The Covid19 impact in India: A case for health


Covid - 19 crisis has led to an unprecedented global crisis exposing some unique nature of emergencies and health threats which are linked to food systems, human - induced conflicts and globalization. In order to counter this health emergency, an unparalleled response has been initiated by governments across the globe, the scientific community and citizens.

On March 25th, India initiated a 21 - day lockdown by adopting social distancing and isolation of citizens, state border closures and a call for innovations to support the government through the crisis despite fewer number of cases. There has been a worldwide recognition that despite the demographic character and socioeconomic vulnerabilities of the population of India, the spread of Covid - 19 and the lockdowns initiated would lead to profound impacts in scale.

While India's healthcare system has decided to ramp up, it is much clear that this is a wake - up call and a case to invest in this sector like never before. The investments made by India in healthcare sector has traditionally been very low i.e., 1.3% of GDP. Other countries make huge investments in healthcare sector such as China (5% of GDP), South Korea (8.1% of GDP) and Japan (10.9% of GDP). The Indian healthcare system is struggling with the challenges which Covid - 19 has bought with it despite instituting one of the earliest architectures of rural primary care system.


Back in 2005, the National Health Mission (NHM) attempted to strengthen the primary, secondary and tertiary healthcare services but the initial gains were not followed with robust investments in the healthcare infrastructure, supply chains, workforce. While 'Ayushman Bharat Scheme' has led to greater access to healthcare systems for poorer households, the question of quality assurance remains unanswered due to already overstretched public health system and underregulated private health providers.

Steps to be taken?

Covid - 19 pandemic has provided an opportunity for meaningful health reform. India needs to be at the forefront to make low cost, client centered medical and health innovations. With the help of civil society, the central and state governments are engaged in rapid responsive measures with several initiatives from private sector each other. The offer of economic package by the finance ministry also provides a platform for these steps which is rallying behind the medical workforce that is at the battleground. In order to envisage a much stronger health system, we must consider the following approach -

Invest in human resources for health - Recent studies show that the current human resource density at 29 per 10,000. It is of great importance for India to reach the norms set by WHO (as of 2016) for health workforce density of 44 health workers per 10,000 population. Also, India needs to focus on enhancing quality through upskilling. This can be done by emergency response training competencies using medical equipment's will develop. Private sectors and other healthcare providers play a crucial role in identifying potential cases and ensuring quarantines.

Role of community health centers and district hospitals - This is an important factor when populations are under lockdowns and mobility is limited. Local community bodies, panchayats, urban local bodies and citizens can help the state administration in order to ensure that the cases are isolated early and supply chains for drugs and essential resources are functioning properly. This can be achieved by effective communication plan to spread right messages. Trained staff and medical equipment's are needed by the district hospitals so as to manage the cases effectively at the facility. The use of tele - medicine can be effective in these situations where it is hard to reach areas.

Low-cost innovation in medical technology - Enabling rapid response can be done by identifying and easing the regulatory frameworks for developing new medical products. The burden on the system can be eased by regulating the prices of essential drugs, low-cost mass development of masks. India needs to further strengthen its bio-medical research capabilities and invest in 'Made in India' health technologies. It also needs to provide easier operation facilities for health technology startups to function with tax cuts.

Taskforce to understand the impact of Covid - 19 - The pandemic presents an opportunity to expand the 'Ayushman Bharat Scheme' combined with universalized health insurance model. Social distancing has been largely implemented in India and may result in new challenges of anxiety and mental health. There is a growing need of a state level task force that represent not just administrators and doctors but also engage with wider civil society to address the long - term effects.


What's Next?


Though there is a lot of information about Covid - 19, vaccines are still awaited and for now prevention is the most effective option. Simple measures of social distancing, working from home, washing hands and wearing face masks have resulted in nations achieving remarkable results.

Many drugs have been tried and tested including hydroxychloroquine, remdesivir etc. It is also known that 'Cytokine Storm' is a major contributor to the mortality of advanced Covid - 19 infection. It occurs when the immune system unleashes a very strong attack in response to the virus leading to damaging blood vessels, blood clot formation, multi organ system failure etc. Corticosteroids have been used for treatment of inflammatory bowel diseases, cancers etc. The RECOVERY (Randomized Evaluation of Covid - 19 Therapy) trial was assessed too but there was no benefit in the outcome of patients who were not on respiratory support.

A vaccine has been considered as an easy solution to this pandemic although producing it in a short span of time is not an easy task due to safety concerns. Since the beginning, researchers have been trying hard for a vaccine and many claims to be in line to bring back normalcy to the world. However, even after such efforts 'a one-time cure it all' vaccine cannot be expected due to genetic variations of virus.


Hence, due to the contagious nature of the virus and looking at its incubation period (average of 12 days) it is important to adopt to social distancing measures along with good hygiene and personal protection by wearing face masks and using sanitizers.


After months and months on battlefield of the pandemic, India did make progress but at a slow pace. However, the entire situation has taken an immense turn on the healthcare fraternity, restored a sense of pride and unity. Healthcare fraternity, researchers and community leaders have come together for the survival and better future of its citizens as these are uncertain times. People have finally realized how important it is to set aside the differences and come together as a community. Even though the current situation is uncertain, it is our responsibility as citizens to plan for a better future. This too shall pass!

By - Shivang Jitendra Khare

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