures are aimed at restricting this spread as much as possible.

Every Indian state today has similar priorities: add new beds, increase capacity of intensive care units, requisition portions of private hospitals, order lifesaving ventilators, recruit medical practitioners on contract, weigh in on extending services of retiring doctors and nurses and earmark select government hospitals for Covid-19 patients.

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The blueprint also encompasses converting medical colleges and railway coaches into isolation wards, stadiums into quarantine facilities, and readying part of hospitals under defence, central police forces and railways for Covid-19 patients.

That is not all. In an unprecedented directive issued on Tuesday, the railway factories were asked to immediately assess the feasibility of manufacturing items such as hospital beds, medical trolleys, masks, sanitisers and, most importantly, ventilators. Because Covid-19 patients often encounter acute respiratory troubles, authorities have deemed it critical to have adequate number of ventilators.

“We are readying 7,000 beds, or half of Indian Railways’ hospital strength, for Covid-19 patients. We are ordering about 500 ventilators and examining the feasibility of manufacturing ventilators in our own factories,” Railway Board Chairman Vinod Yadav tells ET Magazine.

There are only 94 ventilators in 128 railway hospitals across India. In fact, India’s ventilator inventory is estimated to be a mere 40,000, clearly inadequate given the scale and reach of the coronavirus. International experiences have shown that 5-10% patients need ventilator support to survive. As reported in the international media, doctors in Italy and Spain are facing an ethical dilemma of prioritising who should get access to the limited number of ventilators at their disposal.

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In India, as in most nations, not all available ventilators can be plugged out from the intensive care units. So, the number of equipment that can be made available for Covid-19 interventions is far too less.

In Assam, for example, 36 out of 200 ventilators being used in government hospitals are non-functional, says an official, adding that most of those in working condition have been deployed for critical patients.

“We can spare about 50 ventilators for Covid-19 patients. We have requested private hospitals to spare another 50. We are expecting the arrival of 150 new ventilators in a week,” says Kumar Sanjay Krishna, chief secretary, adding that the state government is also converting the ophthalmologist department of the Gauhati Medical College into a Covid-19-only hospital, in addition to turning the Guwahati-based Sarusajai stadium into a quarantine facility.

In Telangana, there are about 1,000 ventilators, including 22 that arrived recently. Already, three hospitals in Hyderabad, with a combined capacity of 1,200 beds, have been earmarked for Covid-19 patients. “We can treat up to 10,000 Covid-19 patients in the state,” says S Narasing Rao, principal secretary to CM.

It appears the central and the state agencies have worked in tandem to add new health assets, something that is indispensable to minimise the impact of a potential catastrophe. But the key problem is that India’s health facility indicators are below par in any global parameter.

Sample this: Italy has 4.1 doctors and 3.4 hospital beds per 1,000 persons. Yet its infrastructure appears to be crumbling today. In comparison, India has only 0.8 doctor and 0.7 hospital bed for 1,000 persons, according to a World Bank report collating global healthcare indices between 2011 and 2017. South Korea has 11.4 hospital beds per thousand, the report indicates. The US, which saw a dramatic spike in infection last week, has 2.6 doctors and 2.9 hospital beds per 1,000 persons.

All these indices lead to a simple conclusion: if the situation in India exacerbates, the defence forces are bound to be deployed. And the forces could possibly do more than just convert a portion of their 133 hospitals for Covid-19 patients.

PK Barbora, former Vice Chief of Air Staff, says: “Indian defence hospitals may not have a large contingent of specialised doctors, but our personnel have the capacity to quickly convert a barrack into a hospital. Also, Indian defence forces possess a number of 20-40-bed mobile hospitals which can be airlifted.”

Let us hope for the best, but prepare for the worst.
(Catch all the Business News, Breaking News Events and Latest News Updates on The Economic Times.)

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