The Mess in Indian HealthCare

India's hospitals are currently short of doctors, medical equipment and ICU beds, with authorities struggling to cope with an unprecedented health crisis. A surge in COVID-19 cases has overwhelmed the health system. 

Hospitals in India have become overwhelmed due to an unprecedented surge in coronavirus cases. Authorities in the capital in Delhi have instructed 33 private hospitals to reserve 80% of their intensive care unit (ICU) beds for COVID-19 patients amid a shortage of facilities in government-run medical institutes.

At the beginning of August, Delhi had successfully contained the pandemic spread, with the cases dropping to less than 1,000 per day. But there has been a resurgence of the virus across the country, and the capital city had not been spared.

The overall number of COVID-19 cases in Delhi has now surpassed 230,000. In the last eight days, more than 4,000 new cases have been recorded daily.

"There seems to be no end to this crisis. We are overwhelmed with rising infections. It is not just Delhi; there is a shortage of trained medical staff in both government and private hospitals across the country," Dr. Anoop Saraya, who works at Delhi's All India Institute of Medical Sciences, told DW.

Data from the local government's hospital occupancy app, Delhi Corona, shows there are no ICU beds with ventilators available to coronavirus patients in eight of the capital's 11 top private hospitals.

"The number of patients being admitted had dropped, but since the beginning of September, they have started going up again. There is a similar situation in Uttar Pradesh and Bihar states. I am afraid that the spike in cases will strain the entire public health system," Dr. Rajeev Chawla, a consulting pulmonologist at Indraprastha Apollo hospital in Delhi, told DW.

Hospitals Completely Overwhelmed -

• India recently surpassed 5 million COVID-19 cases, with almost 85,000 deaths. It is now behind only the US in overall COVID-19 infections. The cases have doubled from 2.5 million in just a month.
• There is chaos in several cities, with hospitals running short of medical equipment. Many patients are unable to find a place in hospitals.
• In the northern state of Punjab, shortage of beds, crowded hospitals and overworked health workers exposed the frailty of the health system. The state's infection tally has risen rapidly to 87,100 cases with over 2,500 deaths in the past few days.
• The situation in Mumbai, India's financial capital, is relatively better, with at least a third of normal hospital beds still unoccupied. However, the hospitals there are still operating round the clock, and ICU beds and ventilators are scarce.

Attentional Healthcare System is a need of an hour-

• Perennially low public financing for healthcare, primarily responsible for poor infrastructure, equipment, human resources, and ultimately poor service delivery, has seen some significant budgetary allocations by both state and federal government.
• The epidemic has highlighted the critical role state governments need to play in the healthcare sector. Most of the health policy analyses and recommendations have primarily targeted the central government, even though, as per the constitution, state governments are responsible for healthcare delivery. In the present epidemic, as the management of epidemic was delegated to state governments, for the first time, state governments have taken a leadership role in managing the healthcare sector.
• The epidemic has led state governments to create several middle managerial positions, brought attention to health planning, organization, and management of supply chain, which has been sorely missing in the period before the epidemic.
• The epidemic has brought attention to the importance of coordination between public and private sector facilities. During the epidemic, extensive coordination is being observed between the public and private sectors for testing, reporting, bed availability, and treatment.
• The epidemic has pushed private hospitals to improve their operational efficiency. On the one hand, because of the COVID, hospitals’ operating cost has increased due to the use of PPE, masks, social distancing, and testing. On the other hand, many state governments have mandated private hospitals to treat COVID patients within a specific price range.

The Conclusion-

According to Insurance Regulatory Development Authority’s annual report 2018-19, only around 25 per cent of the population has some form of health insurance to protect them from catastrophic healthcare expenditure, which drives millions into poverty in India every year. In years to come, deeper penetration of health insurance is expected.

Finally, the epidemic has led to the adoption of healthy behaviors, including hand-washing, face mask, sanitation, and social distancing. These behaviors are expected to reduce the spread of other infections, such as tuberculosis.

Thus though the epidemic has created extensive disruption across all sectors of the economy and lives of people, at the same time, it has pushed some of the long-pending reforms in India’s health sector.