The Covid-19 pandemic and the subsequent response is something we haven’t seen for a hundred years. In a relatively short time, over 15 million people have been infected and 650,000 have died. This virus has captured the attention and imagination of governments, scientists, the media, and most importantly the common man like no other viral infection I have seen in my five-decade-long medical career.
It has turned the world topsy-turvy. The economy is in crisis, the healthcare industry is struggling to survive, tourism, hospitality and the airline industries are completely bankrupt. Our children are falling behind and the simple pleasures of life like visiting friends and family, going on holidays, going to restaurants, malls, and movie theatres seem like a distant dream. The disease has even cast a shadow over death; funeral processions have given way to Zoom funerals.
Covid-19 is undoubtedly a serious problem and the government and the medical community (myself included) agreed that we needed to take drastic steps like the lockdown to try and contain the virus.
Unfortunately, while coronavirus has taken centre stage, all the other illnesses have been relegated to the back burner and they are causing immeasurable suffering. It is a very infectious disease but its mortality rate is low compared to other viral illnesses like Ebola, Smallpox and SARS. Coronavirus has claimed around 30,000 lives in a country of nearly 1.4 billion. Most of our healthcare budget and medical resources have been diverted to Covid-19 care at the cost of other diseases which have higher morbidity, mortality and affect more people.
While decisive action was the need of the hour, we have now been battling the disease for a few months and we must incorporate the lessons we’ve learned and re-evaluated our position.
We quarantined or isolated millions of people, locked down entire countries, banned air, sea and land travel, built several disease-specific hospitals, Covid-19 Care Centers, added ambulances, and ramped up testing. Now let’s look at some statistics of Covid-19 compared to the other illnesses in our country:
From the data, we can conclude that Covid-19 accounts for a very small fraction of deaths in our country and yet a disproportionate amount of our finite resources are being allocated to battle Covid-19, at the expense of several other diseases that have significant mortality.
Even the most advanced countries like the USA and the UK were not able to effectively control Covid-19 despite spending trillions of dollars and the countries are on the verge of a massive economic slump.
The question India has to answer is can we afford to spend billions to combat Covid-19 when the true cost is measured not just in dollars, but also involves sacrificing the care of the patients with other illnesses?
India has faced numerous contagious epidemics like SARS, H1N1, HIV and many others. However, Covid-19 is the only epidemic we’ve ever seen where hospital footfalls have decreased by 60-80% because patients with non-Covid-19 illness fear going or are unable to go to a hospital. Non-communicable diseases like diabetes, hypertension, heart disease, obesity are deadly, especially if untreated and the care of these patients is being interrupted.
This disruption has not just compromised the care of the sick. Many children around the world are unable to follow their vaccination schedules, which leaves them and society as a whole vulnerable to many otherwise preventable, communicable diseases.
Giving up is never the answer and we cannot let Covid-19 run amok but since we don’t know exactly how long Covid-19 will be around, it may be time to try modify our approach which entails:
Common sense precautions - social/physical distancing, wearing of masks, cough etiquette, repeated hand washing, keeping your surroundings hygienic and avoiding large gatherings.
Non-hospital care for asymptomatic or mildly symptomatic patients
Reserving hospital beds only for the moderately and severely ill patients
Protecting healthcare workers by educating them on personal protective measures, use of PPE and practicing universal precautions
Reverse isolation of vulnerable people like the elderly, diabetics, patients with cancer, people on immunosuppressants, CKD, etc.
Enlisting the media to combat fear psychosis and stigmatization.
With these measures, we could not only overcome the Covid-19 pandemic but also bring back continuity of care for patients with other diseases.
I’ve always considered myself extremely fortunate because my job saves lives. Many of us in the medical community have been struggling because the acute shortage of beds means turning away patients we could have saved. We can save so many lives by making sure the care of non-Covid patients is not interrupted. But we need everyone to do their part. With the combined power of the government, technology, awareness programs and personal responsibility, we can create a safe-environment in hospitals for every patient.
The lives of Covid-19 patients are precious, as are the lives of every other patient. No pandemic lasts forever and we will get through this one as well. Until then, let’s make sure we adopt a balanced approach and take care of all patients as best we can.
(The writer is Chairman, Manipal Hospitals)