There is a dire need of more doctors, nurses and paramedical personnel

It's very heartening to see the continual growth in recovery rate of Corona positive patients ( today it is above 67 per cent ) and consistent downfall of fatality rate ( today it is 2.10 per cent) throughout the country . The recovery rate has doubled the rate of being affected people recently. The need of medical attention (for the Covid- 19 patients) is also receding gradually reached to 33 per cent .

Not only that the number of tests has increased very rapidly and reached above two crores by conducted by above 1370 laboratories. When the pandemic was acknowledged by our country in the month of January there was only one testing lab (National Institute of Virology , NIV Pune ) now there are multiple research & development centres , universities , medical colleges and ministerial & departmental labs , railways and airports engaged themselves in the Rapid Antigen Tests for corona Patients. The fatality rate of less than two per cent and recovery rate of above 67 per cent are also one of the highest successful rates among very few Countries in the World.

However all these positive developments should read with a cautious rider. The number of positive cases are increasing day after the day enormously all over except in a few States. The Medical infrastructure already in existence is not commensurate to the number of positive cases. States like West Bengal, Nagaland and Arunachal Pradesh have decided to extend their lock down till August 15. States like Odisha , Jharkhand , Chattisgarh and Andaman & Nicobar Islands are clamping lock down on every weekends . All Southern States which are considered to be modern as highest rate of Educatiin and upgraded modern health infra are witnessing spike in Corona cases gradually.

The most of the Covid tests are carrying mainly X-Ray examination. As part of my visits to inspect the bills of Corona patients at Corporate Hospitals I have had an opportunity to interact with the top most Doctors and Hospital Administrators of Pune City ( which is one of the most affected Cities in the Coutry after the 4 Metro cities and the Greater Bengaluru City).

As per one of the Directors of the Hospital and a Neurologist who was himself involved in the treatment of Covid patients the CT scan should be made as compulsory as X-ray test is not sufficient to identify the pneumonia in any person and by the time it reaches to the higher level everything else is also seriously affected the sufficient time is not at the exposure of the Doctors to treat the patient, ultimately resulting into the fatality of the patient. Hence CT Scans should be a compulsory part of Covid tests instead of X-Ray tests. The number of ventilators available and sufficient Oxygen supply is still not yet percolated down (even) to the Corporate hospitals.

One Administrator told me the ventilator which was available at the cost of Rs 5000 before pandemic , now being quoted at Rs 20000 . That is also immediate supply in bulk quantities is not available .

Another important problem of medical infrastructure is severe lack of Oxygen supply. The situation is like thatvsometimes the Hospitals had to take the support of Police fir the O2 supplier to be fall in line.

Although Corporate Hospitals ( for that matter any other Hospital ) ready to upgrade their number of beds for the treatment of corona patients exclusively , their efforts are seriously being hampered by less availability of Ventilators and Oxygen supply.

Another valuable suggestion received was all the Hospitals till the pandemic is finished to be made as ICU type of wards with full upgradation of infrastructure and Oxygen & Ventilators supply. This suggestion may be costliest and finance cost to met out this may be a stumbling block in this regard.

To meet the pandemic situation the Prime Minister of India Narendra Modi announced in one of his 'Man ki baat' that he will ensure at least one Medical College in each District of the Country . There are about 740 Districts in the Country. Accordingly 75 Colleges have been approved and sanctioned by Central Govt to start. The same rate of speedy sanctions and approvals should accorded even to the Nursing Colleges and Colleges/ Institutes of Lab Technician Courses.

Two days back a bus depot in Bangalore has been converted into 200-bedded Hospital. On Saturday, Uttar Pradesh Chief Minister inaugurated a new 400-bedded dedicated Covid hospital in NOIDA. Likewise in the previous months Railways and some other Departments like Tourism started / converted their working places as dedicated Covid wards. But whether there are qualified Doctors , Nurses and Technicians to run/ manage / maintain all these newly started dedicated hospitals??!!

During my visits to the Corporate Hospitals the CEOs/ MDs expressed their anguish since the required number of Doctors , Nurses and Paramedical staff is not readily available. Already their number ( with proper training / skills ) is less. As rubbing salt on injury all these migrated nurses and technicians from other States had gone back to their native places. Now the existing Doctors and Nurses demanding double the salary / payment packages before the pandemic.

In order to cope up the situation the Hospitals temporarily may utilise the services of AYUSH Doctors ( Ayurvedic , Yoga, Unani, Siddha and Homoepathic ) who were also recognised as proper Doctors as per Desi Medical system. However the main treatment and medication should be held under the supervision of MBBS / MD Doctors. The non Clinical faculty Doctors who are normally not so active , their services can also be co-opted in the covid wards apart from their Lab & Teaching functions.

Similarly BDS/ MDS Doctors could be involved in wards as they knew administering injection and other medical treatments as good as MD / MBBS Doctors. B.Pharm / M.Pharm holders are also be allowed to work in covid wards just to manage routine activities under the prompt and proper supervision of Allopathic Doctors.

Another severe issue crippling the services to Corona patients is less number of Nurses and Lab/ other Technicians. Hitherto the Govt is conducting only Staff Nurse Courses. In fact the present situation demands more ANMs ( Auxiliary Nursing and Midwifery ) and GNMs( General Nursing and Midwifery). There is an urgent need to start one ANM training centre in each Assembly Constituency/ Block. The services of these Nurses can be utilised locally then and there itself . After 10 th Standard Nursing Course can be started as part of Vocational Education for two years.

The added advantage of ANM/ GNM is that the poor people normally the lower sections of the Indian Society attracts to this kind of courses as they can settle in some hospital locally at their Town / Village (migratory/movement tendencies are less for these sections). This is witnessed in many small clinics & Nursing Homes at Constituency/Block/ Mandal level .

The same is applicable for medical/Lab Technicians Courses also. However instead of training these people for only one Course they can be trained in multiple techniques. So that whenever the necessity arises they can be utilized in any section. For instance one technician can be trained and well equipped with as Respiratory Technician / ICU Assistant / Emergency Ward assistant / TMT Technician/ etc. As per the demand and necessity they can be posted in different wards.

Last but not the least as of now there is only one ASHA (Accredited Social Health Activist) in each Village . They can be appointed even per each Hamlets and specially for SC & ST Colonies also exclusively . As these ASHAs are immediate link between the Patient and PHC/UHC, increase any number of these workers will improve the health conditions in the Rural Areas / Urban Slums .

In Pune, one prominent private Corporate Hospital has been training the Auto rickshaw / Taxi Drivers for emergency response for few days. They are being trained for what to do if their passenger shows any sudden emergency respiratory /cardiac ailments before he/ She could reach to the hospital . Each driver is given a certificate of 'Arogya Dhoot'. Such commendable practices may be adapted by govt / municipal hospitals also throughout the Country.

(The author is Joint Commissioner of IncomeTax , Pune City)