Abhishek Kumar & Sameeksh Patna India

Covid-19 preparedness: A special challenge for India

The coronavirus pandemic has spread across 190 countries and has killed for more than 27,000 people worldwide, creating a challenging test for humanity. In its updated figures, the Ministry of Health and Family Welfare stated that 20 Covid-19 deaths were reported so far in the country whereas the total number of active corona cases crossed the benchmark of 900. Indian government along with the active help of the Indian people is trying to control the spread of the virus within the country.

While being the second-most populous country in the world, with more than 1.3 billion inhabitants with a high density of population, millions living in rural villages and urban slums, India has registered a lesser number of positive cases as the virus has not spread as rapidly as elsewhere. To date, the Indian government has pursued a step-by-step approach and was quick enough to activate its health management system, with early screening at airports from mid-January onwards, issuing travel advisories and in coordination with states, imposing restrictions on social gatherings. “Valid precautionary guidelines” were issued to keep the public well informed and prepared. GOI also undertook evacuation operations on large scale from several countries of its citizens in the wake of this outbreak. So far, it has evacuated nearby 1500 passengers from COVID-19 affected countries.

Due to the ongoing unprecedented situation of rapid virus spread, Prime Minister Narendra Modi announced on 24th March that the nation would go under a 21-day lockdown to combat the spread of the virus. The mathematical model of ICMR suggests that social distancing is the only way. It can result in lessening the total no. of estimated cases by 62 percent and the high number of cases by 89 percent.

Capacity Build-up:

Amid the danger of transmission from the population is rising, the government is working on the capacity build-up of required infrastructure which includes permitting private hospitals to start admissions of patients with suspected Covid-19 infection, increased no. of testing labs (156 including 35 private). Although this has resulted in increased capacity to monitor about 60,000 cases a week, but India’s less test ratio per million raises serious concerns. As of March 27th , India has tested only 27,688 samples.

Necessity is the mother of invention and there is no substitute to domestic capability. Pune based Mylab is one such example of capacity building that has brought a ray of hope. It is the first Indian company to obtain certification for its diagnostic test Covid-19. Altona Diagnostics from Germany is the other company that has obtained approval. It usually takes four hours for test results to be released, Mylab's estimates a 2 1/2 hour for a test. Mylab kits are capable of testing 1000 samples from big laboratories and 200 from smaller one, and the price will be about 1200.

Healthcare infrastructural preparedness:

It cannot be overlooked that the COVID-19 pandemic has put a huge burden on medical workers across the globe. Doctors, nurses and other paramedical staffs are working 24*7 to treat infected patients and stop the spread, with many themselves catching the virus.

India has less bed patients and hospital patient’s ratio with just 0.5 hospital beds for every 1,000 people. According to recent data of OECD, India has not only poor health infrastructure but it has also one of the lowest doctors’ inhabitant’s ratio. On an average on every 1000 people it has 0.8 doctors.

On March 25th the United Resident & Doctors Association wrote to Prime minister asking for quick intervention. The letter claims of 83 numbers of resident doctors of Nalanda Medical College and Hospital (NMCH), Patna came into contact with positive patients of corona and a majority of them are now suspected of being positive themselves. Either they are actually facing this or this can be out of apprehension of contacting a positive case. In fact, doctors across the country are facing shortage of PPE (Personal protective equipment). Few doctors have already been tested positive.

Understanding the severity of the situation, on 24th March Prime Minister announced allocation of INR 15000 crores to strengthen healthcare infrastructure and ordered procurement of 7.5 lakh PPE kits from HLL Lifecare. GOI is also putting efforts to build an additional 40,000 ventilators for emergency treatment with the help of PSU’s. Even if the number of corona cases does not increase, this could still be helpful for the states’ to strengthen their healthcare infrastructure for future.

Other Measures:

Different ministries of Government of India are undertaking various measures to provide reassurance to every section of society which includes telemedicine, facilitation of online courses for students across the universities through Swayam online courses, e-pg pathshala, etc. Financial relief such as, extension of the last date for filing March, April and May 2020 income tax and GST returns to June 30, 2020, no minimum balance requirement for the next 3 months has offered a much-needed help.

On Thursday, the finance minister Nirmala Sitharaman announced a number of measures to support the most vulnerable part of our society to survive through this pandemic. Under the economic package of INR 1,70,000 crore Govt. has talked of providing free grains through PDS, money transfers through DBT, free cylinders under Ujjawala scheme for next 3 months, doubling of loan availability (up to 20 lac) for self-help groups (SHG’s), increasing MGNREGA wages by INR 20, paying of PF contribution of both employer and employee of small establishments having no. less than 100. All these steps were much required but the scheme does not talk about migrant labours and no clear provision for construction labours and small and medium enterprises as well. In its announcement F.M said that state governments can use welfare fund of INR 31,000 crore for providing relief to construction workers.

Way ahead:

Few of the government measures like loan availability for SHG’s and increased MGNREGA wages seems to be future focused as there are no clear directives about continuation of MGNREGA work during the lockdown period. So, the government can think of transferring money directly into their bank account but the challenge is to avoid duplication of beneficiaries. Some labours are registered under one scheme while others in another scheme of government. For future an inclusive database of labour force (including unregistered and internally migrated) must be made by the government for avoiding duplication and effective implementation of its schemes as and when required. Clear directives should also be given to states for bringing uniformity in implementation of the scheme especially for providing relief to construction workers.

Government must also take immediate steps to ensure proper availability of protection equipment’s for doctors and paramedical staffs, and increase the number of tests to control the further spread of Covid-19. The only possible way to reduce the load on hospitals is to ensure proper contact tracing and increase the number of tests so that none of the cases are left untraced. On the other hand, every individual should participate with the government and practice social distancing. As can be learnt from the U.K government, the GOI can also ask for help from NGO’s and volunteers to participate with it reaching out the vulnerable section. This will help mobilize the Gareeb Kalyan yojana and other such indirect benefit transfers.