India, a land of almost 1.4 billion people, is suffocating under the COVID-19 pandemic crisis. With the sheer numbers infected, no country’s health care system nor its infrastructure can sustain this onslaught and provide care to its citizens. The vulnerabilities are not solely a shortage of beds and hospitals but resources such as oxygen, ventilators, vaccines, testing facilities, personal protective equipment, trained nurses and doctors to treat covid patients.
As per the experts, though India’s infection rate is significantly increasing the number of deaths when compared against the number of confirmed cases has been consistently low. As the devastating second wave of the pandemic continues to grip the country, experts have raised concerns about another virulent wave that may hit the country by the end of this year.
In his interviews with various media, Dr. Devi Prasad Shetty, Chairman of Narayana Health, predicts that India will most likely face a third wave with the possibility that it will predominantly target children, especially those below the age of 12. This is due to the coronavirus mutation and the choice of host that the virus tends to affect. The first wave primarily attacked senior citizens with comorbidities such as kidney disorders, diabetes, and cardiac issues. The second wave targeted the largely young breadwinners of a family. The third wave is likely to attack children since most of the adult population has already been immunized or infected.
The Covid pandemic is affecting rural India which presents a greater challenge compared to what urban India has been dealing with. Unlike the cities, rural areas do not have private hospitals and the accessible government hospitals are severely short of medical supplies, equipment, and staff.
The Covid-19 pandemic is causing large-scale economic disruption across various sectors in the whole country. The pandemic not only has devastating effects on India’s healthcare but is likely to have a severe long term economic impact on its people. The nationwide lockdown to control the spread of the pandemic has only exacerbated people’s financial difficulties. The impact of outof- pocket healthcare expenditure, loss of income on personal/family finances and social distress lay a heavy burden culminating in the widening of economic disparities and worsening of socioeconomic inequalities.
The economic slowdown, resulting in loss of business and daily wage earnings, makes it difficult to buy even basic food items which could aggravate malnutrition among the people. The harmful effect of this inadvertent fallout would be on the most vulnerable populations, namely women, especially pregnant women and children, consequently negating previous gains of maternal and child health and nutrition-related National Programs.
Among the affluent, the duration of the lockdown is directly proportional to the worsening of glycemic control in patients with diabetes through poor physical activity and consumption of calorie dense foods. As a result, there can be an increase in diabetes-related complications putting an additional load on an already overburdened public healthcare system. Furthermore, such uncontrolled diabetes and increased cardiovascular complications have the potential to increase the severity of Covid-19 virus in patients.
The pandemic has had a devastating effect on the emotional, mental and psychological health of the people. There is an increase in chronic stress, anxiety, depression, alcohol dependence, and selfharm and heightened physical abuse (domestic violence) has been reported as a consequence of the lockdown. Mental health issues are going to be a long-term problem for the country.
Mumbai, one of the most overpopulated cities in India, initially struggled with one of the highest number of cases in the country but controlled the virus with widespread testing, strict lockdowns, and a decentralized COVID management system. The accolade winning Mumbai Covid-19 model took a decentralized approach by setting up command centers in each of the city’s 24 wards, each center responsible for about 700,000 people. These centers were equipped with ambulances, doctors, telephone operators, Liquid Medical Oxygen tanks and basic infrastructure to take care of patients. This arrangement effectively distributed the massive logistical burden of the all- Mumbai command center.
Also, instead of a first come first serve basis, patients were allocated beds as per the severity of their condition. Eighty percent of beds in private hospitals were taken over by the government to better allocate resources to those in critical condition. A decision was made to maintain surplus medical necessities. At most hospitals oxygen storage capacities were increased by installing new cryogenic tankers. SUVs were refurbished into makeshift ambulances to transport patients.
Mumbai also set up command centers where health experts, medical interns, school teachers, and many other volunteers worked in shifts twenty four-seven to operate helpline numbers of the 24 wards in the city. Gearing up to get ahead of a potential third wave, Mumbai is building four large centers across the city with pediatric Covid- 19 units and is working closely with a special task force that includes some of India’s top pediatricians.
The Covid-19 pandemic has caused indefinable pain, misery and economic distress to many people and various industries throughout the country. The media is spreading gloom and doom, concentrating on showing patients on roads outside overflowing hospitals, desperate people awaiting beds for relatives dying in their arms, the bereaved breaking down and the burning of dead bodies.
But amongst all this terrible dark pandemic cyclone there are so many stars twinkling brightly. There are so many compassionate and caring individuals helping others in need, young and old doing whatever is necessary to help their fellow human beings. From finding hospital beds, to transporting people, cooking food for others, providing provisions, landlords forgiving rents, people taking in children who have become orphans due to Covid-19 and any number of countless acts of kindness. A ray of hope for humanity.
Sohni Reddy is an Internist in San Antonio, Texas. Her career has given her the opportunity to live in various cities fostering her love of traveling. She enjoys cooking, baking, choreographing and volunteering.