As coronavirus spread like wildfire from Tier-1 to Tier 2 cities to villages across the country stretching the existing overburdened healthcare system, Covid-19 infected severely ill patients requiring isolation beds and ICU beds besides basic oxygen facilities are likely to be at the receiving end in view of shortage of specialists and needed emergency medical infrastructure.
India is third-worst virus hit country among the world with US and the Brazil topping the list. On an average, India is reporting almost above 45,000 cases daily. “Though recovery rate is also on increase simultaneously, once the patients had started to die in a smaller city or town, the Government will have to be ready for the huge demand for medical needs, “ said a doctor from the AIIMS, Delhi on the condition of anonymity.
According to the Union Health Ministry, around 3 per cent of active patients need ICU beds, less than 3 per cent need oxygen support and only 0.45 per cent need ventilators. However, in contrast, in villages and small cities there has always been deficiency of the specialists and the healthcare infrastructure.
Sample this: India has 1.1 million allopathic doctors registered with the Board of Governors/State Medical Councils/Medical Council, while for people living in rural areas, the government allopathic doctor-patient ratio is 1:10,926, according to the National Health Profile 2019.
Assuming 80 per cent availability, it is said that around 920,000 qualified allopathic doctors and specialists may be actually available for active service.
It gives a doctor-population ratio of 1:1404 as per current population estimate of 1.35 billion, which is lower than the World Health Organisation (WHO) norm of 1:1000.
In addition to doctors, the country has a little more than two million (2,048,979) registered nurses and midwives, many of whom need infection control training to care for patients with airborne infections, according to reports.
Almost from all the districts in Maharashtra, Delhi, Tamil Nadu, Gujarat, UP, Rajasthan, West Bengal, Madhya Pradesh, Haryana, Karnataka (in that order) are registering the cases. The North-eastern region is also not left untouched by the virus calling for better health services.
Overall, India has an estimated, 1.55 million nurses, and 750,000 nurse associates, according to the Ministry. In addition, there are around 200,000 dentists, 600,000 AYUSH qualified practitioners, about 1.1 million pharmacists and 700,000 qualified allied and healthcare professionals, including those in labs, radiology, physiotherapy, optometry, occupational therapy, nutrition and life sciences.
According to Dr Srinath Reddy, President of the Public Health Foundation of India (PHFI), the availability of physicians and nurses varies widely across the country, with the central, northern, eastern, and northeastern states being poorly served.
Rural areas have an especially severe shortage of qualified health professionals.
Researchers in Chennai too after conducting an independent statistical analysis have asserted that the number of Covid-19 patients who need ICU beds might exceed the existing inventory of around 32,000 beds by early August.
Sitabhra Sinha from the Institute of Mathematical Sciences, Chennai, and his colleagues have suggested that a demand for ICU beds from 3 per cent of the patients would approach the 32,000 limit by August end.
Shortages of critical-care medicine specialists and nurses could hamper the country’s ability to deliver efficient ICU services to every patient who needs them, Shikha Panwar, a senior critical-care specialist in Faridabad, Haryana echoed similar concerns.
