BENGALURU: Even while there has been a considerable decline in fresh Covid-19 cases, the second wave is not over yet. Dr Devi Shetty, cardiac surgeon and founder-chairman, Narayana Health, speaks to TNSE about the third wave situation in the country, in the state and how not just health infrastructure, in terms of oxygen beds and ICUs are important, but how special planning and action needs to be taken towards getting human resources ready.
Tweaking the NEET exams is one of the easiest solutions, he says. Dr Shetty, who heads the expert committee on combating the third wave of Covid-19 in Karnataka, speaks about ways to deal with vaccination hesitation and how inoculation is very important to reduce the impact of a third wave.
We are talking about the third wave. Are we done with the second wave? When do we expect the third wave?
No, we are not yet done with the second wave. Half the patients who are in ICU are still there. Lot of people have had severe lung infections and ICUs are not fully empty of Covid patients. But yes, the new infections have come down.As far as the third wave is concerned, I do not think anyone can predict this. We should be prepared for the next wave any time after September.
When you say we must be prepared, what specific preparations can we make?
We have to assume that the third wave will be 30 per cent more severe than the second wave. I can’t say for sure whether it will be as bad or worse than the second one, or whether it mainly involves children, etc. If we think that the next wave is going to be less severe than the previous one, we tend to lower our guard. Failure to prepare is like preparing to fail. We should be prepared.
We are lucky that in Karnataka, our government is proactive. There is a task force created and the Chief Minister and Health minister are involved in checking the preparations, etc. However, our biggest worry is that every wave throws up new surprises.When I was a medical college student, I had a poster in my room which said, “When I had answers to all of life’s questions, they changed the question paper”. This is what Covid is doing to us. So, we should be prepared for surprises. Creating paediatric ICUs, oxygen beds as much as possible, health infrastructure, will definitely not go waste. We desperately need more paediatric beds, ICU beds, oxygen beds, etc. These are progressive steps taken by the government.
Now that there is work happening on health infrastructure, what about human resources? Doctors are exhausted. How do we manage this crisis? Is there a quick fix to this?
Yes, there is a quick fix. There are only a few countries in the world which can come up with a quick fix and we are lucky we can do it. If you want.The NEET P-G exam is scheduled in September, and that is too late. There is a possibility of Covid hitting at that time. We may not be able to conduct the exam, so this should be advanced and held as early as possible with just one month’s notice to students. Then, the results need to be published very quickly.Around 1,80,000 doctors appear for NEET.
Of those who clear the exams, 35,000 doctors can be directly posted in the Covid ICUs. About 1,40,000 doctors should be told to join as government doctors on a temporary basis and paid stipends for the duration they work. Based on how many months they have worked, they should get the grace marks for the next year. There should be a record of their attendance, etc. Giving grace marks to a doctor who worked for a government facility is standard procedure, so you are not doing anything new. These doctors should be posted in Tier-2 and Tier-3 cities with enough facilities for them. It is here that the healthcare staff are needed the most.
Has this idea been proposed to the government ?
Yes, there has been a discussion on this. Their fear is exploitation. How do they monitor if a private hospital provides a certificate saying someone has worked in a Covid ICU? Everyone can come up with a certificate. But I would say that’s the reason we should recruit them as government hospital employees. There will be documentation, attendance records, etc.
There is a lot of vaccine hesitancy amongst people. How can this be overcome?
Today, everyone is moaning about not having enough vaccines. Trust me, in another month, we will have a good number of vaccines to enhance the pace of administration.Then comes the issue of vaccine hesitancy. This has to be addressed NOW. For this, other than creating awareness, videos of housemaids, helpers, etc, showing their entire family vaccinated, can be publicised. This will be better reassurance than celebrity endorsements.
Also, certain policies have to be put in place. For instance, people should be allowed to take public transport with either a Covid-negative report which is not less than a week old or with a vaccination certificate. Even if it is one jab, that’s good enough. All employers have to come up with a similar policy for their staff. All housewives should encourage and support their housemaids, drivers, etc, to get vaccinated.
Another policy change which has been suggested to Karnataka is that vaccination should not remain in the refrigerator for more than 10 days. If a hospital gets 50k vaccine doses, it should administer all of it within 10 days or give it to another hospital which doesn’t have vaccines. This way, government hospitals will become efficient and private ones won’t be able to hoard it. Also, vaccination spots cannot be at a far away place and people made to wait in long queues. It must either reach their place of dwelling or work. Insurance companies too should insist that policyholders get vaccinated .
Also, government hospitals are considered as potential hotspots and many people avoid going there for vaccination. The government should provide vaccines to all small and big private hospitals too and pay Rs 150, which is the cost to administer the vaccine. There is Rs 20,000 crore in CSR funds available and this money should be mostly spent now on vaccines. In our experience, very few people who have had both doses of vaccination have landed in ICUs.
Many post-Covid complications are being seen. Is there a strategy in place to handle this?
Why it happens, who it happens to, no one knows. In general, asymptomatic patients are not suffering with this. It is mainly those who have stayed in ICUs and have had steroids, etc. There surely is work going on to handle this. However, the only solution I would say is to vaccinate and ensure the next wave is similar to the common cold.
There is a buzz in political circles that you have been asked to join the Union Ministry as Health Minister. Is this true?
I have absolutely no political interests.
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