Combating future storm

Since inception of the world, we are devastated from time to time across with the extinction threat. Three major destructive factors – primarily human conflict, Ramayan – Mahabharata war to world wars, are completely preventable. Second, natural calamity in the form of flood, famine, earthquake, volcanic eruptions, etc., is preventable to a great extent. Third one is pandemics at regular intervals with newer organisms – wiping reasonable population. COVID-19 has surpassed history as well as the recent ones like Spanish flu, swine flu, and chikungunya. Earlier, we faced crisis with plague, cholera, tuberculosis, polio, which are now under control. We are hopeful that vaccine, prevention, and specific anti-COVID therapeutic products development will save the globe.

COVID pandemic exposed the world that we have no imagination to prevent and combat with quality control including the affluent nations. Hence, its due to rear desired disaster management. Primarily, we need universal preventive measures like adequacy of detection facility and correct vaccine for every human. Take control against unscrupulous politicians, drug dealers, and users. Government of India taxes in unlimited fashion. Let preventive medicine be free for every citizen. After settling prevention, we concentrate on education at all levels. Every medico-paramedic must be fully trained with resuscitation, adding special stress for airway care, oxygenation, medical compressed air, and basic life-saving as well as for organ support.

In situation like pandemic or natural disaster, they can support intensive care functioning.

With experience of COVID-19, for future we have to concentrate for adequate hospital beds, personnel, basic and ICU drugs, compressed medical air, and oxygen. Special stress must be laid for provision of oxygen therapy appliances, oxygen concentrators (preferably for each casualty), ICU beds, and buffer stock for and step-down beds after release from ICU. At any given time, every hospital must have the provision for doubling ICU beds. During respiratory support, nebulization is an integral component. In case situation worsens, ventilatory support is mandatory and every ICU bed must have a ventilator. Hemodynamic monitoring, laboratory facility, radiology, and physiotherapy are integrated to combat crisis.

WFSA (World Federation for Societies of Anesthesiologists) had categorized hospitals to level I, II and III in 1992 World Congress at Washington. This was adopted by the Indian Society of Anesthesiologists with certain modifications.

In India, whether a primary health center or sophisticated hospitals all have to follow the same norms. Up-to-date recording facility and at regular intervals we must sit to discuss and analyze data.

COVID-19 crisis has put the nation to shame; let us not get a repeat. Proportional to the size of the nation, at this juncture what we need is up-to-date primary health centers and step-by-step development including level II and III. After creating beds, we need personnel, emergency resuscitative care, medicine with top priority for vaccine, oxygen, medical compressed air, equipment for airway care-oxygenation, oxygen concentrators, ventilators, monitors, and recording facility.

To combat pandemic health crisis, priority lies with prevention. Resuscitative care respiratory – hemo­dynamic and metabolic care taking should follow. It is high time the world under a common roof formulates universal prevention medical challenge and gears up to take future challenge and combat such storm.