Mumbai: The COVID-19 pandemic has been a learning experience for all of us in all healthcare sector ranging from the public sector to the private sector and the governments. In terms of epidemic preparedness, it is obvious that India’s dismal spending on public health created a near collapse of infrastructure during the pandemic. The geographical disparity in health care development manifested in the ability of states to combat the pandemic on a state level. Therefore on a national level there should be a pledge to increase the Government outlays on health to at least 3 per cent of the GDP (Gross domestic product).
On a global level in future, the ability to contain the epidemic by curbing spread through international travel should be a priority. The timely intervention and response of WHO should also be reviewed. A mechanism needs to be set and more powers need to be given to the WHO to create policy binding on all countries.
For the infrastructure creation for epidemics in terms of dedicated hospitals rooms are required. In this context the model of portacabins, plug and operate ICUs (Intensive Care Units) with dedicated cubicles with positive and negative convertible Air Handling Units (AHU’s) can help combat any kind of infectious viral disease in a safe and effective manner.
Looking to the future the concept of reusable Personal Protective Equipments (PPE’s) and training for their use along with universal safety precautions can be a template for the future. If this is in place much of the loss of lives from the medical fraternity and the resultant panic and chaos among the health care workers could have been avoided.
The arrangements for staff to travel and stay in transit camps in schools or such vacant infrastructure can be considered in the future preparation for the pandemic. Many hospitals faced problems in providing adequate quarantine facilities for the staff following COVID duties, provision for this along with food subsidies can be beneficial for future pandemics.
The use of the epidemic act to take over hospitals was a publicity exercise where instead of giving relief to the private sector they were compelled to provide care to the patients at unrealistic rates and resulted in more hardship and trouble for both patients and the hospitals. At such times a big infusion of support in terms of finance and trained manpower was required and not diktats given by bureaucrats.
A review of the Epidemic Act should be done with all stakeholders on board. The ability to take care of emergency cases with infection was lacking especially for patients with Heart disease, strokes and chronic kidney diseases. A clear policy on the same needs to be enunciated.
Another aspect which can help in preparedness for the future is a free and equitable distribution of medicines which are crucial to help control the pandemic.
At the national level, the lockdown created immense hardship especially for the poor. A critical analysis of the cost-benefit analysis of lockdown vs adoption of universal safety precautions should be done. It is my view that had we exercised more discipline in Sanitization, Mask usage and Social Distancing (SMS) the damage would have been far lesser.
Our cities and slums became the hot spots for the spread of the coronavirus and in this context, the questions of urban planning, sanitation and provision of pure and safe drinking water must take priority in epidemic preparedness for the future.
A robust adult vaccination programme can also become a national policy to keep the population safe and secure from infections in future.
An investment in wellness and preventive model of healthcare with a focus on mental wellbeing can be a major factor in our preparedness for the future.
On a social level civic sense, consideration for people around us and coordination among NGOs with experience of dealing with disasters can be taken up to create a coordinated disaster management effort. It can be of great help in dealing with epidemics in future.
However, as a nation and as humans we do not learn from the mistakes of the past. It is a maxim which I want to repeat “Those who forget history are doomed to repeat it”.
(Dr Vispi Jokhi, MS (Orthopedic) is the Chief Executive Officer, Masina Hospital, Mumbai. He has been working for more than three decades in the Hospital and Healthcare Industry)
Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.