Author: Chaitanya Roy, Member DelTech MUN & DebSoc Delhi Technological University (formerly DCE)
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus.This virus is highly contagious so its positivity rate is high and it showed devastating effects during the 2nd wave of covid in India.With the emergence of the highly transmissible Delta variant (1.617.2), the Delta Plus variant (K417N and additional mutation) of SARS-CoV2, there had been over 0.5 million cases every day for consecutive three weeks (April–May 2021). India was at the epicentre of the global viral rampage. The catastrophe of this crisis was unprecedented, pushing the health care system to its breaking point.With a positivity rate of 15–20% (April–May 2021) and the healthcare system pushed to its limit, accompanied by increased mortality, the situation was rather grim then. Though the central command scrambled all its resources and logistics to streamline the supply chain, the efforts were insufficient in response to the ongoing crisis due to a disproportionate rise in the case. Furthermore, with just 20% of the population fully vaccinated (62% received one dose), vaccine shortage was one of the many challenges for the world’s 2nd most populous nation back in March–May 2021, besides the logistics to deliver and store the vaccines.
INVESTMENT IN HEALTHCARE AND INFRASTRUCTURE…
Apart from infectious agents, non-viral factors played a significant role in the COVID crisis. The second factor to blame is India’s abysmal investment in public healthcare over the last few decades. The current crisis has not only crippled the feeble public healthcare system but has also exposed its vulnerabilities. Then, there are issues with infrastructural inadequacies, a shortage of trained manpower and human resources, inadequate funding, poor accountability, corruption, bureaucracy, and state-wise-region-wise variabilities of healthcare services and the availability of physicians.50–55 India’s public spending on healthcare has been nearly stagnant with just around 1–1.15% of GDP for over a decade, even though there were multiple promises to increase this spending that really did not take off 56,57- Compare India to other nations; US (16.9%), Germany (11.2%), France (11.2%) and Japan (10.9%). Further, healthcare spending in India is also the lowest amongst the BRICS nations.
Of late, a great initiative by the present Indian Government has announced an equivalent of 9.87 billion dollars to rejuvenate the health sector.59 This includes US$ 915.72 million for PMJAY (Ayushman Bharat Yojana) in Union Budget 2020–21, under which the Government of India aims to provide free access to healthcare for 50 crore people in the country.
The Government of India aims to increase healthcare spending to 2.5–3% of the Gross Domestic Product (GDP) by 2022.As per economic survey 2021, an increase in public health expenditure to 3% of the GDP can reduce out-of-pocket expenses from 60% currently to nearly half and, therefore, ease the health-related spending in low- and middle-income groups.
India COVID-19 Vaccination Drive…
As per the current guidelines, anyone above the age of 18 is eligible to receive vaccines. But with uncertainty in vaccine stocks and availability, accomplishing this is a significant hurdle for the Government. Also, as cases peaked in April and May 2021, a large section of the vaccine workforce got exposed and had to go for quarantine, thereby impeding the vaccination rate.35,36 So, we have both shortages and the slowed pace of vaccination. India has over 65% of its population in the age bracket of fewer than 35 years.37,38 This amounts to a headcount of over 900 million; factor it by 2 for a double dose; it needs 1800 million or 1.8 billion jabs. Even with the maximum achievable vaccination rate of 25 million jabs/day, it will take at least 18 months to fully vaccinate this population, provided there is no shortage of stocks. This means a substantial population will remain vulnerable for about a year and more to infection. Then, there are issues with vaccine hesitancy39,40 and challenges in reaching out to those in distant and remote locations.
Conclusion…
The silver lining is that when governance fails, social connectivity keeps hope alive. This is seen in the current COVID wave where people were connected through digital social networking platforms like Facebook, Whatsapp, Twitter, etc., to arrange for beds, medicines, oxygen, and doctors. The NGOs and Sikh Gurudwara conducted enormous philanthropic activities, and people came forward to contribute whatever they did through PM CARES contribution and other charities.145–147 COVID19 has not only caused tremendous devastation in both economy and livelihood for India but also has contributed to substantial “non-Covid- preventable death.” The COVID-19 tsunami has enormously affected the ongoing treatment of several manageable ailments due to the closure of these specialty clinics instead of COVID care. This led to a spike in non-COVID-related, otherwise preventable mortality. Oncology care,148,149 planned surgeries150,151 cardiovascular intervention152,153 kidney failure and dialysis,154,155 to name a few, that were all severely affected, leading to an increase in the death count. As a country, India needs to chalk out plans to ensure that parallel healthcare services continue in pandemic times so that non-COVID patients are not left aside. These require a sufficient pool of separate sets of specialty clinics, trained physicians, and dedicated nurses. With a resounding crunch in workforce and logistics, this is something that policymakers need to ponder at as a long-term strategy.
NOTE: The views expressed in the above mentioned article by the author are driven through the sources mentioned below. There is no intent to hurt someone’s sentiment or values.
·
Indian Express
· National Library of medicine.