Till now only Government healthcare professionals are combatting the pandemic. Where are the other stakeholders in the healthcare sector?
Given India’s resource limitations and constraints, both at the Centre and State level, it is amply clear that the measures to battle the Coronavirus require more than just State efforts. There is a need for a comprehensive public health national policy to make adequate capacity available, in true letter and spirit, till the grassroot level. When the clock is ticking and much remains to be achieved to handle an unprecedented pandemic, it is the time for the private sector to stand up and be counted and open up for the public.
The present scenario: On the one hand, we hear that the pandemic will last up to 2024 and on the other, we are told that the virulence of the strain will be low but infectiousness high. This gives rise to so many questions. Is herd immunity the only answer for us? Who are the major players in India who are protecting the country from the shackles of this disease? We all know that the task at hand is humongous as we have to manage a population of 1.3 billion, discipline them, take care of their basic needs and provide them with appropriate healthcare. Even the fastest-growing trillion-dollar economy in the world will need help at a time like this. There is an old adage that, “Charity begins at home.” Hence, the private sector, which gains a lot from the Government, must stand by it now and provide equal support to the country’s infirm and powerless population.
The role of the health sector: The Corona-warriors, hailing from the Government sector mostly, are giving their all in the fight against the pandemic but the resources are limited. Some private hospitals have come forward and they have been included in the list of hospitals approved by the Government for COVID-19 testing and treatment. They have the exact modules to be followed for treatment and submit daily data to the Director, Preventive Medicine. However, the big question is where are the others? Till now only Government healthcare professionals are combatting the disease. Where are the other stakeholders in the healthcare sector? If this were a war and all the security forces were not a part of it or doing enough, nobody would have spared the Government. This is a similar situation, just that the warriors are from the medical fraternity. Whether a war happens or not, the military is trained for it. Similarly, these are the situations for which doctors/nurses are helped, given resources and educated to serve. What about the Hippocratic Oath that doctors take? If not in these situations, then when is a doctor supposed to protect patients? It’s the same “Do or Die” situation for both, soldiers and medical professionals. It is the same threat to life and a family to provide for. It’s the same as keeping the country before self. It’s the same selfless and unconditional love for the countrymen that should be the guiding principle for healthcare professionals in the private sector now. The private sector hospitals should rise to the occasion now and take the responsibility of training healthcare staff, organising sessions and making their infrastructure available for the nation to fight this Corona war.
The same goes for pharmaceutical giants. All grants, permissions, compensations and concessions were made by the Government to bring them to this stature. So what about their responsibility towards the nation? How come everyone is selling masks and sanitisers at double the cost? Where is the personal obligation and commitment to the country? Aren’t we meant to give back to the country in times of need? What about the Corporate Social Responsibility (CSR) of these pharmaceutical companies and corporate hospitals? In spite of the present Financial Year 2020 CSR estimate of Rs 2,000-Rs 3000 crore, this is only a drop in the ocean when it comes to the support that is actually required on the ground to fight the pandemic. This is the time that India Inc. should give with both hands to support the populace and country which has made them what they are, in the first place. Sadly, there are very few examples emerging from this direction.
Also, now that the Government itself has a PM Cares Fund dedicated for the COVID-war and is open to accepting all CSR funds, it needs to be decided whether these funds must be merged in the Central repository or used for welfare measures in States. There is a need for a centralised system which will reduce duplication of efforts and make the funds immediately available for use without disturbing the already planned projects.
Major challenges: COVID testing, even at subsidised rates and a cap of Rs 4,500 per test, is a luxury even for the middle class, let alone the underprivileged. Hence, the people who are most susceptible to disease will not have affordability or accessibility to these tests. How many tests can be done daily? And how many days will it take to screen the whole population? The Indian healthcare workforce of around four million is majorly employed in the private sector and that, too, mainly in metro and Tier-I and II cities.
This lopsided availability needs to be addressed once we are on our way to fighting COVID-19 throughout the country. The World Health Organisation (WHO) standard of 22.8 doctors and nurses per 10,000 population is met by India, keeping aside the distribution patterns. A whopping 70 per cent of the population lives in rural India, which is backed by only 33 per cent of the healthcare workforce.
The Primary Healthcare Centres (PHCs) are the ones on whom the onus of care lies in these testing times. These centres, which have been made outdated by private practice, now have to be at par to combat the disease. So where are the privileged and fund-surplus clinics and private practitioners now? If they cannot open their clinics to help the nation in its time of need, why can’t they work in these PHCs? Primary healthcare workers are already scanning zones for Corona-positive cases. It is time for the specialised lot to come in and offer their services.
There is going to be an absolute dearth of ventilators, beds, ICU set-ups, nurses and doctors. COVID-19 has impacted hugely the supply of medical aids, be it electrical, mechanical, pharmacological or economical. The increasing demand needs to be taken care of and planned for, both in terms of availability and supply logistics. In an economic slump, how will the expenses be met, and on what opportunity costs? Pharmaceutical giants need to step in and take full responsibility for making supplies available with logistics, whereas the hospitals need to provide services and make operations smooth.
The Coronavirus crisis at the moment has an unclear path. Actions will depend on a hypothetical acceptance of either a delayed recovery or a prolonged contraction. Delayed recovery if we see a count rise till April, followed by control through social distancing, when the testing is fast and the virus is seasonal, will give an optimistic public approach by April.
Or else the prolonged contraction phase where peak is not achieved until May, with ineffective testing and failed social distancing, and the virus is non-seasonal, the virus will trail till the end of the year keeping all engaged and resources exhausted. In both the scenarios, the role of the private industry and pharmaceutical giants is large, with immediate action required. At the moment, the major challenges that are apparent are bridging the gap between knowing and doing. That the COVID-19 has an exponential growth is easy to know but tackling it is difficult unless similar experiences were seen and lessons were learnt in the past.
Response management: Private hospitals need to start planning critical care massively to control the pandemic surge in healthcare systems. Without this the number of deaths cannot be contained. Achieving it once can give us the confidence to fight resurgence later, if any. Capacity-building to empower the Government by private hospitals is required. Simple things being done religiously right in a controlled and quick manner is required. Surveillance of the disease, followed by contact tracing and then quarantine, needs all private hospitals, pharmaceutical companies and IT giants to step up together. The quicker and wider we screen, the better we can control the devastating outcomes. This will in turn relax social distancing measures once we are down the slope for positive cases.
The credibility and accessibility to antibody test screening needs to be widely made available to understand zero-prevalence and to start with the concept of herd immunity. If the private sector will not help now, it will become very difficult to restart the economy. The vicious cycle needs to break.
Corporate Social Innovation via philanthropy, media advocacy, social responsibility tasks and shared values by the private sector will need to leave a positive impact not only for the present but also for the future, when all will be well. It can also be taken as brand development.
If the private sector doesn’t come to the aid of the nation on its own, then the Government will have to take over hospitals and laboratories for some time for creating ICUs, isolation wards and testing samples. Universal healthcare is everyone’s right and the Government will need to ensure its availability across all strata of population throughout all geographical boundaries. It is time to double up the responsibilities. After all, we are all in this together.
(Writer: Sakhi John / Kritie Pasrichaa; Courtesy: The Pioneer)