India has been hanging on a shoestring since the COVID-19 pandemic has been infiltrating across the nation. On March 14, 2020 the Government notified the nation about the extremity of the pandemic. In envisioning the complexities and threats, it declared a national level lockdown. Consequently, this left thousands of migrants and many other people stranded far away from their homes.
Procurement of the maximum standard of health care is a non-discriminative fundamental right, as highlighted by the constitution of the World Health Organisation as well. Nonetheless, the poor and the underprivileged are facing difficulties in accessing the required health care services. Due to arduous financial conditions and poverty, several are starving on the roads. Additionally, many have fallen prey to the illegalities of private sector hospitals.
As of August 3, 2020, there are 579357 active cases in India with 38135 deaths in total. On May 17, 2020, Union Finance Minister, Nirmala Sitharaman claimed that the government has endeavoured to cope with the pandemic.
Orders of the Centre regarding the COVID-19 outbreak
In an order dated 20th April 2020, Health Secretary, Preeti Sudan underlined the need for safety measures for Doctors and health professionals fighting against COVID-19. Notably, it stated that the Centre supplied a ballpark figure of 5.11 lakhs PPE kits to several states and Central Hospitals. Thus, adding to the existing stock of 2.75 lakhs available with the states. However, due to lack of domestic manufacturers of PPEs, the MoHFW partnering with Ministry of Textiles endorsed the production.
Since then, the industry has multiplied by 56 times. Moreover, market analysts predict it to become the largest supplier of PPE kits. Within 2 months, the Indian PPE Industry has profited from Rs. 0 to Rs. 10,000.
Have states conferred with the ICMR guidelines in fighting COVID-19?
Firstly, the Delhi Government in its official portal, the State currently has 8887 beds and 4081 vacant beds. However, it is unclear as to why several people have approached the HC to report the unavailability of beds for patients. The Centre, in the beginning, ordered the states to abide by the ICMR guidelines. They must take legal proceedings against private/corporate hospitals who disregard the general guidelines on treatment of COVID-19. In fact, the State even prosecuted all such persons under Section 188 of the Indian Penal Code and Section 67 and 58 of the Disaster Management Act as well. A ballpark number of 8 Hospitals since then provided their support for the COVID-19 treatment in the state.
Secondly, China’s quest in developing hospitals in 10 days has stimulated an insight to BMC. BMC constructed an idea for a 3-storeyed pre-engineered building on Kasturba hospital premises.
As in April 2020, Kerala Government created a South Korean model kiosks to test for COVID-19. Ernakulam district administration expresses that, “the model installed by Kochi Government is one of the first of its kind in India”.
Apart from the gloves, WISK consists of magnetic doors, ultraviolet lights and an exhaust fan. Further, the patient being tested will be seated on the opposite side of the WISK. The doctor can thus collect the sample using the gloves and give it back to the patient. Ernakulam District Medical Officer Dr. Kuttappan acknowledges its success and says:
Since the officials would disinfect the gloves and chairs, there will be no persistent danger.
Disposal of the Dead against Rights of the Dead
A disheartening video in Kolkata went viral on social media on the 11th June, 2020, where decomposed bodies, allegedly infected by COVID-19 were seen to be loaded into a van by the city civic body for cremation in broad daylight. In the opposite side of the nation, the Sion hospital in Bombay was found to have placed positive dead bodies of COVID-19 patients with the civilians admitted for treatment. Many oppositions were raised regarding this, including a letter by BJP Leader Kirit Somaiya on 7th May, 2020 to ICMR.
States have not only neglected the MoHFW guidelines of Dead Body Management providing for Standard Precautionary measures as well as their commitment to provide proper medical treatment. The Madras High court in a Suo Moto case (W.P. No. 7492 of 2020) passed an order on April 20, 2020. It underlined that, the right to life in Article 21 cannot be restricted to mere animal existence. It means something more than just physical survival.
Magnetising involvement of private sector health care for coping with COVID-19
Since the liberalisation of 1999, India has constantly been urging for the majority involvement and contribution of private sector in the health industry. Presently, public health facilities are carrying out the testing and treatment procedures of Covid-19 pandemic. A published article by Indu Bhushan, the CEO of Ayushman Bharat, expresses the need for private sector contribution to the pandemic.
He states that Private sectors ought not to be ignorant about the ever-growing problems of the pandemic. They must contribute to support the government with all the bona-fide intentions. To get the situation up to speed, the Supreme Court questioned the feasibility of giving accommodation to the specific health care workers near their workplaces.
The government could have taken over the private hospitals with negotiations with the staff and infrastructure. Astoundingly, the cost of shouldering 100 bedded hospitals is way less than creating those number of beds in the government sectors. Thereby, private doctor can relax and aid the health sector at the same time.
In an interview with The Wire, Dr. Laxminarayan, Center for Disease Dynamics, Economics and Policy and lecturer, expressed his opinions. He states that, in extreme circumstances, the pandemic may affect nearly 60% of the Indian population i.e. 700-800 million people. However, majority of them will only have mild effects. Moreover, the number of figures declared by the Union did not appeal to him. Appropriately, India needs to step up its game. The authorities must have 10000 people tested every day, as in accordance to the ICMR guidelines. Yet the jumbled figures are proving ineffective for any form of development.
Earlier, in 2017 the Ministry of Commerce and Industry in India, initiated a task force including civil servants, researchers and techno-experts in fields of healthcare and Artificial Intelligence. Unfortunately, it did not include a medico-legal expert to assess the laws for tech-health and AI. This stands as a cautionary sign for policy makers to urgently take suggestions from medical experts in the legal framework of AI. What the Government is lacking is the execution of such strategies.
Inadequate medical supplies have plagued hospitals all over the nation. Thus, patients have to make critical decisions in offering their minimal wealth and assets. As many as 31 individuals who can hardly manage to breathe may have to afford an available ventilator. This might be a challenge in the long run since the debate for free Covid testing seems irresolvable. No accurate information has been provided by the government of India regarding the set price of Rs.4500 on testing kits. Many social workers and advocates have spoken up about this issue in court proceedings and social media platforms. The pandemic has endangered the life of the poor as well as the middle class families.
It is very important to note here that testing cannot be determined by cost. It is only the threat of mass testing, economic downfalls and societal pressure that is holding the country back from recovering.
In conclusion, with the growing need for efficient health care in India, Private and public sector services have to be extended in double-folds. Henceforth the private sector has to take a bigger steps towards partnering itself with the government to fight the pandemic as swiftly as it can.
This article is the second part of the two part series on India’s Healthcare Infrastructure and COVID-19. Read the first one here.