Adding to the already grim situation in India's Covid-19 catastrophe is the acute shortage of qualified infectious disease (ID) specialists—there are less than 50 ID experts in the country— who have expertise in handling the pandemic among other infections like HIV and TB and protect the communities from such health threats.
Health professionals said that, especially, at a time when India is fighting the Covid pandemic along with rising menace of antibiotic resistant infections, the need for more ID expertise has become a clear focal point.
It is high time the Government looks at the severe shortage of ID specialties and does the needful, they added. ID doctors are certified specialists in diagnosing and treating IDs associated with bacteria, parasites, fungi – and viruses, such as the new coronavirus that has wrecked the health and economy world over.
They are seen as a critical asset to the medical and public health communities. In fact, Dr Kamini Walia, senior scientist from ICMR, indicates that though the Government has announced establishing ID blocks in district hospitals (DHs) which augur well with the overall intent to step up the fight against IDs, especially antimicrobial resistance (AMR),the plan will remain on paper due to the lack of adequate human resources particularly ID experts.
In a review article in a recent edition of IJMR, a government journal, she said, setting up ID blocks in DHs is not enough if not met by adequate human resources and infrastructure to implement these interventions in secondary-level hospitals. “The first and the most important challenge is the absence of ID physician posts in DHs and the dearth of trained ID physicians in the country,” Dr Walia explained, “To be effective, the ID blocks would need to be supported by trained manpower such as ID physicians, microbiologists, infection control nurses, clinical pharmacists and well-equipped diagnostic laboratories.
ID physicians would be central to creation of the ID blocks." Dr. Neha Rastogi Panda, Consultant, ID Department, Fortis Research Memorial Institute, Gurugram asserted that “India is already becoming a hub of bugs and the pandemic should therefore be a wake-up call for India to take steps to plug the demand-supply gap.
In India, only AIIMS Delhi and CMC Vellore have started offering Doctorate in medicine in IDs recently.” Also, AIIMS Jodhpur, AIIMS Bhopal and KMC Manipal University have recently started the DM from January 2021 while fellowship in NABH accredited ID programme is being run in four institutions Apollo Hospitals (Chennai and Hyderabad), Hinduja Hospital (Mumbai), and Sterling Hospital (Ahmedabad).
But these are not enough, she said. Dr PH Chandrasekar, educational coordinator for Department of Infectious Diseases at Wayne State University, Detroit, USA too minced no words as he said, “The department of ID has remained an ignored stream. The government should recognize this field as a sub-specialty.” ID is still a young branch in India. The educational system never thought of introducing it as a sub-speciality. In the US, it was introduced way back in 1960, Chandrasekar, a patron of National Clinical IDs Society (CIDS), said, adding that ID is the highest cause of death in India but there is a dearth of doctors to support and provide medical care to such patients.
“There are many doctors who without any formal training in ID call themselves a specialist”, he said, as per a report.
To improve the availability of trained ID physicians, the country should look at creating more ID fellowship opportunities which can be offered online, with compulsory practical training for a short period, chipped in Dr Panda.
Concerned at the acute shortage of ID specialists, Dr Panda along with a few other ID specialists, early this year, had represented before the Union Health Ministry seeking recognition of the ID specialist as a separate entity and starting ID departments at central government and state government institutes in public interest.
They also favored mandatory requirement of NABH standards to have trained IDs specialists for hospitals and IDs to be incorporated as subjects of special importance in the medical education system.