‘If not the virus, an overwhelmed health system can kill’
4 min read . Updated: 25 Mar 2020, 12:40 AM ISTSeethalakshmi. S
We must understand that no doctor can work in a Covid unit for more than six hours a day, says renowned cardiac surgeon Dr Devi Prasad Shetty
Bengaluru: It’s time to ease regulations for medical education, and certify final year students so that more doctors can be sent into Covid-19 wards to treat the flood of patients that India is soon likely to have, says renowned cardiac surgeon Dr Devi Prasad Shetty, who is also chairman and founder of Narayana Health. In his nearly four-decade career, Dr Shetty has been known for pioneering programmes to bring life-saving surgery within the means of thousands of poor families. In fighting the coronavirus pandemic, he says India faces its biggest health emergency ever. If we do not pull out all the stops to scale up the health infrastructure, we will have to deal with the kind of situation Italy is facing, he said in an interview. Edited excerpts:
You have said Covid-19 will hit us hard. How is it different from Ebola or H1N1 or any other outbreak that India has faced earlier?
The difference is that this virus is extremely contagious. It spreads through casual or minute contact with the infected. Though it is not yet airborne, it is dangerous because it spreads through droplets. For instance, if someone has coughed into a mobile phone and you take that phone, you contract the virus. It spreads like wildfire and that’s what is happening across the globe today. One person can give it to three people. It multiplies. Italy is the best example—cases jumped from 300 to 2,000 in less than three weeks. So if it is not the virus that kills, it will be an overwhelmed health system that can kill.
Is India’s public health system prepared to handle a pandemic of this proportion?
The National Health Services (NHS) in the UK and the US health system have not been able to manage the virus. In the whole of Bengaluru, for instance, we may have just 1,000 ventilators. If the virus spreads, we will run short of ventilators. If we do not take immediate steps, we will reach a situation where doctors will be pushed to decide who goes home and dies, and who dies in the hospital. That’s how grave it is. And that is what is happening in Italy and the US. So you can imagine our situation in India.
The government is trying to contain it, but are citizens doing enough?
The educated class in India was a big letdown. What is the need to defy instructions on social distancing to safeguard your own health? This forced the government to impose a curfew, clamp Section 144 and more. The government had no choice but to declare compulsory lockdowns. We could have avoided all of it and locked ourselves up much earlier for our own health.
We in India have a golden opportunity to contain the spread by ramping up our health infrastructure immediately. We need to urgently start mass production of ventilators and personal protection equipment by local companies. Organizations such as the Defence Research and Development Organisation(DRDO) must come together in this mission. We need ventilators, ICU beds and suction instruments. That’s all. But we must have enough of them, keeping in mind the rapid spread we are seeing daily. We can do it.
What about the shortage of doctors and medical personnel?
Yes, Italy’s biggest problem is shortage of skilled manpower and beds. So what did they do? The medical council told universities to start giving out certificates of practice nine months ahead of students completing their courses. This way, they got 10,000 doctors into the system immediately to attend to emergencies. Then, they got 300 intensivists from Cuba. In a country that has one of the toughest medical education norms, they have scrapped final examinations and got students into the system. In India, we need to do all of that right now.
Is that possible in India where we have so much red tape?
Our doctors are our assets. We have 50,000 doctors/specialists and medical students. Then there are another 20,000 students who have graduated in medicine from China and Russia. Don’t bother about examinations now. Make them board-eligible and bring them into the healthcare force immediately, so that we don’t face a shortage of doctors. We must understand that no doctor can work in a Covid unit for more than six hours a day. Therefore, we need a large force of medical personnel. We have huge medical colleges and teaching hospitals in all states. Open all of them and bring in these thousands of doctors to be available to treat the infected.
There is no doubt that we must liberate regulations at this hour. Make online consultations and e-prescriptions legal in India like the rest of the world. We cannot afford to ask patients to come to hospitals at this juncture and infect more people. The Medical Council of India (MCI) has a huge role to play in these critical times to ease a lot of regulations.
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