As the number of COVID-19 cases increases exponentially across the country, the healthcare workers are working in a dangerous situation, as they are forced to work without proper personal protection equipment (PPE).
By Tuesday evening, India had reported 527 positive cases of the novel coronavirus. The experts, however, say that the country may have somewhere between 300 to 500 million infected people in the coming four months. Though many of these might still recover or face only mild symptoms, thousands will require hospitalisation. The already distressed public healthcare system of the country is set to face serious challenges.
According to data by the Union Health Ministry, as of March 17, there is one isolation bed per 84,000 Indians, and one quarantine bed per 36,000 Indians. The data states there is one doctor per 11,600 Indians, and one hospital bed per 1,826 Indians.
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Though the predicted number of cases are roughly between 300 to 500 million, the Health Ministry has reportedly decided to arrange 7.25 lakh body overalls, 60 lakh N95 masks and one crore three-ply masks. The estimates of Preventive Wear Manufacturers’ Association of India (PWMAI) say that to deal with the influx of the patients, a minimum of 5 lakh health workers including doctors, nurses, paramedics, maintenance and other support staff will be required. If three units of PPE are required per person a day, about 15 lakh PPE will be required daily.
“This is a conservative estimate,” said Sanjiv Relhan, PWMAI chairman. “Even if we consider one PPE per day per health worker, we cannot provide it. The WHO guidelines suggest you have to change your PPE when you go from one patient to another. We cannot even imagine it.”
In the media briefing by the Health Ministry and the Indian Council of Medical Research on Sunday, when the joint secretary Lav Agarwal was questioned about the lack of transparency in procurement of the protective gear, he said that PPE are now being manufactured in India itself, which used to be imported earlier.
He was also questioned about the government’s failure to maintain a stockpile of personal protective equipment (PPE) despite World Health Organization (WHO) guidelines. But he responded by saying “Where is the report?”
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On February 27, the WHO had issued guidelines, which said: “The current global stockpile of PPE is insufficient, particularly for medical masks and respirators; the supply of gowns and goggles is soon expected to be insufficient also. Surging global demand − driven not only by the number of COVID-19 cases but also by misinformation, panic buying and stockpiling − will result in further shortages of PPE globally.”
Though the guidelines were issued on February 27, Indian government waited till March 19 to issue a notification prohibiting the export of domestically manufactured PPEs and the raw material for the PPEs, says a report by The Caravan.
But doctors working with the AIIMS have drafted a protocol. One of its clauses says that each health worker will attend to COVID-19 patients in six-hour shifts, which indicates that each worker will require four PPE changes daily.
On March 16, the Resident Doctors’ Association (RDA) of AIIMS, in its letter to the management, pointed out that it “sadly found that most of the wards do not have adequate universal precaution components”.
Another doctor from GTB Hospital wrote on twitter that doctors and nurses have not been provided with the N95 masks.
Another doctor, Harjit Singh Bhatti, tweeted: “Pathetic situation, Healthcare workers in Assam Medical College are forced to cover themselves with plastic bags which are used to carry biomedical waste bcz of lack of personal protection equipments. Can PM @narendramodi take this issue seriously & provide #PPEsBeforeApplause (Sic)”
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