Covid learnings and their importance
Of all the learnings from the pandemic, I think the most important of all would be that Covid is not a crime, but a disease and as such has to be treated as one.
A healing touch is what works more than excessive restrictions or expensive treatments. A sick man needs solace. Granted that a certain percentage of Covid-positive people needed hospital admission and oxygen administration, it is equally true that a vast majority of Covid patients needed just a sound home treatment protocol. Controlling the hype was crucial to ensuring that the base of the pyramid stayed where it should, that is, at home. During the second wave in Lucknow, there was a point when everyone who was Covid positive felt they needed hospital admission and almost everyone who reached a hospital, felt in need of L3 care. And so it was natural that health systems were overwhelmed.
The next learning would be that decentralised systems alone work. Community Health Centre level activities need to be boosted and strengthened both in terms of numbers of primary health workers and paramedical staff, as well as in basic infrastructure like adequate quantities of drugs and consumables, availability of vehicles, along with proper training and behavioural orientation of the surveillance and Rapid Response Teams (RRTs) in CHCs. It is also important to support the medical officer in charge (MOIC) of the block with a good pool of doctors enabling them to do efficient follow-up of home isolation patients.
The real-time bed-status updation done by the Covid facilities twice or thrice a day should be on a public domain so that what the command centre sees is also what the public see. It is also important that command centres do not insist on an over-centralised rigid admission procedure.
Any hospital, capable and willing to treat Covid should be allowed to do so through a transparent online self-registration system. Having a larger pool of Covid hospitals would mean an exponential increase in the number of available beds and critical care.
All dedicated big Covid hospitals should have their own independent liquid oxygen plants and all medium and small facilities can have oxygen generator plants. It is equally important that there is a sound oxygen use protocol in place.
One also has to emphasise the need for regulatory action in the matter of overpricing of treatment costs by private Covid hospitals. There is the need for a sound grievance redressal mechanism at the district level, which will look into complaints and make an objective assessment of treatment standards, the drugs and procedures prescribed, the prices charged, and take impartial action where required.
The one lesson, however, which I think we all have learnt, and I hope conclusively, is to stop thinking in silos, once and for all.
In summing up I can only add, based on my experience visiting Covid homes and meeting and talking to ill people in wards and ICUs of Covid hospitals, that what a sick person mostly needs is just an assurance that all will be well, that he will be okay and that for better or for worse we will be with him all the way. That assurance medicines and machines cannot give. It can only flow from one man to the other, heart to heart. The pandemic was indeed a time of untold misery and loss but it was also a time when men—at least some men— became angels.
A HEALING TOUCH IS WHAT WORKS MORE THAN EXCESSIVE RESTRICTIONS OR EXPENSIVE TREATMENTS. A SICK MAN NEEDS SOLACE