Dr Nandakumar Jairam, Co-Chair, FICCI Health services committee and CEO, Chairman & Group MD, Columbia Asia Hospitals discusses the struggles of private healthcare providers during the pandemic with Shweta of BW Businessworld
What is the impact of Lockdown due to Covid-19 on Health Sector?
The Covid-19 pandemic has affected us in several ways. Firstly, it has strained the healthcare resources of the country as the healthcare sector has to brace itself for many patients, some requiring intensive care, others isolation, all mandated in the management of Covid-19 patients. This has stressed the healthcare infrastructure considerably.
Also, because of the pandemic, there is fear and patients with other conditions are not seeking care in hospitals. This depletion in the number of patients has created a financial strain on private healthcare and providers are looking at the means of ensuring that they continue to survive in this environment. Their presence is necessary, not only for Covid-19 patients but also for others with routine health issues.
Another way in which this has affected the health care sector is that the stress levels of all health care workers have risen. One understands that this is not just because of the fear of getting infected, but various other factors like staying away from family, different environment to stay, working hours etc.
Finally, I would say that certain things have improved. In the initial stages, there were concerns of shortages of protective gear for healthcare professionals and the quality of what was available. This has improved.
How essential it is to resume certain areas or units of the healthcare industry?
It is heartening that the government has very clearly and very proactively put down the path for the management of Covid-19 patients throughout the country. This has enabled us to understand that there would be dedicated hospitals for Covid-19. So, it is important that patients do not fear that they would contract Covid-19 by visiting the other hospitals and routine work should and could start.
We must understand that babies still must be born, TB patients must be treated. Other patients with conditions like hypertension, dialysis, and renal failure, need to continue their treatment because their treatment is crucial to prevent complications. Routine work must restart quickly, and the government should do everything possible to do so.
Also, I have heard that the government is looking at other activities like extending more labs to do Covid-19 testing, that is extremely important because that is very crucial for us to diagnose and contain the epidemic patients. We have done very well in the last several weeks of the pandemic in our own country compared to others.
The manufacturing industry involved in producing biomedical equipment needs to double up quickly and all medical infrastructure needs to ramp up. I hear that MHA is looking in this direction and an announcement regarding this is awaited. I hope it starts on the 20th of April.
How prepared are the private hospitals for coronavirus patients?
There are fever and flu clinics that both private and government healthcare has set-up and at these, we do find patients coming in. However, inpatients are by and large directed to hospitals by the government. Today, in our hospitals, we have very few Covid-19 patients as most of them go to the designated hospitals. We would only admit patients based on instructions and specific orders from the health authorities. We would not like to contravene or interfere in the smooth and efficient manner in which the entire government machinery has acted in the situation.
Hydroxychloroquine is considered to be a precautionary drug. In many cases, it has proven to be effective but in how many cases it has failed?
The value of Hydroxychloroquine in the management Covid-19 is not proven. Many centres have questioned its value. The ICMR, however, has suggested that this should be used for protection in specific situations namely, in the healthcare personnel who are exposed and for families who have come in contact with Covid-19 positive patients.
It does not mean that taking hydroxychloroquine gives you immunity against the virus. It may only mean that the disease is maybe a little less virulent. However, as stated this is not a proven point.
It is difficult to say how many failures there are because the very value of the drug is still questioned. Only time will tell us, as to whether this drug has any clinical use in the treatment or prevention of this infection.
Apart from safeguarding the healthcare service providers, where else the health sector lacks? How can we overcome it?
In the subsequent months and years, we need to relook at the entire healthcare sector of this country. It is necessary that the government and private players dialogue and understand what the lacunae are, and how one should be prepared to rejig.
Clearly, the number of beds and the infrastructure that is required for a population of our size is still much less than what is optimal. Also, there are more beds available in urban centres, fewer beds and infrastructure and few specialists in the rural areas and in the semi-urban areas. This itself is a problem and requires to be addressed.
Health, remaining a state subject, has its own set of advantages and disadvantages. A comprehensive plan to restructure healthcare in the country should be evolved in conjunction with both the private and the public level. Bodies like Niti Aayog would be best off looking at it.
Further, it is important to note that there is still a lack of specialists in the country. Medical infrastructure and equipment like ventilators are far from what is optimal in numbers for the country.
If private healthcare has to survive, the government will have to look at how to support them. Today, nearly 70-80 per cent of healthcare in the country is provided by private healthcare players, yet they are not in good financial shape. And if private health care does not survive because of financial considerations then the entire healthcare of the nation will crumble.
Keeping this in mind, I would urge that we have a long and medium-term of solution for healthcare in India.
Do you think India has enough resources and funds to tackle the pandemic, like Covid-19 both now and for the future? What about clinical research?
Opportunities for research in India is immense. The number of patients that India has and the population automatically make it a very convenient place to do clinical research. I would strongly suggest that we should invest in clinical research in India, which would enable us to innovate and come up with solutions which are cost-effective in healthcare.
With this pandemic, we have proved that the country can quickly put up necessary resources and fight, irrespective of how big the problem is. I do not believe that even the developed countries have shown the kind of grit that we have, and the resources that came together at one shot, the speed, the efficiency are commendable. This needs to continue.
Earlier, there was mutual mistrust between the government and the private health care, which was detrimental and not helping us to move forward. This has been, thanks to the pandemic, put to rest. However, this needs to have permanency. We need to work together and ensure that we understand each other's focus, importance and presence and move forward.