COVID19 has emerged as the one most impactful adversary that humanity has confronted. Deceptively small, embarrassingly easy to dissolve but destroying with out pause. It’s not like we wouldn’t have a mechanism to keep away from and even tolerate when contaminated. It’s not like we don’t know the way to diminish its results. We even know that hundreds of thousands will be saved by the only of no price social measures together with hand washing and social distancing . Regardless of all these efforts if the virus infects a small subset of Indians the well being system might be overwhelmed. This isn’t due to any lack of effort on the a part of the federal government and even the non-public sector. It’s a query of numbers and having properly designed infrastructure to sort out this scourge.
India has been a pacesetter within the provision of primary healthcare for numerous ailments. Even the WHO has acknowledged success in eliminating polio and small pox. India’s well being equipment is made for public well being measures-from administration of tuberculosis or malaria to monitoring and treating numerous social determinants of well being . Nevertheless if the implored, begged, requested, therapeutic distancing just isn’t performed fully we might be sitting on the cusp of a toll in contrast to that seen in latest reminiscence. The general public and even the non-public well being community just isn’t geared for mass vital care at this scale. No nation has been ready for this pandemic. Modeling and simulated gaming has been reputed to offer concepts and plans however the rapidity of this onslaught has created the necessity for on the spot strategic pondering. We have to take this chance to additionally ask ourselves if it is a nature given window to wash home. Not actually as many people are in all probability doing now throughout our time at dwelling however for our well being techniques.
We at present have the dream state of affairs of a laser concentrate on well being, a US $2 billion fund in addition to empty streets and hospitals. Well being care groups could have much less work until and if the surge happens. We should now use this as a sabbatical for our docs , nurses, paramedics, lab groups, well being directors, affected person helpers and everybody who’s a healthcare trade stakeholder. We should quickly, vigorously and completely educate and alter our method to well being. Alter it from an off-the-cuff laissez faire “chalta hai” perspective to a compassionate, science primarily based and outcomes enabled system of care. We should combine wellness and train, mindfulness and stress aid together with the potions and choices that fashionable medication affords. We should quickly assemble current groups to boost, join and combine our vital care infrastructure. Utilizing India’s distant expertise and web primarily based telemedicine strengths we should always join each ICU with a hub and spoke mannequin to make sure uniformity of protocols and a assure of high quality. We should sort out our largest issues: cardiac illness and cardiac demise, malaria and dengue in addition to organophosphate poisoning that ruins lives day by day. We should sort out our trauma and burns in addition to the immense want for managing sepsis.
India can present the world that it has the flexibility to overcome adversity with magical ingenuity. India can present the globe the way to take care of its aged, infirm and unvoiced. It might present as soon as once more that this nation is the embodiment of vasudeva kutumbakam with really common residents. The innovation and low price creativity that may quickly change how we stay and deal with the sick will create waves of alternative to remodel international locations in Africa, Asia and South America who’re residing generally worse lives. We should use all our sources to associate the private and non-private sectors to take a contemporary method for our lives are really at stake. We should make sure that authorities techniques catch as much as properly functioning non-public fashions and personal healthcare lives as much as its dedication to public well being. Hospitals don’t have any doorways and other people transfer from one to the opposite, usually looking for price effectiveness and comfort. Allow us to give them one of the best.
If all healthcare personnel commit that in these three weeks we study managing vital sickness, study the fundamental rules of protected care and provides our careers a contemporary begin we’ll really transfer mountains. When Hanuman introduced the Sanjivani herb by lifting the Dronagiri mountain to treatment Lakshmana it was deemed a monumental job. Now we have an analogous problem forward of us. We have to elevate Indian healthcare up, excessive above the inefficiency, apathy, disrepair and despair that it usually finds itself sufferer to. We have to discover the therapeutic herb inside this technique for it’s in there-we might need to shake the mountain a bit and maybe transfer some rocks round .
Underneath the management of the Authorities of India and the assist of all these , who might distance themselves from or assist numerous political ideologies , we should communicate as one voice for the enemy forward is staring us squarely within the face. Each breath might be deadly if viral particles are shared. Each whiff of air inhaled might be devastatingly laborious to take if lung injury units in. Now we have the sources, the necessity, the chance to vary how hospitals are structured, how an infection management is practiced and the way cleanliness will be really instilled. That is our second to shine: cough etiquette diminishing tuberculosis, managed site visitors by tele-commuting reducing our AQI to Himalayan high quality, dwelling certain households rediscovering the enjoyment of togetherness, tobacco use disappearing as information of the important nature of the lungs is remembered and naturally residing by way of this imminent hell and thanking all with gratitude for the reward of life.
Philosophical and wistful ideas apart, is there a sensible solution to get this performed ? Here’s a blueprint that should get edited and executed by the top of the day by the neatest minds in India’s different planning equipment – docs, scientists, engineers, public well being specialists, politicians, enterprise homeowners and the lay public. Can this be performed we might ask? A nation that may share data with the contact of a button with no correlation to literacy, a nation that may handle the funds and the procuring of billions around the globe, a nation that may roll up their sleeves and clap over a trillion instances will do that.
1 Manage Zoom conferences of the MCI, AIIMS deans , non-public hospital CEO’s and the insurance coverage authority to prioritize emergency, vital care and put up vital sickness administration in all well being establishments over the subsequent 5 days
2 Start day by day schooling of all nurses and docs in addition to paramedics in managing vital sickness and particularly respiratory failure, an infection management and ventilator use
3 Place a name to expertise leaders to develop a completely useful ventilator in 5 days
4 Hospital challenge groups to quickly assessment modular ICU creation , use hub and spoke fashions in addition to digital expertise to create a seamless affected person journey from a primary to a tertiary heart – full in 5 days
5 Standardize lab processes and reeducate lab groups on greatest practices as per the NABL
6 Guarantee monetary fashions out there to ensure non-public enterprise income together with public hospital sustainability . One measurement won’t be sufficient – we’d like a plethora of concepts for healthcare buildings to cater to 1.3 billion Indians.
7 We should analysis this endeavor and share classes for the world . Delegate this job to our highest printed establishments
8 Medical doctors who’re leaders in vital care, pulmonology, inside medication , cardiology in addition to public well being should verify the rules to be adopted nationally for all vital care
9 Pharmacies should implement normal greatest practices of protected prescribing and allotting utilizing the assistance of hundreds of pharmacy and PharmD graduates
10 Affected person schooling should start in earnest with the participation of the massive variety of medical , dental and allied discipline trainees and graduates. It is a multimedia pleasant nation and loves its music and dance . Innovate in schooling and remind everybody concerning the life saving hand wash, don’t contact your face aphorism . Digitise medical information that exist already and start a paperless medical interplay for the longer term.
All this in 21 days ? No – all this in 5 days to plan and then you definately solely have 16 days to execute. Properly that’s not a very long time in a standard yr. That is removed from normal-our existence is threatened . This isn’t a film – pinch your self – you’re awake and the chance is actual . Nevertheless with over 400 million Indians who will help by studying and planning and doing we’ll actually have over 100,800,000,000 man/girl/little one hours to get this performed by simply committing 12 hours a day to this effort.
This includes sacrifice. This includes group. This invokes our sense of humanity. We should put aside our ego, our want for household connection, our need to satisfy our mates . We have to have an earnest and dedicated effort not in contrast to numerous apocalyptical films the place the Earth is saved by the daring hero. We should all step up and discover our internal hero and work in direction of our widespread future. Allow us to start the 21 day miracle: Reworking Indian Healthcare : for everybody, in all places , endlessly. The planet awaits.
© Dr Sai Praveen Haranath
MBBS, AB, MPH, FCCP
Senior Pulmonologist and Intensivist
Apollo Hospitals, Jubilee Hills, Hyderabad, India
This text is a private opinion.