WATCH: Dr Devi Shetty says next big shortage is going to be of doctors, nurses and other frontline healthcare workers
India on Wednesday saw a record single-day rise of 3,60,960 coronavirus cases, while the toll crossed two lakh following 3,293 fresh fatalities
As India struggles to combat the second wave of the COVID-19 pandemic, Dr Devi Shetty in a recent op-ed in The Times of India, warned that the next big shortage the country is going to face is that of doctors, nurses and frontline workers.
"Based on data from the first COVID wave, positivity rate should remain at 25-30 percent for the next 3-4 months. Every day over 3 lakh people are testing positive. Statistically, for every positive patient, there will be at least five more patients who are positive but not tested," Dr Shetty, cardiac surgeon and chairman and founder, Narayana Health, wrote.
Shetty said this means at least 15 lakh people are getting infected every day.
"Assuming that 5 percent of them may need ICU care, we will be adding about 75,000 ICU patients every day, who need to stay in the ICU for about ten days. Unfortunately, we only have 75,000-95,000 ICU beds, which were full even before the pandemic reached the peak," Shetty added,.
Dr Shetty noted that compared to the first wave, the second wave is seeing ICUs being flooded with youger patients. "So most of the patients who die are going to be young breadwinners of the family, withdevastating social implications," he added.
He added that India needs to add 5 lakh new ICU beds in a few days to prevent this calamity. Any bed with central oxygen in a government or private hospital can be converted to an ICU bed with a few accessories, which can be procured easily, he added.
"Unfortunately, beds do not treat patients. Doctors, nurses and paramedics do. Well before COVID, shortage of medical specialists in government hospitals was 76 percent. Most of the government hospitals’ ICUs are suboptimal and COVID patients end up in short-staffed private hospitals. Frontline workers who did a phenomenal job during the first wave are tired and exhausted. We need a few lakh young, skilled and vaccinated nurses, paramedics and doctors to win the battle," Dr Shetty wrote.
India is the only country in the world that can produce a few lakh young COVID frontline workers in a few days, just by changing the regulations, Dr Shetty argued.
"The greatest bottleneck in expanding ICUs is the shortage of nurses. There are about 2.2 lakh nursing students who finished GNM or BSc training, just waiting for the exam. The nursing and ICU serving paramedical students should be exempted from appearing for the exam to graduate and given preference for future government jobs, provided they work in a COVID ICU for one year. Most students would love to take up this offer," Shetty further wrote.
The second greatest hurdle is the availability of specialist doctors, he added. "Over 25,000 young doctors are about to finish training in various medical and surgical specialties. NBE or NMC should exempt them and the ones who failed in past exams and offer a degree if they work in COVID ICU for one year," Dr Shetty urged.
"There are a few thousand medical specialists with diplomas in critical specialties like intensive care cardiology or emergency medicine who aren’t recognised by the Medical Council. If the NMC recognises these diplomas, we should get thousands of motivated and skilled medical specialists to manage COVID ICUs across the country," he stated.
Shetty said a Covid ICU is the worst place to work with PPE and that doctors rarely encounter a situation wherein we need to be thinking about our lives first before saving the patient’s life. No monetary incentive can make one work in the COVID ICU for months together. We need to give young nurses and doctors a life-changing gift to face the battle, he added.
"Let’s be practical and accept that whatever we are doing currently inside the hospital to increase ICU beds is not working. That’s the reason why today private hospitals are not providing ICU beds even for millionaires," Shetty wrote.
We belong to an amazing country that can solve life-threatening challenges in remarkable fashion, Shetty wrote.
"We started the war against COVID with virtually no PPEs and very few ventilators. In a few weeks we produced enough PPEs and ventilators to become a net exporter. Today the entire country is gasping for breath due to lack of oxygen. Thanks to the generosity of the industries and the government’s interventions, the oxygen shortage will get solved shortly. We have a tiny window of opportunity to address the manpower crisis and prevent one of the greatest human tragedies," he added.
We have no doubt that our government under the able leadership of Prime Minister Narendra Modi can convert any catastrophe into an opportunity to save precious lives, Dr Shetty concluded.
Situation grim in India, states reel under COVID
India on Wednesday saw a record single-day rise of 3,60,960 coronavirus cases, which pushed the total tally to 1,79,97,267, while the toll crossed two lakh following 3,293 fresh fatalities, according to Union health ministry data. The 3,293 new fatalities include 895 from Maharashtra, 381 from Delhi, 264 from Uttar Pradesh, 246 from Chhattisgarh,180 from Karnataka, 170 from Gujarat, 131 from Jharkhand, 121 from Rajasthan and 100 from Punjab.
This comes on the same day that several users complained that the the CoWin portal and the Aarogya Setu app crashed while attempting to register for COVID vaccinations in the 18-45 age group ahead of the third phase of inoculations on 1 May.
Meanwhile, the Serum Institute of India announced that the price of its COVID-19 vaccine Covishield would be reduced for states from Rs 400 to Rs 300 per dose. SII''s CEO Adar Poonawalla took to Twitter to announce the "philanthropic" gesture. Poonawalla added that the price cut will save thousands of crores of state funds as well as countless lives. This follows widespread criticism of the pricing policy of the SII, which sold the initial doses of Covishield to the Central Government at Rs 150 per dose. Many states have objected to the different prices for the vaccines.
Also on Wednesday, Maharashtra, the worst-hit state in India, extended its COVID curbs by 15 days while extempting essential services have been exempted from the curbs. Addressing media persons after a Cabinet meeting, health minister Rajesh Tope said though the COVID-19 situation seems to have stabilised to some extent in the state, all the ministers pitched for extending the on-going curbs.
"Today, the number (of daily cases) is 60,000-plus. There definitely is some stability. We had earlier predicted that (daily) cases may go beyond 70,000. But that has not happened. Now I hope and pray to God that this may be the peak and there will be a decline in the graph daily," Tope said.
Tope also added that the vaccination drive beginning May 1 cannot be launched in the state due to unavailability of sufficient number of vaccine doses. This, as reports of the shortage of the vaccines poured in from various parts of the state on Wednesday including Mumbai, where people stood in long queues outside the vaccination centres in scorching heat and humidity but were left disappointed.
A day before West Bengal is slated to hold its eight and final phase of polling, the state logged 17,207 fresh COVID-19 cases, the highest-single day spike recorded thus far. The toll climbed to 11,159 with 77 more fatalities which is also the maximum count during a day. The metropolis accounted for 22 fatalities, followed by neighbouring North 24 Parganas (16) and Howrah (5). The remaining deaths were reported from several other districts. The new infections include 3,821 cases in Kolkata and 3,778 in North 24 Parganas.
Bihar gasped with an active caseload that sniffed at the six-digit mark on Wednesday when a jittery state government also came out with more stringent restrictions in a desperate bid to contain the contagion that has been spreading at an alarming rate.
The severity of the outbreak of the second wave which has been blamed on new, mutant strains which are said to be much more contagious and lethal can also be gauged from the fact that the active caseload happens to be more than one fifth of the total number of 4.41 lakh cases reported in Bihar since COVID-19 struck the world in March last year.
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