As the tsunami of COVID-19 cases hit us in India, an unprecedented situation is unfolding for the current generation of Indians who have not witnessed chaos at this level. Uncountable bodies have piled on the streets; people are struggling to find spaces at funeral grounds for their loved ones as pyres are being built in makeshift crematoriums. There is an acute shortage of oxygen across the country, which is generating a public health nightmare.
Public images abound of people experiencing a catalogue of mistreatment and denial of justice, the trauma of which will remain etched in memories for decades to come. The human catastrophe paints a grim picture, where people are left to die and families are pleading with the hospital authorities for their relatives who are desperately ill.
Even as cases spiked, the country’s Prime Minister Narendra Modi remained in data denial. Modi hosted huge political rallies without wearing a face mask, flouted social distancing, and endorsed mass gatherings by thanking the public for turning up in huge numbers. His government encouraged thousands of Hindu pilgrims to gather along the Ganges River for the Kumbh Mela festival, which started in January and ran well into April. Huge errors were at play, which could have been avoided, had the government not taken a nonchalant attitude toward the virus, with no planning, social support, or accountability. Instead, the Modi government deliberately ignored the scientific figures and endorsed traditional methods as the cure to the virus.
The country has recorded the highest one-day tally of new COVID-19 cases of around 3,77,000, anywhere in the world – a record it has broken again and again over recent days. India is also seeing its highest number of deaths per day since the pandemic started.
We’re together in the storm; are we in the same boat? Is it really true that COVID-19 does not discriminate? Is it really true that we are together and equal in this suffering?
When we look around, we can see that COVID-19 is far from being indiscriminate. People with resources, money, power are better able to physically distance, work from home, and retain their job, and resources.
More affluent people, not only have lower risks of becoming infected or dying from COVID-19, as reflected in a combination of factors, including better access to healthcare but also carry a lower underlying burden of morbidity that predisposes to worsen COVID-19 outcomes. It thus turns out that we are in the same storm, but some of us are on a ship with sails, some on a boat, but some are trying to swim without gear, with a constant fear of drowning.
COVID-19 discriminates! Those who are already vulnerable – for example, people surviving on low incomes, those living in unhygienic conditions, those with poorer education and healthcare, and individuals with less access to nutritious food – are more likely to become infected with the virus and die from COVID-19.
In India, some of the best healthcare in the world is delivered through the private sector. Nine out of ten doctors in India work in the private sector. But the fact remains that for nearly 600 million rural and urban poor, quality, affordable healthcare is beyond their reach. Despite being the fourth largest economy in the world, India is near the bottom of the U.N. Human Development Index and healthcare inequities contribute greatly to India’s low standing.
A recent report by the WHO highlighted the fact that nearly 70 percent of India’s population spends most of their available income on healthcare. Each year nearly 40 million Indians are thrown into poverty because of out of pocket health spending. A report by Save the Children estimates that there is a shortage of 2.6 million health workers. In short, although much progress has been made in India in tackling disease, particularly communicable disease, much more needs to be done.
Now as prosperity grows in India, so too does the economic and social burden of chronic non- communicable disease. Despite an abundance of quality, domestically produced generic medicines, few drugs are available to the poor — largely because of a lack of primary healthcare delivery. A recent study published in The Lancet highlighted the fact that less than 10 percent of cardiovascular patients in India had access to some of the cheapest medicines for the management and prevention of cardiovascular disease.
At the heart of India’s growing healthcare crisis is the issue of health system capacity and adequate funding. Without health system reform, India’s healthcare inequities will grow, as will disparities between the growing affluent middle class and the rural and urban poor. As for public funding of healthcare India spends about 1 percent of GDP. Although medicines make up the lion’s share of health spending, India commits less public funding for pharmaceuticals than almost every other country in the world.
According to the WHO World Medicines Report, public spending makes up only 4% of pharmaceutical spending in India. By contrast in China, which has experienced many of the same issue of health inequities as India, over 40 percent of spending for medicines is publicly funded. In developed countries like France, U.K. and Germany the public sector contributes over 70 percent of spending in medicines and in the U.S and Canada public sector spending on medicines is between 40 and 50 percent of the total.
India recognizes that it has problem in health equity and has once again committed to provide more resources for healthcare. It has also announced a commitment to develop a system of universal healthcare. But the question is: will it adequately fulfill this commitment? Also in question is whether or not the approaches India takes to health reform will improve health equity.
Yes, we need to accept, the government is waking up. The policy makers are running pillar to post, at all levels of community to cover the damage and stop the massacre. Apart from kaing some quick makeshift hospitals, enagaging more than ever number of medicala staffs, government is also trying to control spread of panic, mis-information or black marketing. Be it oxygen, Remdevesir, Ivermectin or even hospital beds, government has formed monitoring groups to ensure timely and economic supplies to the citizen.
In the last 10 days, the Indian Railways has operated a total of 432 special train services from Maharashtra and 1166 special train services from Delhi. Presently, the Indian Railways is running a total of 1512 special train services per day for supplying essentials, including Covid-related medicines. Additionally, the government has also roped in the Indian Air Force (IAF) to airlift oxygen cylinders, regulators and essential medicines to battle the pandemic.
23 mobile oxygen generation plants are being airlifted from Germany. These will be deployed in static hospitals and provide adequate oxygen to the needy. So, the problem is not an oxygen deficit per se! There was 50,000 tonnes of surplus oxygen last week, but paucity of cryogenic tankers and oxygen cylinders are the issue. Even here, yet again, some states failed miserably.
Government has released more than Rs 31,500 crore of disaster funds since the pandemic began, increased oxygen supply to 3,300 MT/day in the last few days and taken immediate measures to address Remdesivir shortages. In the face of such facts, it is evident that the government is doing more than its fair share to tackle the Covid crisis. The record turnouts for registration could be significant for India’s covid-19 vaccination drive, as the beneficiaries will not only enjoy easy access to free treatment, including covid care, but can also get vaccinated for free across all the hospitals empanelled under the scheme.
At 1.17%, India, despite surging Covid cases, has the lowest fatality rate in the world, which is a commendable achievement. While India took only 95 days to vaccinate 130 million or 13 crore people, the US took 101 days and China 109 days. A biased, leftist international media, that is trying to demonise India’s Herculean efforts at reining in Covid, would do well to know that, while India has a population that is over four times bigger than the US, our total number of Covid mortalities are over three times lower than the US’. Despite having a population density of over 455 persons per square kilometre, versus the US at 36 persons per square kilometre, India, has done an outstanding job in carrying out the world’s biggest vaccination drive, with over 13.54 crore people already vaccinated.
Hope people and the government learn from the past mistakes and understand sooner that only with collective efforts and actions, will we be able to beat the pandemic. The importance of pooling risks and protecting the poorest. The importance of labour rights and public health systems. Hope we understand that even if one person remains positive with the virus, we shall soon gain be in the same massacre again. Each life shall be important, specially the vulnerable ones. Now from 1st May, when India is going to open the vaccination for all its adult citizen, we as fellow countrymen hope that without any discrimination, we all , together shall sail through the storm.