By David Boucher, MPH, FACHE
During the first wave, India was holding its own against COVID-19, but as new variants moved in, health authorities needed to lock down more firmly and target these lockdowns areas to stay safe. In May, India’s virus toll during the second wave was the third-highest reported in the world after the U.S. and Brazil with more than 300,000 deaths. The official death toll could be much higher than reported.
The worst part is that many of the sick could have been saved if they had oxygen and other much-needed supplies. Cases are abating in Indian cities but the numbers are still climbing in poor rural areas.
War-time Effort called for to Combat Rising COVID Cases
Using the lessons learned from a war-like mobilization of human and economic resources borrowed from China and South Korea, there had to be a multitude of actions to fight rapidly increasing COVID cases in India. This effort required a coordinated plan across different parts of India’s healthcare system, the private and public sectors as well as the whole society.
Healthcare leaders called on the Indian government to take a war-time response and mobilize the Indian military to curb the unprecedented crisis engulfing the country. The government needed to be aggressive in securing enough ICU beds, life-saving medicines, hospitals and healthcare professionals to handle the dire situation.
The country needed to deal with the healthcare official shortage by bringing in medical students, nurses, paramedics and others into action for a battle stance. The public also needed to play its role in this fight by staying home, always wearing masks, regularly washing their hands and taking all the necessary precautions to stop the spread of the deadly virus and its variants.
Compassion, Focus and Speed are Essential
In addition to tremendous compassion for the suffering patients and overworked healthcare workers, there were also many instances of society having a heart and helping their fellow neighbor. Thousands of volunteers built field hospitals, signed up to find oxygen and ventilators, brought food and supplies to the needy and so much more.
This experience also illustrated the importance of speed. In a major crisis like this pandemic, time is of the essence and action needs to be taken quickly. It’s not the big that ate the small, it’s the fast that ate the slow.
However, actions need to be focused. Having focused action can lead to a high social impact in a short period of time. For example, through our Aster Volunteers program, we built four field hospitals in highly affected areas with bed shortages within a few weeks and this provided necessary oxygen and ventilators represented a much-needed focused action. In addition to equipment, we recruited and trained doctors, nurses and paramedics to run the new field hospitals which ranged from 50 to 100 beds. The field hospitals were targeted toward the underserved population who were struggling to access proper care.
In New York State, health officials set up a large field hospital at the Javits Center in Manhattan to accommodate COVID-19 patients. Later, it was used as a mass vaccination clinic where some 500,000 shots were administered. Other large-capacity sports stadiums were also repurposed to vaccinate people.
Telehealth Played Major Role to Help Abate the COVID Crisis
The COVID-19 pandemic changed the rules of the game for telehealth around the world. It was widely used by people to maintain their health and kept people from rushing to clinics and hospitals and spreading infection. And in India, telehealth was a lifesaver for so many people.
As the numbers rapidly climbed in India during the second wave, Aster created a helpline and offered free telehealth consultation to COVID patients and their caregivers. Some 100 doctors from our facilities in Gulf countries volunteered to be available 24/7 through our Aster e-Consult app to assist in the crisis. This intervention kept patients in the safety of their home and not rushing to hospitals as well as helped to stop the spread of infection.
Unfortunately, the surge in cases caused anxiety, fear and panic in people who were treating their symptoms with bad information on the internet and facing unintended consequences. The Aster telehealth app with experienced doctors helped patients seek appropriate treatment and calm people down.
Public and Private Partnerships Are Necessary
It’s important for public and private partnerships to work hand in hand with the local governments with multiple interventions like mass screening, management of isolation facilities, provision of staff and facilities to treat critical care cases. In India, public-private partnership can go a long way to build the necessary eco-system required to stop infectious diseases from spreading.
The proposed 17,000 rural and 11,000 urban primary health centers will not be enough to address the issue of access faced by 90% of India’s poor population who don’t have health insurance. Government partnership with private healthcare providers can help scale-up the number of health centers to cater to majority of the 65% of the population which still lives in rural India and provide low-cost service to urban poor.
These centers can be run by health workers and act as the first point of contact for people reporting any ailment, testing, and taking the necessary measures for reporting, isolation and quarantine. Similarly, to manage the current second wave in India, public private partnership has played a key role in tackling bed shortage, addressing oxygen/ventilator requirements, vaccination drives and local production of medicines and essentials.
David Boucher, MPH, FACHE, is Chief of Service Excellence, Group/Corporate Level for Aster DM Healthcare Limited. David is also a graduate of Slippery Rock University of Pennsylvania (’80), and a member of the Slippery Rock University Health Administration Board of Stakeholders.