Hyderabad: Instead of getting bogged down by the number of Covid-19 positive cases on a daily basis, we should be focusing on people who are recovering from Covid-19 and the mortality rate, says president, Apollo Group of Hospitals, Dr K Hari Prasad. The noted doctor, who was also an ace cricketer and a contemporary of Md Azharuddin in Hyderabad, believes that despite huge population and inherent infrastructure challenges, the country has by and large done well against Covid-19 pandemic.
Interacting with Telangana Today, Dr Hari Prasad, who is synonymous with Apollo Hospitals in Hyderabad and has served for more than two-decades, points out that less than one percent mortality rate and good recoveries in Telangana State speak a lot about the efforts of the State government and private healthcare providers.
Medico-socio-economic impact of Covid
The Covid-19 disease, apart from being a medical challenge, also had social impact on individuals and families. The moment individuals test positive for Covid-19, they become untouchables and their family immediately gets isolated in the community.
Even after death, Covid victims quite often don’t get the respect that is usually given by following rituals during the last rites. Preventive measures such as physical distancing, use of masks, use of sanitisers and work from home culture have created a whole new way of living, affecting the mental health of individuals in the community.
The Covid-19 has also impacted families financially. There is no economy that is spared, there is no sector that has escaped the impact of Covid and there is no family which did not have to face the financial implications of the pandemic. So, when we talk about Covid-19, we also need to understand the medico-socio-economic impact of the pandemic.
Need to focus on recoveries and mortality rate
I have observed that there is all-around concern about rapid increase in infections instead of focussing on recovery and death rates. Despite being amongst the top five countries in terms of number of infected people, recovery rates in India are higher than most developed countries and death rates are significantly lower.
Less than one per cent mortality rate considering the number of active and discharged cases as on date in Telangana State speak a lot about the efforts taken up by the State government and even the private healthcare providers.
I must commend governments and public health officials, over the way the situation of Covid-19 outbreak has been handled has really helped to reach to the present level. Given the huge population and also the historical burden of infrastructure limitations that we have, I feel that we are moving in the right direction in handling this pandemic.
However, there are always opportunities for improvement and the government and private players are aware of it and are striving to introduce effective interventions at regular intervals.
Learning about Covid-19
By and large, Indian medical fraternity has done extremely well in keeping-up with the rapidly evolving preventive methods, diagnostic tools and management protocols of Covid-19 and SARS-CoV-2.
I personally feel that the pandemic has provided an impetus for public-private-partnership to flourish. New communication platforms like WhatsApp groups among clinicians worldwide have acted as conduit for information sharing. This information sharing has made it possible for doctors to establish common diagnostic and management protocols across institutions, which are also updated at regular intervals. Such communication channels are helping doctors to understand and share information on what kind of treatment modality is working best to treat the infections.
Handling non-Covid patients
Handling non-Covid patients has been a challenge. As a community, we have been so pre-occupied with Covid that the remaining diseases have been literally put on cold-storage, which is not advisable. The non-Covid diseases in the community are not being treated and a day will come when the healthcare system will get overwhelmed.
We have to accept that Covid-19 has scared people away from hospitals and clinics. People prefer to stay home even when they have symptoms of a potentially serious medical condition. However, we must accept that critical medical conditions like cancer, heart ailments and strokes do not wait and will continue to progress. It is critical to understand this fact and seek medical help as and when required because waiting is not a solution.
Treatment and clinical management for non-Covid patients also has evolved, with an increased use of telehealth and virtual technology solutions by the clinicians for consultation and monitoring. The pandemic has resulted in more telehealth and teleconsult options.
Telemedicine has been in vogue for decades but never became popular. The Covid-19 pandemic, however, has given it a great impetus. As a result, online and video consultations are becoming a new normal. They are safe, effective, minimise the risk of disease transmission and keeps patients connected with their doctors. Telemedicine is here to stay and will at least partially change the way healthcare is delivered in the country.
Infection control & hospital preparedness
We have ensured to follow strict infection control practise framed by MoHFW, CDC and WHO. Meticulous planning has gone into providing a safe environment for patients and staff in Apollo hospitals. Measures such as screening at the entrance of the hospital, setting up fever clinics to segregate suspected, confirmed patients from rest of the visitors, creating dedicated care units for patients suffering from Covid-19, change in workplace culture, ensuring physical distancing at every area, etc. were introduced.
Our safety measures are far more scientific and stringent. However asymptomatic carriers still pose a challenge like they do in the community and there are no known methods to identify and isolate these asymptomatic carriers who could spread the infection.
Management of Covid cases
To manage Covid-19 cases, we had to reorganise our hospital networks and assistance activities within a short period of time. We undertook a slew of measures aimed at managing positive cases including immediately moving entire departments, setting up multi-disciplinary teams, providing appropriate PPE kits, training the teams to manage patients, identifying different routes to enter and exit the area with adequate signage, upgradation of the electrical, oxygen systems, room ventilation, installation of equipment, and in parallel separate the paths and finding location for the non-Covid patients.
We focussed a lot on increasing our bed strength, particularly ICU beds, specifically equipped wards with negative pressure, with separate routes, anterooms and dedicated teams. Many areas in our hospitals were transformed and reopened in a few hours, renovations completed in a few days, beds made available, equipment installed, adequate PPEs provided, risk prevention and reduction measures adopted. This has been a continuous process and has kept the entire healthcare system on its toes. Credit must be given to the Govt of Telangana and the private providers for stepping up to meet the challenges.
Risk to healthcare workers
The Covid-19 infection risk increases manifold for healthcare workers. Despite all the training, use of protective equipment, infection control protocols and other safety measures, healthcare workers stand a huge risk of being infected themselves. Despite this, potentially life threatening risk healthcare workers soldier on and have been at the forefront of this war against coronavirus.
A seriously ill patient, recovering and being discharged from a hospital brings a smile on their face and motivates them to keep going despite all the risks, hardships and negativity. In an extraordinary situation like this, we tried our best to keep our healthcare workers motivated by creating an environment of positivity.
Future of Covid
The SARS-CoV-2 is not going anywhere and it is here to stay. Apart from small pox and polio we have not been able to eradicate any other infectious disease for a century. Covid infections will peak, plateau and then come down to become a part of the regular disease burden in the community. Based on the trends that are visible in Telangana State, it’s clear that the peak of the disease has begun in Telangana State and based on the results of many other countries, this may last until mid of September.
The entire whole world is just waiting to hear the good news on the vaccine front but when it comes, it may not live up to our expectations. We have vaccines for many infections including BCG vaccination for TB. Vaccines will reduce the rate and severity of infections but eradicating the infection is a far cry. However, behavioural and lifestyle changes to enhance immunity and reduce comorbidities will help in reducing the impact of SARS-CoV-2. We can learn from difficulties and this epidemic has reinforced two facts, ‘prevention is better than cure’ and ‘health is wealth’. We need to stay safe and stay healthy.
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