Though Covid positive cases of late have started coming down in many large states, it would be premature to believe that India is now on recovery mode. The slow coverage of vaccination, inadequate availability of vaccines, refusal of two major manufacturers, Pfizer and Moderna, to engage directly with state government of Delhi, societal indifference at many places to vaccination, instances of grassroots level health workers facing local wrath against their efforts to ensure vaccination of the target groups, are worrying signals indicating that the fight against the pandemic is going to be long and protracted.
Experts have warned of a third wave in India. Even after the third wave would be over, there is no guarantee that there would be no further virus-related epidemic in India in future. In the past, India had gone through many epidemics with considerable loss to human lives and economy. It is worthwhile recollecting the horrors India went through during the Spanish Flu epidemic of 1918 which had claimed nearly 18 million human lives. The extent of chaos was mind-boggling. Sanitary Commissioner’s report for 1918 had mentioned about all Rivers of India having been clogged up with dead bodies because of shortage of firewood for cremation. Poet Suryakant Tripathy wrote of Ganga swollen with dead bodies. Misery and economic slide-down caused by the pandemic led to swell of emotions against the colonial rule.
Our Constitution in Article 21 provides for Right to Life. It is the birth right of every human being to health and medical care. State must discharge this constitutional responsibility by bringing in substantial improvement to health infrastructures and services. Both the waves of the pandemic revealed inadequacies in the existing health infrastructure. While the first wave demonstrated inadequacies in safety kits for doctors and medical staff and ventilators, the second wave revealed the deficient oxygen support arrangement in hospitals including well known corporate hospitals. By the time adequate arrangements could be made, many human lives had been lost.
Proper medical care to a person in need has to be ensured. While it is a matter of satisfaction that Odisha Government is working on a world class medical facility in the SCB Medical College in Cuttack and has been able to put in place 50 dedicated Covid hospitals including 30 private hospitals and created 11000 Beds for Covid patients, the importance of having credible medical facility in all the thirty districts cannot be minimised. This will ensure timely service and ensure equity. What is needed now is an Odisha Model that would be adequate to meet the challenges of the third wave and also future virus-related epidemics.
Experts are talking about the vulnerability of small children in the third wave of the pandemic. This would mean we need to accord priority to mothers in vaccination so that the affected children needing hospitalisation have their protected mothers by their side in hospitals. A state-level initiative in this regard would be welcome.
All District Government Hospitals (including the districts having Medical College nearby) in Odisha should have at least a 20/25 bedded ICUs with adequate Ventilator facility for adults and 10 bedded Pediatric ICUs with full complement of Specialists, Doctors and para-medical staff. The infrastructure created to meet the present wave should continue without being dismantled. Persons with qualification in hospital administration should be inducted to district hospitals to take care of Reports/Returns/Statistics and other essential administrative responsibilities and doctors engaged in such activities released to take care of patients.
There is widespread reluctance to be identified as Covid positive because many apprehend loss of jobs and pursuits of vocation. A Covid positive person silently carries on selling vegetables or works in grocery shops or keeps driving the auto rickshaw. This facilitates spread of the infection. This problem can be addressed through a well-designed testing of larger number of persons. Odisha needs to activate the wide infrastructure of Mission Shakti in ensuring testing on a much larger scale. Post Covid counselling is a critical help that should be available at PHCs and CHCs in an exclusive window. Oxygen availability in Government Hospitals and even private Nursing Homes in the state needs substantial augmentation. A corporate hospital in a neighbouring state has introduced an arrangement of lending Oxygen Concentrators to needy patients in their homes. Entrepreneurs could have such an arrangement in Odisha towns.
A short time-bound programme for vaccination is the need of the hour. So far Odisha has administered both doses of vaccines to just about 15 lakh persons. The state would continue to be vulnerable to the pandemic with only 3 to 4% people fully covered under vaccination. We can ill afford to have indefinite closure of schools, colleges, commercial establishments, postponements of critical examinations. The present situation calls for substantial augmentation of budgetary outlay on Health and a realistic deployment of manpower requirement for having functional hospitals.
Constraint on resources should not stand on the way of a healthy health infrastructure. If necessary, the continuing liberal funding on many populist programmes may have to be reviewed and resources should be allocated to Health sector on the grounds that saving human life is the paramount responsibility of the government.
(DISCLAIMER: This is an opinion piece. The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same. The author can be reached at firstname.lastname@example.org)
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