Dealing with pandemic: Our response should have been better

What normally keeps doctors, nurses and other health care staff going is the satisfaction of being able to help the patients. But to see patients die because of the lack of something as basic as oxygen, anyone can imagine the mental, physical and emotional attrition.

Unfortunately, in our system these issues are not even studied and we do not prepare for them. If a study were done, we would find out how many doctors do not even know how to operate an oxygen cylinder. Not because they were not trained but because it is not something they do in their day-to-day job. I have not operated an oxygen cylinder ever since my postgraduate days. If I am given an oxygen concentrator, I will have to watch videos online to understand how to operate it.

The situation we are facing was not impossible to handle. If the government had wanted, they could have recruited and trained a staff prepared to handle the disaster and it had a whole year to do so. But let alone additional recruitment, even posts which were vacant before the pandemic have not been filled up.

The Covid second wave is now spreading into the rural areas, where there is an acute shortage of trained personnel. When we city dwellers get fever, we know it's time to take a paracetamol. But think of an agricultural labourer. They have to be told even the basics. If we had trained young medical staff who could speak to people in rural areas in their own language as to how to be in the prone position, how to breathe, what precautionary medicines and other steps to take, they would not be running for miles with patients on their shoulders to the nearest city to see a doctor.

A health care system is not a warehouse of manpower, medicine and equipment. You cannot just put doctors, nurses, ventilators and a tray of medicine together and expect them to develop an instant chemistry and start working with each other. Health care works through processes which need to be in harmony with each other. Without that, it would lead to perfect anarchy and that's what we are witnessing.

To my knowledge there were no specific trainings, webinars or any other drill organized by the Health Ministry in the past one year to prepare a batch of healthcare staff to specifically deal with the second wave. These actions require meticulous stock taking and planning. There has been no planning which the government should have done as per the mandates of the Disaster Management Act.

Just last week the Supreme Court asked the government to submit a national Covid plan listing the details of production and distribution of oxygen, essential drugs, health care infrastructure and vaccines. In response the government in a 200-page affidavit said that the Disaster Management Act of 2005 already provides for a national disaster management plan so there is no need for a new plan.

A National Plan for the entire country was prepared in the year 2016 and was revised and notified in November, 2019. The Centre claimed that the 2019 plan can be supplemented by the issuance of additional guidelines to tackle any aspect of disaster management.

But there was no pandemic in 2019. If you read the Plan, the word ‘virus’ appears just once in a casual, non-consequential manner. The word ‘pandemic’ appears at just two places and dwells more upon how pathogens work, how they can jump from plants to humans and so on. The plan provides no clarity on what actions are to be taken in the kind of disaster we are facing.

The government claims day to day actions need not be outlined and are to be left to the executives to take instant decisions on the spot. It shows government’s nonchalance towards the entire pandemic.

The Supreme Court in its order dated April 30, 2021 noted these claims by the government but specifically mentioned that they were only noted for public record purpose and are not endorsed or accepted by the apex court.

(As told to Sanjukta Basu. Dr Bajpai is Assistant Professor at the Centre of Social Medicine and Community Health at JNU)