While the nationwide lockdown will surely help in ensuring social distancing, the first step in the battle against the coronavirus pandemic, it is a long and tough path ahead for India’s rickety public healthcare system to tame the deadly virus. From shortage of masks and protective gear for medical professionals to woefully inadequate number of ventilators and ICU beds, the challenges are many and complex. With just over 70,000 ICU beds for a population of 1.3 billion, India presents a nightmarish scenario if the community spread of Covid-19 gains momentum resulting in hospitals across the country being over-stressed. Since there is an unprecedented threat to public health, the Centre and States need to display extraordinary alacrity and speed in ramping up healthcare infrastructure and delivery systems. Medical professionals have been complaining about pathetic facilities in hospitals drafted for serving the Covid-19 patients. Procurement of ventilators should have ideally started in January when the pandemic started jumping the borders. At least now, urgent steps must be taken to mobilise the industry to speed up production. The Centre must order mass production of masks and personal protective equipment for healthcare workers. If the virus curve is not flattened over the next few weeks, the existing medical facilities will get overwhelmed. Urban slums can be potential hotspots for the rapid spread of the respiratory pathogen. Overcrowding, poor sanitation, social dependency, larger number of human contacts, low immunity and poor medical facilities provide the ground for tremendous speed of virus transmission in slums.
Over the years, the successive governments have ignored the public healthcare system leading to a situation where primary and secondary healthcare centres in most parts of the country lie abandoned or unmanned. The coronavirus pandemic has brought into sharp focus the country’s broken healthcare system, abysmally low public spending and skewed priorities when it comes to addressing the challenges from infectious diseases. India carries a disproportionate burden of global infectious diseases, particularly the ones of zoonotic origin. However, the outbreaks of Nipah in Kerala and acute encephalitis syndrome in Bihar in recent times exposed the gaps in the public healthcare system such as weak surveillance, lack of public awareness, poor nutrition, sanitation and ill-equipped health facilities. Many infectious diseases could be prevented and controlled with a robust public health system and adequately trained public health personnel. Poor public spending on healthcare is a key hurdle in the fight against infectious diseases. At present, India’s expenditure on healthcare accounts for just 1.17% of the GDP, one of the lowest in the world. It has one of the lowest density of health workforce in the world. The pandemic must serve as a wake-up call to revamp the sector in a mission mode.
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