CENTRE’S BELATED STEPS MUST INCLUDE HOLISTIC APPROACH TO HEALTH
Like many parts of the world our country too is grappling to prevent spread of Covid -19 to the third stage. This is a precarious situation wherein every step has to be taken cautiously with lot of precaution. The medical, paramedical staff and the safai karamcharis are at high risk. Several doctors and nurses have already lost their lives in China, Italy, Iran and Spain after they caught infection while caring for the sick.
Even though flu is a common disease but sometimes it could take serious forms. The world has witnessed the influenza pandemic of 1918-1919, known as “Spanish Flu” or “La Grippe”, which killed between 20 and 40 million people, which is more number of people than in the First World War. More people died of influenza in a single year than in four years of the Black Death Bubonic Plague. It has been cited as the most devastating epidemic in recorded world history. Between 17 and 18 million Indians died in this. We lost 6% of our people. More women – relatively undernourished, living in unhygienic and ill-ventilated dwellings, and nursing the sick – died than men. The 1918 pandemic is believed to have infected a third of the world’s population.
But those were different times. Medical science was not as much advanced to fight back the disease as it is today. In comparison we have much more advanced medical care nowadays. We have more information about spread of diseases and their control measures. The fear, however, is that there is much more increase in mobility which can be the cause of fast spread of infection. In India so far we have been saved of community spread of Covid-19. But there is lot of uncertainty in the coming days.
Keeping this in view, the government, on the advice of medical scientists has taken certain measures including lock down. Social distancing, (or better call it physical distancing/medical distancing), is an important way to prevent spread. The Johns Hopkins COVID-19 modelling for India points out that ‘social distancing is an important step as the virus spreads through droplet infection. But a national lockdown is not productive and could cause serious economic damage, increase hunger and reduce the population resilience for handling the infection peak’. The poor people, which form more than 50% population of the country, may not be able to withstand this situation if some effective measures are not taken by the state to fulfil their basic needs for sustenance of life.
In such situations people look towards the state for care and help. The announced packages by the Prime Minister and subsequently by the Union Finance Minister are meagre in the wake of huge requirements for investments in the health system to provide for safety equipment, personal protective equipment (PPEs), increase of beds and other infrastructure and to fulfil basic needs of almost 50 crore of our 54 crore labour force, which has been rendered jobless suddenly and has no means for livelihood due to lockdown.
The government woke up too late and then abruptly announced the lockdown and curfew. This decision without adequate warning and preparation has caused lot of displacement among the migrant workers in different states. These people are now facing hunger and we expect them to face Covid-19? When the first case was reported on January 30, many at the responsible positions in the State Assemblies and Parliament started spreading myths for the sake of image management for the government in the face of the Coronavirus scare. Scientific guidelines were also totally ignored, when some groups were seen taking out rallies and jostling with each other beating thalis, playing ghanties and shankhs with the misplaced and woefully misinformed hope that sound would kill the virus. In many such rallies, politicians and bureaucrats were seen leading. It was even more sickening to watch the current Chief Minister of Madhya Pradesh taking oath of office in the presence of hundreds of people totally in contravention to the medical advice.
It was good on the part of the government to announce insurance coverage to doctors for Rs.50 lakh, for nurses Rs.30 lakh and others in the health sector for Rs 20 lakh, but this package once again ignores the emergency needs of health professionals and paramedicals and other workers of the health system to meet the challenge. Immediate investments are required in the health sector for PPEs, masks, increasing beds in hospitals and creation of new facilities in school buildings and stadiums to meet the emergency situation of testing, segregating and quarantine of those tested positive in these places. As per estimates our country has about 40,000 ventilators only. Govt. has decided to purchase 40000 more. But in this global crisis, it may be difficult to get these from abroad. However, the requirement is being estimated to the tune of ten lakh if the situation worsens.
We need immediate steps to improve nutrition level of our population. An announcement of Rs. 500 per month to those with Jan Dhan accounts, many of which have already been closed, is very insufficient. Government must ensure balanced diet for all citizens providing 2,100 calories and required amount of minerals and vitamins.
In a very bold statement, senior consultant gastroenterologist and transplant hepatologist from Hyderabad, Dr. Manisha Bangar, challenged government’s approach and dared government not to waste energy on ghantis and thalis, but care for those engaged in care of the patients. She suggested the government to ask corporate to dig into their deep pockets and to take money from the huge amount of offerings lying with our temples.
Several doctors from the organization called Indian Doctors for Peace and Development (IDPD), who are engaged in relief work, have reported from different states the difficulties being faced by the health professionals in the absence of basic items like masks and gloves.
The Kerala government has released a relief package of Rs. 20,000 crores. Punjab, Rajasthan and Delhi also have come out with economic relief packages. United States of America has passed CARES Act (Coronavirus Aid Relief and Economic Security) which includes cash relief, small business loans to enable payment of wages to workers, industry specific loan guarantees that largely protects cargo industry and its workers, health care that includes free health care, extension of tax deadline, provision of loan holidays to students and industries. Australia has come out with $189 billion economic rescue package. Germany, UK, EU etc all have come out with economic relief packages as well. Why is our government refraining from being liberal in announcing the package?
What we need at present is to do large number of tests at random because the number being projected may not be correct in the present situation. Stress level among the population is increasing, including among children and teenagers. Lot needs to be done to allay their fears and reduce stress level. Such stress can lead to anxiety, depression, loss of sleep etc. Not much is being done in this direction till date.