Positive lessons from the pandemic

A crisis always presents both dangers and opportunities. The once-in-a-lifetime pandemic has changed the way we live, think, act and react. While the dangers of Covid-19 have been experienced, reported and documented extensively, the other side of the crisis, the positive side, has hardly been written about.

Covid-19 is perhaps running its last lap. But in its wake, it has transformed healthcare. It has changed the way people, hospitals, pharma companies, the diagnostics industry and governments think about healthcare. And it has also brought to fore many important questions pertaining to public healthcare.

Until the pandemic hit us, most private hospitals, pharma companies, diagnostic companies and the government were trapped in, in the words of the late Harvard professor and famous author Clayton Christensen, ‘marginal thinking’. The hospitals were so invested in physical infrastructure that they felt the marginal effort and cost of adopting new ways and technologies was very high. Medical equipment, diagnostic, pharma and vaccine companies too suffered from the same syndrome. The pandemic has changed that.

Earlier, India had to wait for 15 to 25 years for vaccines for polio, BCG, Hepatitis and Encephalitis to reach its shores. But the scenarios have changed now. For the first time in history, India got a vaccine for a widespread disease like Covid within a month of its global launch. The first Covid vaccine was launched in the USA on December 10, 2020, and Covishield was launched in India on Jan 16, 2021. And weeks later, India launched its own home-grown vaccine Covaxin. It took a pandemic to change the marginal thinking trap. As per the Ministry of Health and Family welfare’s dashboard, currently, in India, over 193 crore doses of the Covid vaccine have been distributed. This reflects India’s tremendous success in getting almost all eligible adults vaccinated in just 1.5 years and shows the change in mindset.

Covid has also shrunk capacity expansion cycles to days from months and years. During the pandemic, hotels and empty buildings were retrofitted to build make-shift hospitals in a matter of days.

India did not have a single PPE kit maker pre-Covid. But manufacturers raised to the challenge within a few weeks. Today, India is an exporter of PPE kits and masks. It is no small feat.

India had only two testing labs prior to Covid. Today, there are over 200 public and private labs with a capacity of several million tests per day. That India has conducted 85.35 crore Covid tests as of June 2022, is evidence of its enormous transformation.

In the middle of the lockdown, faced with the need to train medical personnel to deal with the deadly virus, Karnataka set an example by going online. The module, managed by NIMHANS, reached nearly three lakh, medical staff, across the state. The tele-ICU facility, a first again by the Karnataka government, was a classic example of leveraging technology to build scale. Pulmonologists, intensivists, virologists and other specialists could attend to critical Covid patients in remote villages. Today, telemedicine is fast becoming the mainstream. This would not have been possible without a pandemic.

Are we prepared?

The Himalayan effort of private and public sectors helped us scrape through the pandemic with only a few bruises. It is indeed a monumental effort, but are we out of the woods yet? Are we fully prepared for another pandemic? The answer is yes and no.

Yes, because both the private and public sectors have learnt to respond fast, and on a scale, to a crisis. No, because a lot needs to be done to help people sail through another pandemic without much hardship.

Here are the critical areas the healthcare sector needs to focus on in order to be fully prepared for another pandemic.

Universal health coverage: Though governments bore the cost of Covid in most cases, lakhs of people had to spend huge amounts of money on Covid treatment. Pandemic aside, the rampaging non-communicable diseases (NCDs) are wreaking havoc. The steep medical bills to treat NCDs have pushed lakhs of people to poverty. Doctor-people ratio: Improving the ratio is critical. Efforts of the Union and state governments to increase the number of medical seats in the last few years are laudable. But every district needs to have a medical college and a hospital, as they are the pillars of tertiary treatment at the district level.

Communicable and non-communicable diseases such as TB, cancer, and neurodegenerative diseases are slowly raising their ugly head. These have to be tackled on a war footing or these ‘slow pandemics’ can wreak havoc.

Government healthcare spending needs to be increased from less than 2% now to at least 5% of the GDP to make adequate funds available to achieve these goals. We have learned some painful lessons at the expense of far too many lives, but the public and private sectors are now working together to ensure that every citizen has access to universal, viable, sustainable and inexpensive healthcare.

(The writer is the Chairman of Manipal Health Enterprises Pvt Ltd)