Cities need more ICUs, specialist staff to fight COVID-19, say experts

With lack of specific treatment for COVID19 and absence of a strong healthcare infrastructure and specialists a second wave of infection could lead to an extremely challenging situation in small cities of the Mumbai Metropolitan Region MMR warned health experts on Friday They cautioned that if the state government does not shift its focus to cities like Kharghar Panvel Bhiwandi Mira Bhayandar Vasai and Virar now then it might become a challenge laterMumbai Thane and Navi Mumbai are set to handle a second outbreak of novel Coronavirus infection expected early next year but small cities or regions within the MMR are yet to gear up said the health expertsSenior allergy and asthma specialist Dr Wiqar Shaikh said the pandemic has significantly stressed the public healthcare system in India because the countrys expenditure on healthcare was pretty low in the past decade In 201920 India spent merely 129 per cent of its GDP Among the countries classified as the poorest in the world Indias share of public expenditure on healthcare is far too low than other nationsMira Bhayandar Municipal Corporation health worker carries the body of a person who died of COVID19 to the Tembha Hospital mortuary File picSatej ShindeMoreover India has 85 hospital beds per 10000 citizens and eight physicians per 10000 people and therefore the countrys healthcare sector is simply not equipped for a crisis such as COVID19 said Dr Shaikh referring to a Fitch study He also cited a Confederation of Indian Industry CII report that said Indias public healthcare system is chronically underfunded leaving huge gaps in the primary healthcare deliveryMore than 80 per cent of the population still does not have any significant health insurance coverage and approximately 68 per cent of Indians have limited or no access to essential medicines he said The availability of free medicines in public healthcare facilities has declined to 89 per cent from 312 per cent for inpatient care and to 59 per cent from 178 per cent for outpatient care during the past decade he addedTemporary centres a mustUnder these circumstances Dr Shaikh said it is extremely necessary to have temporary jumbo COVID centres with adequate medical staff medicines lifesaving equipment such as oxygen and ventilators and adequate investigation facilitiesDr Subhash Hira professor University of WashingtonDr Ketan Vagholkar professor of surgery at D Y Patil Hospital said The first COVID19 wave should have served as a big eye opener to healthcare systems And for the MMR one has to accept that it has a heterogeneous culture of healthcare systems The bigger cities like Thane and Navi Mumbai have a stronger healthcare infrastructure backed by a medical teaching hospital as compared to peripheral cities MMRs smaller cities had a tough time during the first wave itself and thats because they didnt have large secondary health care centresWith a second wave already in Delhi and its neighbouring states these smaller cities should become alert and strengthen and consolidate the healthcare infrastructure he addedSecond wave will be worstThere is an urgent need to set up good healthcare infrastructure that has essential speciality and services with respect to treating respiratory ailments and other complications of COVID19 Dr Vagholkar said We also need a standby healthcare guard comprising doctors nurses and supporting staff in addition to basic medical facilities for the second wave which would be more stressful than the firstDr Subhash Hira professor of Global Health at the University of Washington said Mumbai with its neighbouring districts are already facing a second wave of COVID19 While BMC has sufficient resources and surplus funds to tackle it the neighbouring Panvel Municipal Corporation PMC that is just two years old is reeling with the lack of funds The second wave which is believed to be more deadlier than the first requires more ICU and hospital infrastructuresDr Hira added An emergent pattern of illnesses seen in COVID19 patients suggests a multisystem involvement both during acute stage and postCOVID19 stage that lasts about 69 months or longer For Panvel corporation it will require a wider specialist staff not just respiratory specialists Hence the PMC needs to plan multispecialty hospitalsFewer hospital beds and fewer multidisciplinary specialists will adversely affect the demand and supply equation in smaller cities This is when COVID19 treatment gets very costlyKeep scrolling to read more newsCatch up on all the latest Mumbai news crime news current affairs and a complete guide from food to things to do and events across Mumbai Also download the new midday Android and iOS apps to get latest updates MidDay is now on Telegram Click here to join our channel middayinfomedialtd and stay updated with the latest news