A doc’s unconventional prescription for meeting a possible third Covid wave in India

The next Covid wave will be no less than a ‘war’ and India will have to make preparations similar to what armed forces all over the world do in war situations

Vinod Aggarwal May 17, 2021
Covid wave

The Covid situation in India is certainly quite bad. If one watches TV channels, there is nothing right with this front in the country. According to a March 14 update in The Times of India, there are still about 3.7 million active cases, with over 260,000 having already succumbed to the virus since the beginning.  If one believes our media, Prime Minister Narendra Modi’s government has completely failed to tackle Covid. But in this atmosphere of gloom, one well-known eminent heart surgeon has not only cautioned the medical fraternity and government regarding a looming third wave and likely shortages, but also made some unconventional suggestions that deserve proper peer review and due consideration by the government.

During the first Covid wave last year, our TV channels used to tell us about an acute shortage of PPE kits (Personal Protective Equipment ), masks, plastic shields, sanitizers, ventilators etc. From April this year when the second wave hit us, since most of the shortages noticed earlier were met, the TV channels started telling us about the shortage of ambulances, oxygen, oxygen cylinders and tankers, transportation, hospital beds, particularly ICU (Intensive Care unit)/oxygen beds. The second wave, which started from Delhi and Maharashtra, is said to have now moved to Karnataka, Andhra Pradesh, Goa, West Bengal, Uttar Pradesh, Uttarakhand, some northeastern states and several other areas in the country.

Now the Covid third wave is likely to hit us soon. India’s eminent heart surgeon Dr. Devi Shetty, founder-owner of a Bengaluru headquartered hospital chain, has drawn the country’s attention to another category of critical shortages already looming on the horizon. And he has made some very innovative but controversial suggestions which deserve serious consideration, because these have come from a person who is not only an eminent heart surgeon, but also a doctor who is concerned about people’s well being.

For those who may not be knowing this ‘people’s doctor’, 67-year-old Devi Shetty is the founder chairman of the hospital chain Narayana Hrudyalaya, later renamed Narayana Health (NH). NH has now opened 24 medical centers in different parts of the country.

Dr. Shetty came up with his suggestions to tackle the Covid third wave a couple of weeks ago at a doctors’ webinar.

More ICU beds

According to the good doctor, now India was having over 350,000 new Covid positive cases daily. For every single Covid positive person, there were generally five to 10 more infected persons who went untraced, i.e at least 1.5 to 2 million new cases every day.

Building up his case, Dr. Shetty pointed out about five percent of Covid positive patients at any time need ICU/oxygen beds i.e a minimum of an additional 80,000 to 90,000 ICU/oxygen beds every day and each patient needs to spend around 10 days hospitalization. So a total of 800,000 new beds are needed, in addition to 75,000 to 90,000 ICU beds in the country at present, all of which are more than fully occupied. On the lower side, he estimates optimistically, a minimum of 500,000 additional ICU beds need to be made ready before the third wave hits us.

The private sector will have a limitation in creating such a huge additional capacity overnight. But in a number of government hospitals and health centers, there is a lot of infrastructure but not an adequate number of doctors, nurses, paramedics, etc. besides shortages of staff.

The present teams of doctors, nurses, and other health workers have burnt themselves out after working tirelessly for very long hours over the last 14-15 months. They cannot be expected to take the load of these additional patients. So, more doctors, nurses, etc. have to be deployed shortly. According to the eminent cardiac surgeon, this additional load with other patients will need about 200,000 nurses, 150,000 doctors and about 100,000 paramedics/technicians.

Meeting nurse/doctor shortage

Dr. Shetty said there were 220,000 nurses who have finished a three and a half year GNM (General Nursing and Midwifery) course or four-year B.Sc nursing course. These young boys and girls have already finished the full course and are now studying to appear for the exam which will lead to the award of their degrees/diplomas etc. The doctor said the next Covid wave will be no less than a ‘war’ and India will have to make preparations similar to what armed forces all over the world do in war situations. Draft this huge army without degrees/diplomas and tell them if they work in a Covid ward for one year, they will be granted a degree/diploma and also get preference in regular jobs.

Like nurses, about 130,000 young boys and girls have already completed their prescribed MBBS course and are presently preparing for admission to about 35,000 postgraduate seats. Another about 30,000 MBBS doctors have completed PG studies and are now preparing for the exam and there are also almost 100,000 foreign qualified doctors who cannot practice in India till they clear a local exam.

Dr.  Shetty's suggestions are definitely unconventional and not strictly within the four walls of usual bureacratic thinking. But unless somebody has a better suggestion in the run-up to a dreaded third wave, these points need to be considered. Even if due to an accelerated speed of vaccination, the requirement of doctors, nurses, etc. is about 50 percent of the above estimate, it still needs to be given serious thought as the powers that be ponder on making up the shortage. 

There could, however, be hurdles. All the candidates mentioned above may not even be available or willing despite the carrot. Moreover, there may be some more patients in the 0-17 age group as they are still totally unprotected by any vaccine.

(The writer is an entrepreneur and a former journalist. The views are personal. He can be contacted at vinod.aggarwal@uniliftcargo.com)

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