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Healthcare infra can cope with COVID surge, for now

As the number of Covid cases continue to surge, there are growing concerns whether the country has adequate hospital/ICU beds and so on. The good news is that given the low proportion of cases requiring acute care, the facilities are adequate, for now.

India has the highest number of Covid cases in the world after the US and Brazil. But, according to Health Ministry data, as of August 29, only 0.29 per cent of active cases were on ventilator, 1.93 per cent cases in ICU, and 2.88 per cent on oxygen support. This translates to 2,213 cases requiring ventilators, 14,725 cases needing ICU beds, and 21,973 needing oxygen support.

Health Ministry data showed that the country has 1,723 Dedicated Covid Hospitals (DCH), 3,883 Dedicated Covid Health Centres (DCHC) and 11,689 Dedicated Covid Care Centres (DCCC) with a total of 15,89,105 isolation beds, 2,17,128 oxygen-supported beds, and 57,380 ICU beds, in total.

Low severity of infections

“The mortality rate in India is low (about 1.8 per cent), which is about half the global average and this is a reflection of the low rates of serious disease as you show in the numbers.

A very large fraction of positive people show either no or only mild disease,” said Shahid Jameel, virologist and Chief Executive Officer of DBT/Wellcome Trust India Alliance.

 

“However, this is seen not just in India but across all of South and South-East Asia. The reasons may be biological — better innate immunity as a result of high load of other infections. This may be limiting infection to asymptomatic or mild disease,” he added.

But emphasis should now be more on appropriate medical infrastructure in rural areas, as infections are beginning to surge there.

Focus on rural regions

“As the confirmed cases cross 3.5 million, what is required is to raise awareness in smaller towns and villages. Since these parts didn’t see much case surges in the first 4-5 months of lockdown, there is a misconception amongst people that the worst is over. This is resulting in lot of people across the country lowering their guard, which can have devastating impact on the caseload and related complexities,” said Himanshu Sikka, Lead, Health, Nutrition & WASH, IPE Global.

“Unlike metros, the health infrastructure in smaller towns and rural parts is constrained and so is the availability of ICU beds with ventilators and/or oxygen support,” he added.

Given the virulence of the pandemic, the healthcare facilities in rural parts could easily crumble if adequate measures are not taken, experts said.

“Rural areas have poor health infrastructure — not just the number of beds but healthcare workers. WHO recommends 22.8 HCW (Health Care Worker) per 10,000 population; India on average has 20.7 and 11 States are below the national average, with Bihar at 5.3.

“The rural-urban distribution of all HCW is 36:64; for doctors it is 34:66. The real worry should now be care in rural districts and villages where the infrastructure is poor or non-existent,” said Jameel. “One way of bridging the gap quickly is to deploy mobile health clinics in rural areas to provide healthcare at the door. There should be arrangements for isolation/quarantine closer to home — in villages,” he added. – The Hindu BusinessLine