Strong as we are united & weak as we are divided

Why are we choosing to loose a war, which we can win and have to win.

"We are only as strong as we are united and weak as we are divided."

These are my thoughts collated on hearing so many experts and especially influenced by a most amazing talk by Dr Devi Shetty. These are my views, and I am not an expert on the whole topic or the subject and may understand well only few parts of the problem but just a concerned citizen who has collated what experts are saying with some of my own thoughts. I have scribbled my few thoughts, albeit as a novice. 

We seem to be losing the battle of the 2nd wave battle, but the war is still far from over and to win the war we need to be united and a leadership with amazing foresight to win this war and this cannot be one person but a team with one clear focus and enablement to help India win. The call of the hour is a united leadership with a single purpose of defeating this virus and building a core team capable of taking out-of-box decisions; and not a disparate fragmentation with people trying to play politics.

A lot of people still do not understand the whole situation as they have not seen what is happening on the ground especially in Delhi, Mumbai, Bangalore etc. We may blame the foreign media for trying to spoil India’s image but what they are showing is what is happening on the ground.

The first step is understanding the situation on the ground. The reported cases are 3.5 lakhs, actual numbers may be 5 to 10 times higher. With at least 5% requiring hospitalization, it may mean at one time it may become 80,000 to 1 Lakh admissions per day or taking treatment at home. With an average length of treatment of 10 days - it means 10 lakh beds on a conservative level.

India does not have those numbers and simply it may not be possible to do that as we "simply do not have the numbers of doctors & nurses required to man those number of beds" Having beds alone will not mean we have solved the problem as we need staff to man them and the hospitals simply don't have the staff to man the beds thus the level of care has fallen with no one to blame as everyone is trying to do their best.

Also, we need to understand our enemy that is attacking us. We need to understand which variant it is and for that we need to be doing much more genome testing as only when we understand the enemy can we plan to beat it. Once we understand the variant without fearing what the world will think, we are already beyond that situation. Let the world think what they may but we need to let scientists know what is happening and in this we must look up to the standards set by the UK government and scientists. Even South Africa & Brazil have been open about it and we must understand the variant and what will work or not work against it.

Acceptance is the first step in your plan for making a winning strategy. Let us hope for the best but plan for the worst. 

So, what is the solution? Again, I am not an expert on the whole topic and my only understand insurance and some other parts but here is my analysis on how we can win.

We need to increase the number of Covid beds and the staff that will man them. Also accept that people treating low & medium level patients at home will reduce the stress on the hospitals & quarantine centers. 

Yes, oxygen is short, and it requires a clear-cut strategy to win on this and together we can solve this in the next 2 to 4 weeks at maximum as this is mainly a problem of logistics and we have some amazing brains in that area.

We need to start by solving the oxygen problem. All hospitals must immediately work on getting their own oxygen generation plan. Full effort needs to be put on importing these plants from all over the world and installing them in hospitals with the priority being given to places where virus is first spreading and then expected to reach. Handing over to Army logistics the task of getting the oxygen needs for each hospital and building a system of ensuring the delivery to them. 

The second part is understanding of the fact that people are taking treatment at homes and that is severely reducing the strain on the hospitals, so let us encourage that. We need oxygen tank filling stations every 4 km, as we need to encourage people to take treatment at home. Yes, there may be misuse by few but it will help lakhs. A person should be able to get his home oxygen cylinder filled with a reasonable time without any inconvenience. We also need to make the cylinders & accessories available. The focus needs to move to ensuring that people have the access to right quality equipment at reasonable price and are even able to rent it, availability of the ability to rent will reduce the stress on numbers. Use them till you need them and let it be used by someone else when they need it but for this people will need the confidence that we will have them when we need the same.

Next step is availability of the required medicines for the treatment factoring in the worst-case scenario and that people will hoard these medications at home as they don't have the confidence, they can get them at the time of need. India has the capacity & the capability, let us use it to produce the number of doses required and come up with the right treatment protocols. Again, supported by logistics & enablement to make these available. The public & private teams need to work in alignment. There are good citizens give them the space and place to shine in these times.

Creating and helping people set up home care centers, import & build huge stocks of oxygen generators & cylinders along with right guidance to help people manage Covid patients at home. This will result in enabling the hospitals to be able to focus on the worst affected. Only admit those who cannot be treated at home. Set up a central treatment at home center to support all those taking home treatment in each city & state, allow hospitals & fund them to set up these divisions and finally encourage & fund the individual plus companies who can do that. They should be one stop shop for all that a family needs for treating a patient at home, so they are not running pillar to post.

Next is to ramp up the hospitals & beds. Let us not wait, waste is better than to be caught off guard. Hospitals should not be allowed to ask patients to organize for medication, oxygen, or any other thing. We need to make them self-sufficient; how do they expect patients’ families to get stuff in emergency and that's what is causing the panic and the shortage. Create a mechanism where they have one center like a war control room which they can approach for anything they need. They have more capabilities to organize for what they need than an individual. Again, stop creating the panic situation. Lakhs of oxygen concentrators with right specifications need to be imported, the government must waive all duties, facilitate the import, and focus on ensuring that right quality is being imported and the sale can only happen at cost or x amount of profit which incentivizes the people to invest time & effort to do this and to provide them with financing to fund their purchases & stocks. This need to be made into priority lending and done immediately.

Change insurance claim norms, here IRDA needs to take charge. This is not the time for the change of leadership, give an extension to the current Chairman as he has done an excellent job and let him lead the charge. Insurers need to stop insisting on hospitalization for claims, this putting a huge strain on hospitals and people who do not even need hospitalization are getting hospitalized. Claims to be paid for treatment at home, the cost of the same need to be estimated and a fixed cost need to be paid per person which is adequate. This will reduce the claim amounts substantially but there will be misuse as we do have unethical people who will try to take advantage buy let us not hurt the 99% good people for 1% bad people. A covid pool needs to be created for claims and it need to cover all companies’ excess losses and a cover needs to be provided to them for excessive losses so that we can maintain the health of our insurance sector and to get companies to be confident & aggressive in paying the claims. For the time being we can dip into the terrorism pool till the covid pools becomes large enough and this can be temporarily funded too.

Now the next big challenge on ramping up the staff at hospitals, they cannot service more beds without the staff. There Dr Shetty has some great suggestions on allowing all the 2nd & 3rd year nursing students & doctors to work in covid wards and giving them credit for the same. Nothing in life is better than practical experience and they at least have some amount of training. Another batch of at least 5 lakh volunteers need to be taken from various Paramilitary & security forces and immediately be given training to enable them to work & help in the Healthcare system. 

This is a biological war and it need to be treated as same.

Finally, is the vaccination drive. In this we need to focus on vaccinating the work force as people working in various jobs are the economic engines of the country and are what will keep this nation running so they are Frontline warriors as any other person and are also the super spreaders are they must work to support their families. Immediate financial, infrastructure & financial support need to be provided to vaccine manufacturers to increase their production capacity. Support to be provided to the other vaccine manufacturers whose product is almost ready to help them reach a final yes or no and to provide additional emergency use approvals where the vaccine has a great chance of success. We need more sources of vaccines with production in India. Aim needs to be vaccinating maximum people in the next 3 months. Enable entrepreneurs here to provide vaccination at home, in societies & workplaces. We do not want people running to hospitals for the same as they are already under huge pressure and can become infection points thus compounding the problem than helping. Door to door vaccination needs to be encouraged and we have entrepreneurs in India who will deliver on this. The priority needs to be the crowded cities as these are the hubs of the infections and need to be managed. Corporates can contribute by paying for their employees etc. and let the pharma companies make some profit so they are incentivized to ramp up production, give them space, building and the capital costs - it would be a very miniscule cost in the overall fight and can easily be recovered from a tariff on exports.

There are a lot of other issues like space for crematoriums, right governance, right information etc. and I can keep writing but it does not make sense. 

Again, I am not an expert but just a concerned citizen who wants to see India and Indians win. I may be totally wrong and my apologies for the same, but I just could not stop myself from venting on above.

We have a lot of intelligent people and would love for you to give your comments & ideas so we can at least create something which has a little value & helps at this time of a Biological War.

Don't be quiet and just be an observer. Do write your views and comments.