Health workers collect swab samples for COVID-19 testing at a containment zone in Patiala Wednesday July 8 2020. (Photo | PTI)
Health workers collect swab samples for COVID-19 testing at a containment zone in Patiala Wednesday July 8 2020. (Photo | PTI)

Express Expressions | 50,000 more doctors needed to reduce COVID-19 deaths: Dr Devi Shetty

The New Indian Express, and senior journalist Kaveree Bamzai on TNIE’s Expressions, a series of live web casts with people who matter.

While early lockdown helped the government prepare for managing the Covid-19, we need to have a ‘fluid workforce’ in healthcare which should be diverted wherever there is a peak, said Dr Devi Shetty, Chairman, Narayana Health, Bengaluru, in a conversation with Prabhu Chawla, Editorial Director, The New Indian Express, and senior journalist Kaveree Bamzai on TNIE’s Expressions, a series of live web casts with people who matter.

There is still a lot of panic and fear related to Covid19 even though the disease mortality in India is among the lowest. How successful in hindsight has the lockdown been? Also, was that time used to the best that we could?

The best strategic decision that the Indian government took was to go for an early lockdown and the second best decision they took was to extend it. When Covid entered India, we knew it would spread and we needed to be prepared. A key requirement to protect our healthcare workers, Personal Protective Equipment, for example, was a must and at that time there were only three local manufacturers making it in India. They were nowhere close to fulfilling the needs of a country of 1.3 billion people.

Two months into the lockdown, with the government interventions we have over 100 PPE manufacturers. Also, if the lockdown would have been delayed, the health system would have been overwhelmed and half the country’s doctors would have been infected without proper attire. Our understanding of the disease has also evolved.

You had been suggesting two key things to contain the outbreak — one to relax the norms to allow trained healthcare workers to take over the case management and setting up large centres for Covid-19 patients instead of spreading them over to small centres. It does not look like much has happened on that front. Do you agree?

In Karnataka, initially when the cases were low — it was mainly one or two government hospitals which were managing Covid-19 patients. On the other issue of relaxing norms for health professionals, I am optimistic. If we have to reduce mortality, we need about 50,000 more doctors and about 1.5 -2 lakh nurses.

This should be a fluid workforce and should be diverted wherever there is a peak as there would be multiple peaks in India at different times.

There are about 25,000 doctors pursuing speciality degrees but have not completed them; they can be utilised and sent to work in district hospitals.

Over the years, India’s focus changed from infectious disease to lifestyle disease? Is that in some way impacting our management of the Covid crisis or do you think some kind of re-engineering of medical system is needed?

It is interesting how policy makers run the policies in order to protect people. For example, in most developing countries, tuberculosis, malaria and HIV get a lot of focus. These three diseases kill nearly 3 million people every year. On the other hand, lack of basic surgeries such as emergency C-section, laparotomy and those for compound fractures kill about 17 million people annually.

If we design our health system around surgeries rather than managing diseases, including infectious disease, we can do much better. Community health centres that are equipped to carry out simple surgeries can manage many other diseases but it cannot be other way round. Our healthcare strategy has to change to build medical infrastructure around surgeries.

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