Lack of PPEs, ventilators and overall hospital preparedness reported as major concerns
An online survey among 410 IAS officials by the Central government has revealed that there is acute shortage of medical infrastructure in India to deal with novel coronavirus disease (COVID-19).
The survey refutes earlier claims of the Union Ministry of Health and Family Welfare that there were ‘adequate’ beds, ventilators and personnel protective equipment (PPE) in India.
Seventy-one per cent of the total respondents said sufficient ventilators were not available in their respective jurisdictions. Of 266 respondents, 100 disagreed, 91 strongly disagreed, 23 chose to remain neutral and nine agreed to a question regarding sufficient availability of ventilators.
The survey was conducted among district collectors and IAS officials (batches 2014-2018) from March 25-30, 2020. As many as 266 feedbacks were submitted.
Sixty per cent officials either ‘disagreed’ or strongly disagreed with regard to sufficient ICU beds in districts and sub-districts. Close to 50 per cent officials said that there was not sufficient availability of PPE for healthcare workers.
“PPEs like masks, gloves etc for medical staff was an area of concern for several districts and across states,” the survey read.
Eighty per cent respondents agreed that local administrations had a functioning system to identify, test and quarantine infected patients. However, the utilisation of the testing capacity at state level was not mentioned in the survey. This, even though the Indian Council of Medical Research has said that the national average of utilisation is 35 per cent.
Some districts explicitly recorded that there was a shortage of testing kits.
‘The COVID-19 Preparedness Survey’ identified the need for enhanced hospital preparedness in district / sub-district hospitals. Sixty per cent officials responded that hospitals were not adequately prepared.
Only half of the total responding officials agreed that adequate isolation beds were present.
“The majority of districts across the country highlighted shortage of medical staff, equipment and facilities like ICU beds, ventilators, ambulances, oxygen cylinders etc,” the survey read.
“The sub-district hospitals and health centres readiness is an area of focus, particularly in the Northeastern region. Furthermore, it was felt the healthcare workers at district level need capacity building training for COVID-19,” it added.
States of the Union
State-wise, seven surveyed districts in Bihar reported shortage of medical equipment as a major concern. Some of them reported non-availability of masks and other ‘basic medical accessories’, including sanitisers, too.
Delhi officials said there was a need to ramp up testing for suspects. The need for better equipment was also highlighted. Gujarat red-flagged that high migrant inflow as well as that of people within the state was a problem for them; so was the lack of PPEs.
Officials of seven districts of Assam said people were not following the lockdown properly. “Further, there is non-availability of PPE equipment which increase the possibility of spread through doctors and paramedic staff. People are migrating within the state and coming from other states like Mizoram,” officials said.
Himachal Pradesh is bogged down by few testing kits and movement of people. “Tracking/tracing followed by effective testing is not happening due to lack of medical testing kits and other infrastructure,” Chamba’s official said.
His concerns were echoed by the official of Haryana’s Jhajjar. The major concern for this state’s five surveyed districts was labour movement. The inflow of migrants was a challenge to track, as was testing them, along with non-availability of PPEs and ventilators.
Madhya Pradesh’s two district officials counted a general poor health infrastructure as a limiting factor in the fight against COVID-19 as well as availability of PPEs and ventilators.
“Health infrastructure is in poor condition. The district does not have any private hospitals or doctors. The total burden is on government health infrastructure and only one ventilator is available,” Panna’s official said.
Five districts of Maharashtra, which has recorded the highest number of cases so far, said the availability of medical supplies and lack of trained staff had left them worried. “Tribal needs have to be better considered. Ensuring supply of essential goods in these areas is far more complicated when city supply-chains are affected,” said Palghar’s collector.
Nagaland’s three districts recorded there was no testing centre in the entire state and there was a shortage of ambulances and oxygen cylinders.
“There is a lack of essential goods as these have to come from outside the state and the sealing of inter-state borders has resulted in numerous challenges faced by vehicles carrying essential commodities in navigating checkpoints,” its officials were quoted as saying in the survey.
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