Dr Pankaj Wadhwa
Director Endo-Urology and Laser Surgery
Medanta-The Medcity

COVID-19: Blow by blow-another perspective

The COVID-19 pandemic is an unprecedented crisis experienced by most in their living memory. It is an evolving health, financial, and social crisis, the effects of which are undoubtedly going to ripple for at least half a decade in my opinion. It has ushered in a societal behavioral change in the way we are and will conduct ourselves, businesses, religion, and even the way we live.

With current trends of increasing COVID numbers in our country, our burgeoning population and our fairly cavalier attitude, we, not surprisingly, are going to top the charts (in world-wide numbers). I would leave the number crunching and more important community health, financial, trade, and educational implications to the experts in the field. I do have a unique perspective being a clinical urologist working in the private sector which is embroiled in treating COVID, as well as segregated non-COVID patients.

According to feedback provided by large area territorial managers of pharmaceutical companies, the demand of medication erstwhile used in primarily tier I and II city locations, had increased in more remote areas (tier III and smaller districts). They innovated and expanded base to provide medication at these locales.

By mid-May 2020, the time when news channels incessant demand of answers to the question-when will we plateau? had begun to crescendo, we observed a significant shift in the kind of e-consults we were dealing with. Unfortunately, the requirement was a need for a more physical, in-person, consult; and the expectation by the patients were also of a similar nature, while hoping for a divine e-solution. However, the fear of COVID prevented many from seeking early healthcare. The ostrich effect was always prevalent in our society, well it just escalated to are you crazy levels-an expression I often heard being used by a radio jockey on FM radio.

This period also coincided with the realization of the lack of quantity of quality medical facilities in the country. COVID facilities were falling short, despite considerable ramp up by governments at all levels, pitched in by the private facilities. A concerted effort by the industry and researchers in indigenizing testing kits and ventilators was paralleled by more Made in India products by MedTech companies. We even acquired mostly indigenous high-tech endoscopy equipment at our hospital, during this time.

During this entire buzz was also heard a sentiment of over treatment by private hospitals during non-COVID times, fueled by apparent lack of non-COVID patients in hospitals. Even some ludicrous statements such as no patients in hospitals other than COVID, were hospitals over treating in non-COVID times? were heard. Milching was another expression used in the same reference. Our democratic way of expressing at will, even without background /first-hand knowledge, notwithstanding; we in the hospitals could feel a storm brewing and suspected this was just the lull before. With what we experienced in July and August and the swelling number of patients in early September, the expression which comes to mind is Thar, she blows.

We saw more ill patients, almost collapsing due to neglect of their primary non-COVID conditions. Stuck stones in the urinary tract causing irreparable kidney damage, severe sepsis needing ICU admissions instead of standard planned/elective procedures. More advanced cancers needing more extensive radical surgeries rather than organ preserving procedures. Poorly controlled diabetes, exacerbated by the ‘mango season’ and lack of physical activity due to lockdown, fueled extensive urinary tract infections leading to loss of kidney function, even life threatening in some cases. Now that we have unlocked, hospitals will get deluged again, with both COVID and non-COVID cases.

The new normal must be accepted if we are to cope and claw back. The need for more Indian quality biotech/ medical equipment products is urgently the need of the hour. The status quo of high dependence on medical technologies from abroad must change.

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