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Covid19 Epidemic and The Crippled Healthcare System in India

Jun 10, 2020 5:07 AM 4 min read
Editorial

As per a recent study by the Center for Disease Dynamics, Economics & Policy (India) and Princeton University...India has approximately 19 lakh hospital beds, 95,000 ICU beds, and 48,000 ventilators. 

Much of this infrastructure is concentrated in seven states - Uttar Pradesh (14.8%), Karnataka (13.8%), Maharashtra (12.2%), Tamil Nadu (8.1%), West Bengal (5.9%), Telangana (5.2%) and Kerala (5.2%).

With India registering the highest single-day spike of 9,987 COVID-19 cases in the last 24 hours, the country has now stacked up over 1.3 lakh active COVID-19 cases, with deaths inching towards the 7,500-mark.

The COVID-19 curve shows little or no sign of flattening and epidemiologists are predicting that the peak of the pandemic in India is yet to come. With the world’s most stringent lockdown now opening up, India has emerged as the fifth worst-affected nation globally, after the US, Brazil, Russia, and the UK.

Against these daunting statistics, and with the fragile healthcare system in India already pushed to the brink, we see how India’s “pluralistic healthcare system with both public and private health sectors playing important roles” stacks up.

India - Hospital Capacity

 

Public hospitals have 7,13,986 beds, including 35,699 in intensive care units (ICUs) and 17,850 ventilators. It comes as no surprise that a large part of this capacity is exhausted.

As for the private sector, the number of hospital beds stood at 12,15,706, including 60,786 in ICUs and 30,392 ventilators.

 

Thought Experiment

To get a sense of how close we can quickly get to hitting our hospital capacity, let’s look at the COVID-19 patient burden as of today i.e. June 9th 2020.

If we extrapolate the compounded daily growth rate seen over the last 7 days of active cases i.e. 4.2% over the next 30 days, we’ll hit over 4.2L active cases by the beginning of July.

Even if 10% of active cases are deemed serious enough to be admitted into ICU, that comprises half of the country’s ICU capacity. You get the point, right?

 

rise in coronavirus cases in India

 

Let’s Dig Deeper

A rather skewed distribution of resources is another cause for concern.

Kerala with a population of only 3.5 crore (2018) has over 22,300 available beds in public hospitals/government medical colleges. Whereas, bigger states like Gujarat and Maharashtra with populations of over 6.82 crore and 12.22 crore (2018) have only 16,375 and 6,970 beds respectively.

Mumbai - the worst-hit Indian city - on the other hand has 1,094 ICU beds in public and private hospitals. Of them 1,083 are full. There are 464 ventilators in public and private hospitals, of them 437 are occupied. Across Mumbai there are 9,284 beds in Dedicated COVID Hospitals (DCH) and Dedicated COVID Health Centres (DCHC) that treat moderately ill to severely ill patients. 8,635 beds (93%) are already full.

To add to the misery, as per this report, critically ill patients continue to battle for beds.

According to the latest data from Brihanmumbai Municipal Corporation (BMC), 99% intensive care unit (ICU) beds are full and 94% ventilators are occupied in public and private hospitals in Mumbai, but nearly 12% of the beds are occupied by non-critical patients.

This is despite strict instructions from Government officials to admit only severely symptomatic patients to allow beds for critical patients.

Here it is interesting as well as rather alarming to note that private hospitals, which account for 62% of the total hospital beds as well as ICU beds and almost 56% of the ventilators, are handling only around 10% of the workload.

However, with the Government invoking the National Disaster Management Act of 2005, empowering authorities to take over the management of private institutions and given the rise in the number of cases, private hospitals are likely to be taken over by the respective State Governments.

 

Covid19 Epidemic and The Crippled Healthcare System in India

 

Wherein Truly Lies the Problem

India’s patchy healthcare administration and infrastructure can be traced back to low priority allocated to it by the successive Governments.

As per the National Health Profile 2018, India’s public health spending is less than 1% of the country’s GDP - lower than some of its neighbours such as Bhutan (2.5%), Sri Lanka (1.6%) and Nepal (1.1%). In fact, according to the World Health Organisation, India finishes second from the bottom amongst the 10 countries of its region for its percentage spending of GDP on public health.

 

While India has already ramped up its funds to fight against the pandemic, the invisible enemy can only be combated by a robust and comprehensive healthcare system. And this is where the Government needs to step in - providing the requisite regulatory and monetary support.

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