Covid-19: We must prepare for the worst, say experts

Are we prepared for a Covid surge Is our medical equipment functional These questions have bothered the masses and healthcare experts especially with the shutting down of civicrun jumbo Covid care centres and special wards in hospitalsmidday had cautioned against the dismantling of these centres in reports lsquoClosure of jumbo centres amid global Covid surge is worryingrsquo October 19 and lsquoDonrsquot let medical equipment fall into disuse say expertsrsquo October 22 Experts are of the view that the most important part of the preparedness is to keep the public informedWorrisome numbersldquoAssume that 2 lakh people are tested via RTPCR in each metro A Covid positivity rate of 20 per centmdash40000 new casesmdashdaily in each city While 23 per cent of Covidpositive patients will need hospitalisation for oxygen 30 per cent of those testing positive will need hospitalisation ie 12000 hospital beds daily in each metro city added cumulatively for three to 10 daysrdquo said Dr Subhash Hira professor of global health at the University of WashingtonSeattle and advisor to WHOTDRGenevaldquoThe problem staring at health officials now is that several quarantine and treatment centres have been dismantled For example the BKC Covid jumbo centre with a bed capacity of 2000 and an oxygen plant with piped connections to beds hundreds of ventilators paediatric beds and an ICU was dismantled a few months ago Those familiar with its design are disappointed about wasted resourcesrdquo Dr Hira addedAlso read Mumbai All Covid samples to undergo genome test says BMCState preparednessAccording to Dr Hira to avoid panic the state health departments should ensure that the public is informed well in advance of preparedness about treatment centres nearest Covid testing centres and their timings hospitals with oxygen plants and medical supplies through Pradhan Mantri Jan Aushadhi Kendra to avoid blackmarketing and helpline numbers ldquoThe main change will be that the droplet transmissibility of BF7 will be reduced to a quarter by using nasal vaccines ie to infect fewer than four personsrdquo Dr Hira saidDismantled centresrsquo statusDr Wiqar Shaikh professor of medicine Grant Medical College and Sir JJ Group of Hospitals said he was seriously concerned about the global Covid19 situation ldquoThe spike in several countries and the emergence of new resistant variants are worrisome and in India we just cannot afford to be complacentrdquo he saidDr Shaikh added that midday had earlier warned about a possible Covid surge during the winter and said that a bigger worry was the dismantling of coronavirus facilities all over the country He stated that in Mumbai in particular all jumbo Covid19 centres had been dismantled and what remains in the city for Covid19 patients are the Seven Hills Hospital and Kasturba Hospital ldquoIf there is indeed a surge where will patients get hospitalizedrdquo he askedDr Shaikh also said that he was concerned about the state of critical care equipment which was dismantled and has now been put in storage ldquoA surge during the coming weeks could put a serious strain on facilities in Mumbai If jumbo centres have to be opened at short notice will all this equipment be in working condition particularly ventilators cardiac monitors BIPAPCPAP machines and pulse oximeters etcrdquo he askedRTPCR kits for testingDr Shaikh voiced another cause for concern the virtual abandonment of Covid testing particularly the RTPCR swab test He added that RTPCR kits are just not available in several laboratories and hospitals across Mumbai and the same is possibly true for the rest of the country Ramping up facilities for Covid19 testing is he said a critical part of our war against the virusDr Shaikh said that it is now time as is being done in other countries to restart Covid jumbo centres check the functioning of all critical care equipment and begin to employ extra medical and nursing personnel as well as supporting staff Dr Shaikh added that in view of the looming threat the government must do its homework on a war footing and every Covid19 facility must be kept ready for every eventualityLearn from the pastldquoIt is high time we start learning from past mistakes to avoid any lastminute panic The fact that the Central government directed all states to prepare themselves for any oxygen supply shortage is indicative that we need to prepare ourselves for something that is unseen at this momentrdquo said Dr Shaikh reiterating the need for the Central and state governments to make wearing masks and following social distancing norms mandatoryWay out to fight virusDr Ketan Vagholkar professor of surgery at DY Patil Medical College said ldquoThe recent surge of infections due to newer Covid variants in China should serve as a warning to us All major health facilities that are experienced in managing Covid cases should keep part of the facility wellequipped and ready to meet any unprecedented challenge posed by variants These facilities should also take into consideration that all supportive facilities including oxygen supply are adequate An online video consultation facility should be offered by every state civic and privaterun hospital managing such cases so that citizens have access to immediate healthcare advicerdquoPrepare to face the worstDr Santosh Bansode head of department Emergency Medicine Wockhardt Hospital Mumbai Central said ldquoThe whole world is on alert since Covid cases have started increasing We need to be more alert considering our huge population When Covid initially started spreading in India people did not have any idea about where to do tests where to admit positive cases etc Since jumbo centres are closed and private hospitals are dealing with nonCovid patients people donrsquot have any idea what to do if a family member has Covid symptomsrdquoSOP needs to be in placeDr Bansode added ldquoWe must have a clear idea about protocols and places that we can go to for investigations and treatment The government has alerted us but we still donrsquot have a clear idea about Covid patientsrsquo admissions Initially the government developed a helpline for Covid patients This helpline will be needed again for spreading information The state health department should educate people about test centres admission facilities and availability of oxygen and ICU beds for Covid patients so that if cases increase we are completely informedrdquoAccording to Dr Bansode the government must use the media to circulate information about areaspecific Covid facilities ldquoOur backup plan should be ready so that we wonrsquot face difficulties All doctors should also be made aware of where they should refer patients for admissions and treatment We should learn from our past and act promptly so that people wonrsquot suffer in actual situations Drugs that are used for treating Covid should be made available at affordable rates to prevent blackmarketing We have to be ready keeping in mind the worst scenariordquo he concluded