What will be the long term impact of Covid-19 pandemic on the Indian healthcare industry?
There is historic precedence that black swan events like COVID-19, bring with them extreme impact, in terms of human lives, dislocation, and economic losses. Existing structures and cost equations are uprooted and the new replaces the old.
The Pandemic has exposed the inadequacy of private healthcare and importance of spending and strengthening public healthcare. In the longterm; the government will have to re-evaluate and drastically improve upon the funding in public healthcare, infrastructure. The manpower crisis plaguing the healthcare sector has to be managed with efficient and targeted vocational training. Instead of diseases management , health management and prevention will become the norm, as the general well-being of the insured population through medication management and self-care enablement will gain importance. Virtual consultations by healthcare professionals will become the mainstream care delivery model post-pandemic. Robotics which promoted social distancing will make a comeback. Insurance and customer service, both will emerge as key factors.
Do you think that we need a healthcare reboot for India and why?
This pandemic has exposed the fundamental problems plaguing the Indian healthcare system, be it physical infrastructure, manpower, health management. We don’t have an epidemic response mechanism and our public healthcare system is woefully underprepared. So yes, we need a reboot.
The Government must spend more in healthcare to create a more robust and all-encompassing public healthcare system. The country needs more public hospitals and the focus needs to shift from disease management to health management, patient education and prevention. Here the private sector can play a supporting yet secondary role , not primary role as is happening currently.
You’ve been vocal about separating Covid hospitals from non-Covid hospitals. Can you elaborate on the need for the same.
Leading doctors and researchers have always championed the philosophy that having Covid and non-Covid patients in the same hospital leads to multiple issues. Common sense dictates that due to common entry and exit points, common lobby, common lifts, common toilets, canteen etc there is a very high risk of spread of virus from covid patients to non covid patients increasing the risk to life of patients with heart, kidney, lungs diseases etc. That is why , it is safer to treat Covid patients in a separate isolation facility or block and create safe zones for other non-Covid critical patients.
This was only strengthened by a fresh landmark study from 24 countries and 235 hospitals which showed that the death risk among non-Covid surgical patients was 800% higher if they caught Covid in a peri-operative period in hospital.
During this pandemic, doctors, surgeons and all healthcare workers have been under tremendous stress. How can we cope with this situation?
The coronavirus pandemic has taken a toll on everybody- doctors and patients alike. Doctors who are looking after Covid as well as vulnerable non-COVID patients have been experiencing stress at multiple levels.
Many are besieged with the fear of contracting the extremely contagious coronavirus disease themselves. The risk to them makes their family members vulnerable too. Many of the senior doctors treating patients are in the 55 plus age group. More than 300 doctors , many of them young have died in India from covid.
There is a lot of helplessness and frustration among doctors for not being able to do anything for the patient dying from Covid-19. Doctors too are human and it is natural to get stressed about the unknown.
Empathy plays a crucial role in giving quality medical care to the patient. Given the contagious nature of this disease, ambiguity in line of treatment and the long and daunting duty hours, the act of giving emotional and physical comfort to patients could suffer. There is also a tremendous shortage of healthcare workers.
What has been the impact of Covid-19 on cardiology and your hospital business?
Worldwide, the first response to Covid-19 was fear. In March 2020, as per the Government mandate, staff working in essential services such as hospitals continued to work. Soon, many hospitals across the country discovered that their staff members are positive. These staff members perform important functions, such as ward boys, security, engineering, cafeteria and laundry; as they live near slums and they are particularly susceptible.
A hospital is an ecosystem- it’s beyond just doctors and nurses. We had to slow down our patient intake numbers; but also ensure that we didn’t turn away emergency cardiac patients- and offer them a safe COVID free zone.There was a reduction in surgical procedures since the lockdown due to delegation of significant workforce for Covid duty, restriction on overall movement, performing emergency procedures ( surgery , angioplasty etc) and patients delaying routine procedures.
We have operated over 150 cardiac patients, including HNI patients that traveled from all corners of the country, during the pandemic and continue to do so.
We also established the following protocol for all patients. Firstly, Covid test on all patients undergoing procedures: Secondly, Covid test for all relatives- since in India, a relative always stays with patients in the hospital & are mostly young, there is a high probability of them being asymptomatic and transmitting the virus to the patient. They also need to be tested and finally periodic testing of healthcare workers – Most healthcare workers are young and live in crowded accommodations and again have a higher chance of being asymptomatic spreaders.