War against Coronavirus pandemic warrants Second World War like initiatives
India cannot afford to keep its feet off the pedal in the fight against the Coronavirus pandemic which is now taking a dangerous turn in the country of over 130 crores. Certainly, given its population size, infected cases are although far less but there is no scope to take any chance with the unsparing coronavirus. It has taken more than 436,000 lives and infected over eight million people globally.
Even in the most advanced countries like The United States, the havoc let loose by the pandemic is devastating. despite the plethora of resources and availability of highly advanced gadgets, it has lost 116,000 lives including about 31,000 lives in the most advanced and resourceful state of New York.
As India continues its Fight against COVID-19, medical personnel are at the front battling the pandemic and providing services to prevent the spread. India is short of the prescribed strength of nurses & doctors.
The wartime situation has created an extraordinary situation that longs for the extraordinary steps to face the challenge effectively without compromising of human lives and further derailment of the country’s economy during the current economic recession.
Being in thick of the medical issue, I personally feel that the central government and state governments have started building on war footing COVID19 designated hospitals to tackle the ever-increasing number of cases but tragically, where are the professional staff to handle the crisis?
India, till date, stands at the fourth place among the first ten worst-affected countries with more than 3.43 lakh cases and about 10,000 deaths. But, because of its population size and social structure, it cannot be ruled out that the country may slip into a community transmission mode. There is no community transmission so far as per the government records but we have to brace up for everything.
We will be able to build up hospitals on war scale and rope in the private hospitals but the real challenge lies in seeking the services of doctors during this highly contagious pandemic.
During the last three months, the available medical hands and nurses look worn out and fully fatigued with a very high degree of physical and mental strain.
I feel it is the high time that the top-level message should be to avail services of MBBS Students of the fourth year of five years courses. Their services must be availed with a provision that their year will not be wasted. And it will be counted as the meritorious services year for the nation and humanity.
The Rule should apply to all the government and private medical colleges to meet the shortfall of doctors during the current crisis which is staring at us dangerously.
The fourth-year medical students should be brought to work and given a year gap with appreciation and honor deemed pass out in a scheduled year. This will fulfill the shortage of Doctors in a big way.
More important are lakhs of MBBS doctors preparing for PG they should also be brought to the mainstream of working in the Government and Private Hospitals designated for COVID19. The government must announce the deployment of all these medical professionals who after doing their requisite degree course are pursuing masters in medicines and surgery to advance their careers
These doctors, if they join the national task, should be also be given additional weightage on their courses besides a certificate of honor.
Rules should also be tweaked in a fashion that they can get lifetime advantage of these certificates in future employment. It must be done to offer them incentives to join the wartime situation with full enthusiasm. No war can be won without the warlike zeal and spirits. This young lot will be able to abridge the ever-increasing gap in the availability of medical hands in a typical war-type scenario. Moreover, being age on their side, their immunity level, and stress-bearing capacity is many times higher vis-a-vis already fatigued medical staff.
According to sources, a little over 11.57 lakh allopathic doctors are registered with the state medical councils and the Medical Council of India as on January 31 and assuming 80 percent availability, it is estimated that around 9.26 lakh doctors may be actually available for active service. Besides, there are 7.88 lakh Ayurveda, Unani, and Homeopathy (AUH) doctors in the country.
Days ahead of the lockdown, the government told the parliament that 1.2 million Allopathic doctors were registered in India on Sep 30, 2019. Assuming 80% availability, 961,000 may be available for service, giving a doctor-population ratio of 1:1,404 against the WHO prescribed ratio of 1:1,000.
Not only this, As per Indian Nursing Council (INC) records, there are around 8, 85,383 Auxiliary Nurse Midwives (ANM), 21, 29,820 Registered Nurses and Registered Midwives (RN&RM) and 56,644 Lady Health Visitors (LHV) in the Country.
The Nurse patient ratio in the Country at present is 1.7 nurses per 1000 population. However, the nurse-patient ratio varies from State to State, District to District, and Institution to Institution. The problem is more of skewed distribution, with a dense concentration of workforce in some areas and lesser concentration in other areas.
During the current crisis, shortage of trained nurses also emerged in a big way as at some places, these font line warriors also lost their lives and faced shortcoming of various sorts including PPE kits and their duty hours, due to pressure of work, stretched beyond bearable limits. We will have to explore ways and means to train extra hands immediately to meet the shortfall of hands.
India has 1.7 nurses per 1,000 population, 43% less than the World Health Organization norm of (3 per 1,000). This includes nurses, midwives, women health visitors, and auxiliary nurse midwives. Overall, India has 3.07 million registered nursing personnel. This information was shared with the parliament by the government just before the lockdown in the country. (war)
The most significant aspect of the whole strategy .besides number games should be key thrust on measures aimed at boosting the morale of these front line warriors. The morale should be boosted with wartime like incentives and enthusiasm to face the challenge with full war type spirit.
(Shubhang Arora is Executive Director, Yashoda Group of Hospitals)