Hyderabad: “No country suffered worse than India. An astounding 6.1 per cent, or 18.6 million, of its 305.6 million people died of the dreadful Spanish Flu. In other words, India lost twice as many civilians as all soldiers killed during the World War”, Albert Marrin quoted in the book “Very, very, very dreadful”. The 1918 Pandemic has remarkable similarities with the current situation in many ways. To mention three a) There was no cure or Vaccine then and now b) lack of coordination between the countries same then and now c) first panic and declaration of a quick victory. The last point is critical at the time, a lot of Governments, Including India, are under pressure to re-open and restart the economy. Globally, the Spanish flu killed an estimated from 50 to 100 million. China, then with a larger population than India, reported 9.5 million.
The present pandemic gives the same dreadful vibes where the death toll is rose to 16,919 in the country, while the number of cases climbed to 568,346—Ranking India on the fourth position among the worst-affected countries in the world. In terms of daily increase in many instances, India now ranks fourth – after the US, Brazil and Russia.
It is better to look at the events then to learn some lessons.
The success story of Asia’s largest slum Dharavi has set an excellent example for all the COVID fighting states in and cross the country.
Not just Dharavi with over 10, 00,000 lakh population had to triumph its battle against the virus, but also Bhilwara in Rajasthan with over 28 lakh population had fought remarkably.
Whereas, Telangana government appears to be lazy about testing and therefore is ranked second in the testing in the entire country. In early April the state government had an initiated just 400 tests per day. Later, in late June the trial was increased to 2000 per day.
Meanwhile, states like Uttar Pradesh is conducting 22thousand test done per; Maharashtra is conducting 15,000 tests per day; Odisha is conducting 5000 tests per day Meanwhile Bihar is conducting the lowest with about 4000- 5000 tests per million population each day.
| State | Confirmed | Deaths | Test per day (per million) | Population |
| Maharashtra | 1,69,883 | 7,610 | 15,000 | 11.4 Crore |
| Tamil Nadu | 86,244 | 1141 | 12,000 | 6.79 Crore |
| Gujarat | 32,023 | 1828 | 7,000 | 6.27 Crore |
| Delhi | 85,161 | 2608 | 22,000 | 1.9 Crore |
| Rajasthan | 17,754 | 409 | 16,000 | 6.89 Crore |
| Telangana | 15,394 | 253 | 2,000 | 3.52 Crore |
| Bihar | 9745 | 63 | 4,000 | 9.9 Crore |
Furthermore, the test positivity rate (TPR) in Telangana has increased by 100% in over one and a half month, indicating the higher prevalence of COVID-19 in the State. The test positivity rate, which is the percentage of samples that tested positive, was around 5.2% on April 28. This increased to 24.9% until June 20.
When hotspots like Dharavi, Bhilwara and Dilshad Garden in Delhi can fight COVID-19 then why not Telangana?
The slum residents and its doctors had buckled their seat belts to fight against the pandemic. It had adopted 4 T’s model – Tracing, Tracking, Testing and Treating, proactive screening with over 47,500 people covered by medicos and private clinics in home-to-home detection, and setting up fever clinics for high-risk categories. Fifteen thousand through mobile vans and around half a million were surveyed scrupulously by the civic health teams, with around 8,246 senior citizens were identified and separated from the others to arrest any infections, for a total of 5,48,270 surveyed and screened in Dharavi.
Of these, as Pednekar said, the suspected cases were immediately shifted to well-organised COVID Care Centers or Quarantine Centers, set up in all possible schools, marriage halls, sports complexes, etc., served by community kitchens with 24×7 medical services at hand.
Meanwhile, The Bhilwara exercise involved a mammoth door-to-door survey, which covered around 28 lakh people in just nine days. A watch-list of 11,000 people who had flu-like symptoms was prepared, and about 7,000 people were placed under quarantine.
Furthermore, Dilshad Garden, Delhi had been declared coronavirus. “Under this operation, 123 medical teams screened more than 15,000 people living in 4,032 houses in Dilshad Garden. Thousands of people were quarantined, and tests were done,” Delhi health minister Satyendar Jain said. “The hard work of health officials and successful implementation of the operation has made Dilshad Garden coronavirus-free.”
Maharashtra Government undertakes 80% beds in all the private hospitals and bears its expenses.
Meanwhile, the alarming increase of cases in Maharashtra had made the government overtake 80% of the beds in all the private while the hospital authorities exercise the 20%.
The government is sending the patients to private hospitals and is also paying the bills.
Rs 4000: Charges for routine ward + isolation; Rs 7500: Charge for ICU without ventilator + isolation; Rs 9000: Charges for ICU with ventilator + isolation
It’s inclusive of Monitoring and Investigations like CBC, Urine routine, HIV Spot Anti HCV, Hbs Ag, Serum Creatinine – USG, 2D Echo, X-ray, ECG, – Drugs Consultations – Bed charges – Nursing charges -Meals – Procedures like Ryles tube insertion, urinary tract catheterization.
“The lethargic government can also use city’s function halls, and community hall for testing just like Dharavi did,” said Dr Upender Kumar, Dharavi government Hospital.
Several hospitals, paramedical staff, doctors and medical colleges in Telangana must be used
It would not be wrong to say that the Telangana government has equal resources which should be used to its best.
The State has 33 Medical Colleges and 1 Stand-Alone Post Graduate Institute, i.e. Nizam’s Institute of Medical Sciences (NIMS). These 33 Medical Colleges have 5614 Medical Faculties of the category of Professors/Associate Professors/ Assistant Professors/ Tutors. Except for some Tutors, all of them possess the qualifications of MD/MS and some even Super Specialty of DM/M.Ch. There are 3859 Post Graduate Medical Students (MD/MS Broad Specialties) and 381 PG Students in Super Specialties (DM/M.Ch). There are 1012 Non-PG Junior Residents and 1126 Senior Residents.
When the medical colleges have seat reservation for government and management in the ratio of 50:50, then why not use the rate. Just like the Maharashtra government, the Telangana government but at least undertake 50 % of beds of the private hospital and must pay its bills and use thousands of paramedical staff of the private hospitals.
Meanwhile, the state has thirty-three medical colleges and around 4940 (MMBS) and 1971(PG), medical students. With about 20,800 beds in all these government medical colleges. The list of private hospitals, doctors, and paramedical staff is even more.
When Telangana Government and Chief Minister K Chandrasekhar Rao can conduct Samagra Kutumba Survey (household survey ) in A single that is on August 19, 2014, for about 3.5 crores of population deploying 3,85,892 employees then why not COVID-19 screening?
How can a state fight COVID:
Ramp up testing: Government must expand testing facilities and criteria for COVID-19. Testing should not be limited to only those with symptoms who have travelled to certain countries and those who have come in contact with them. Any clinically suspected person should be able to get tested. While containment by isolating patients with the disease, tracing connections, and quarantining individuals returning from nations with an established outbreak may continue to be relevant for a more extended period, the system needs to gear up for addressing community transmission.
Food security and financial support: According to the report, nearly 35 lakh families in the state would run short of cash and saving if lockdown and the pandemic are persistent. In case, there is re-imposing of the lockdown the government must provide ration to the ration card holder for two months in advance and also financial help with at least Rs 2000 per month that would be Rs 4000 for two months. There must be an immediate increase in public expenditure that leads to widespread demand-side support in the form of increased social security and food security measures.
Mobile testing: The vehicle will be able to cater to narrow lanes, more massive and dense areas of District Central, increasing the number of samples collected in a day. The mobile van can collect two samples at a time. This can quickly test the hotspots, slums and contaminated zones in the state. Meanwhile, it can also prevent the spread of the virus as they would be no crowd at different testing labs.
People must be educated and informed: Maintenance of routine economic activity, which primarily means safeguarding of the livelihoods of the majority, should also be acknowledged and acted upon as a public health priority. Public education should also address the need to build solidarity in such times.
Must ensure safety of medical staff: Ensure safe working conditions and adequate protective equipment for healthcare and support staff. These are to be provided not only in hospitals but also for frontline workers supporting home quarantine and isolation. This would require that medical tools such as effective facemasks and sterilizing fluids are prioritized for front-line healthcare workers and patients.
Freedom to Media and social media campaigning: The freedom of the media to report on the epidemic and its consequences must be safeguarded at all times. Just like the ‘Swach Bharat Abhiyaan’ there must be a wide spread campaign facilitating the audiences to know what they should be doing and how important it is to follow lockdown norms.
Better hospital services: Government must rapidly prepare public health services with at least of two hospital with an ICU; potential isolation wards and ventilators; and oxygen supply in every five to ten lakh population. Better supply of medicines and consumables such as oxygen and deployment of human resource.
Government Centre for Disease Control: there must be at least one in every district which is staffed and facilitated to test, identify and provide alerts and advice precautionary measures for pathogenic attacks like the current Covid-19 pandemic. Monitoring committees must be formed in order to have day to day report of the pandemic.
Its time for action! The Telangana government needs to ensure quick testing and proper sensitization of the pandemic is essential.