COVID19 the challenge in India lockdown is the global epidemic of COVID 19, affecting about
85 percent of the world. Surprisingly the most affected are the developed
economies of Europe and the United States, despite its advanced health system
and a very favorable doctor/population ratio. On the other hand, Asian
countries have done well in spreading 'Contagion'. China is moving towards
normalcy, with South Korea and Japan managing to control the spread, while SE
Asia is doing a good job of managing the spread.
Right
now everyone's eyes are on India, which is on 25 March 2020, closed for 21
days. There is concern about how the largest democracy in the world and the
spread of the virus will be managed with a lockdown of 1.3 billion copies.
Questions include; Is it a practice to limit the spread of the virus by
leveling the curve by stopping the spread of the community or is it an attempt
to build capacity and capacity for the spread of the disease in the community.
It is important to underline that over the years India has built appropriate
capacity to deal with periodic disease outbreaks and has developed an effective
integrated disease surveillance system. The question is, is this enough?
Prediction and Projection of COVID 19 Challenge in India:
To understand the calibrated Indian response so far, it would be necessary to look at predictive modeling, one by two study, one by Johns Hopkins and the other by ICMR. Essentially, a Johns Hopkin study released on 25 March 2020 predicts a peak of 25–30 million, infections by 25 April 2020. As of May 2020, hospitalizations are estimated at between 15–20 million people. The study is skeptical about the ability of complete lockdown to affect the spread of the COVID -19 Challenge in India, highlighting that it would only create economic crisis and terror. Inadequate testing has been seen as the most important problem while requiring additional critical care beds and progressively one million ventilators in the coming months. These are valuable information for public health policy decisions.
The
ICMR study on an optimistic scale (published in India Today) predicts 15 a million cases in Delhi, in the metros of Mumbai, Bangalore, Kolkata, in 200
days starting from 5 February 2020. In the worst case, modeling predicts one
Billion cases in Delhi, 50 million cases in Mumbai in 40 days starting from
February 2020. It is worth remembering that the airport screening began in
March 2020. It is estimated that about 15 million heterosexual but contagious
travelers may slip through. He is now being identified for trial. In any case,
public concerns began to rise in March only after news from China, Italy, Iran,
and more stringent measures were taken on international travelers in March.
· Even a moderate and optimistic spread of
the virus will affect a large portion of the population.
· Leveling the curve is not the endpoint of a
"lockdown", it is an important step toward recording time to build
public health capacity to prevent potential community outbreaks.
· Tests, trace, and treatment will be the mantra to verify the extent to which these factors are spread as part of in-depth learning on the patterns and paths of viruses in our population.
Lockdown
is an important and necessary first. For 1.3 billion people, this was the most
important decision that all trips and scheduled actions eliminate the enforced
social distance and isolation.
Surprisingly,
international policymakers no longer see the simple logic of proactive
time-bound measures: In three weeks infected people will recover and become
non-contagious as it has already spread to a community.
Additionally,
the virus has destroyed its destructive power on a global scale and it can
occur in China. As long as we can stop the fresh entry of the virus from
abroad, a test and trace initiative will define the spread of the virus in an
ethical population. China is currently banning all foreigners, and we should
follow the same protocol of screening and isolation for at least six months.
The
country's question is what will happen on 14 April 2020? There is no clarity on
the issue coming from the Ministry of Health or ICMR. Two different scenarios
are possible that warrant a discussion.
Scenario 1: Continue lockdown after 14
April 2020?
If
the current decision is based on the recurrence cycle of the virus through India's
control and isolation, it is unlikely to bring any deterministic consequences
of Lockdown continuation, it is only likely to be social disturbances,
isolation on them, high risk, etc. . Community outbreaks from outbreaks in the
community, 15% hospitalization, and 3% mortality cured themselves by a
majority. While the number may seem alarming, the peak of this cycle is likely
to reach within the next few days. The resource scarcity created by the
continuum will create a chain reaction with serious consequences. An open
question would be whether treatment is stricter than the disease, with little
additional control over contagion.
Scenario 2: Partial lifting of
lockdown
This scenario is more realistic, with a minimum of four months of guided and
targeted participation. A return to manufacturing will be possible with the
necessary and new workplace norms; As rotational workers do roster work, where
possible, work at home and maintain social distance. Large congregations,
sports, public and religious events will need to be postponed. Data and deep
analytics will identify high-risk groups to whom long-term control can be
applied. This virus has to burn itself through 60% of the population for herd
immunity to limit its spread. To prevent this contagion, the early introduction
of vaccines may be the only other option.
§ It
is important to complete an intensive care facility. We need Dr. Is needed
because there is a need to develop the capacity to add 2000 ICU beds per day as
suggested by Devi Shetty (TOI Editorial 26 March 2020). The mortality rate is
directly related to the number of ICU beds. In Italy, whose population is in
the ratio of 13: 100000, the death rate is around 10%, in Germany, the death
rate is 3% in the ratio of 29: 100000 India, which has 2.3: 100000 beds - will
need one million to counter the current predictions of the spread of the
ventilator population ratio. The development of health capabilities should be
the most important priority of the government in which industry should help.
§ Construction
of exclusive COVED19 hospitals requires time. The existing medical/dental
colleges in the states provide a viable option. Each of these institutions,
which has a specialty hospital with approximately 400/100 beds, presents a
unique opportunity to scale resources. 300 accredited dental colleges alone
with 100-bed hospitals can be a useful resource for adding ICU beds and
providing quarantine facilities. Oxygen supplies and ventilators will be
required.
§ Then
there are workforce challenges, especially interns, critical care specialists,
pulmonologists, trained doctors, nurses, OTs, and anesthesia trained ICU
technicians for ventilators. As Dr. Devi Shetty has suggested, 50,000
specialist doctors waiting to appear in the final exam can be added to the
system with some changes in the process of qualifying examination and board
certification. Retired health care workers are already being recalled and will
be a valuable enhancement resource. Also, the dental workforce being remade by
the NHS in the UK can be remodeled. It can also help in enhancing the health
care system in India. All dental surgeons are trained in general, medical,
surgery and can work under supervision in the ICU and provide regular administrative
and logistic support.
§ Armed
Forces Medical Service (AFMS): AFMS has both capability and capability that can
be deployed on short notice. The COAS has already announced that the Indian army can deploy at least 28 field hospitals on short notice. Another unique
opportunity for states is to coordinate with AFMS for emergency training of
health personnel from biological infrastructure (training of service personnel
is integral in AFMS for NCB conditions).
Conclusion:
In this article, we have brought out the Indian point of view. In the background
of two prediction models for the spread of COVID -19 Challenge in India have
attempted to outline, highlighting the possible events of 14 April, outlined
important management approaches to combat the disease. It is important to
underline that India is at war; We need to unite and unite all our resources at
this critical juncture. The economy will suffer a major injury; It is incumbent
to ensure socially marginalized welfare as well as to begin construction. India
is being tested, and it cannot fail.
