Saving lives: on public health conveniences in India

Assist. Prof. & author Pyar Singh Thakur

After painfully grappling with numerous stumbling blocks during the first wave of corona-19 that peaked in mid-September last year, India appears to have learnt meager as a more treacherous second corona wave is wrecking the country. Adored time was wasted as futile before critical conveniences began to be augmented and supplemented to meet the demands of the second corona wave that is soaring at an unparalleled step, leading to health-care conveniences being prostrated; the number of death tolls shows a fast growth of 10.2%. A mad scurry for hospital beds, oxygen, medicines, vaccines and even a quick funeral are witnessed in many cities of India. If the nitwitted rat race for recovering plasma and hydroxychloroquine even in the absence of any proof or evidence of health leveraging was seen and observed last year, there is now hysteria to get remdesivir injection for hospitalized patients, leading to drug dearth.

Though a small trial did depicts that the drug shortened the time to recovery, the World Health Organization’s large Solidarity trial found no evidence of its leveraging in reducing mortality, ethics, initiation of ventilation or substantial rebating in the time to recovery. Being an intravenous injection, remdesivir injection can be administered only in hospital supervisions and care, and any benefit might be seen only in moderately or normal sick patients. Due to an acute dearth of beds, the disease in most patients is often serious at the time of admission to hospital. The Health Ministry’s July 2020 COVID-19 clinical management protocol does suggest that remdesivir injection may be considered in patients with moderate or normal disease. But steroids (a type of chemical substance in human body to improve strength) such as dexamethasone may be better at bolstering patients on oxygen support or on ventilator assist from progressing to respiratory or breathing failure and death. The first corona wave in India and elsewhere clearly accentuated the weaknesses in health delivery. Yet, nearly a year after hospitals were increased beyond capacity and beds and medical oxygen supplies were in short supply, no attempts have been made either by State or Union governments to significantly stretch medical oxygen supplies. According to reports, the Union government took eight months to initiate steps to build oxygen generation plants that will reduce the reliance on pressurized liquid oxygen. Of the one hundred sixty two plants approved, only thirty three have been installed, the Health Ministry tweeted. You have seen that large buildings converted into temporary and passable hospitals, without necessary oxygen supplies to individual beds and sufficient care workers, can at best serve as isolation centers. Despite private health conveniences and support playing only a minor role in treating covid-19 patients last year, NITI Aayog in a 2021 report sees it as a key essence and top- priority to get private parties to invest and expand in tier two and tier three locations, and now increase vaccination at high speed and access to all citizens as this time is not for delay. Furthermore, to provide public facilities and safety, there should be a task force at each district level and block level under the vigilance and control of a nodal officer of each district and block of the country, also this task force keep eye on hoarding of oxygen, drugs, vaccination substances and illegal storage by the suppliers, fraud health services organizations and traders. Public must forbear in this pandemic emergency to serve themselves by government, administration and health care centres as these are rudimentary help and support to the public and complince the protocol of Covid-19. The unprincipled people should be dealt strictly under the baton of law and order in order to care for public with utmost care and health facilities. With the virus unlikely to be eradicated in the near future, being better prepared and managed with vaccines and health-care support and health conveniences will be a candid way to save lives.

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