Did India’s political leaders learn anything from the deadly second wave of Covid? Hospitals in the capital New Delhi are once again overcrowded with patients and health officials do not have enough beds for them. The disease has changed – Dengue, not Covid – but the laxity remains the same. For a country that wants to be the pharmacy for the world, its own healthcare system is very poor. Public hospitals are overcrowded and inaccessible, with some of the lowest government spending of any country. A multitude of private facilities are beyond the reach of most citizens. India’s courts were forced to intervene earlier this year to address disparities in hospital oxygen supplies, while state and federal officials battled over the purchase and citizens gasped for breath. Died in autorickshaw.
The pandemic pushed many people into severe debt for health care, forcing families to sell property, jewelery and even livestock to pay hospital bills. Even before Covid, India’s out-of-pocket medical expenses were among the highest in the world, accounting for nearly 60% of total health expenditure. According to World Bank data, public health spending accounts for less than 2% of GDP, compared to 5.4% in China and the global average of about 10%. Researchers from Azim Premji University found that the virus pushed an additional 230 million Indians below the poverty line, leading to malnutrition and increased hunger.
The first warning signs that it would be a bad dengue season came in late August, when a hospital in Firozabad, in the northern state of Uttar Pradesh, reported an increase in deaths from “mysterious fever”. But it was no secret; It was mostly dengue and scrub typhus. News Laundry reported chaotic scenes at a government-run facility in September, with patients sharing beds, delayed lab reports and a severe shortage of doctors. An open drain and ponds of stagnant water provided a breeding ground for the mosquitoes that spread dengue, while monkeys, pigs, cows and dogs scour the garbage heaps near the hospital for food.
The number of dengue cases in Delhi crossed 1,500 last week, with severe outbreaks and death rates spiking across the country, federal health minister Mansukh Mandaviya intervened. The ministry deployed teams of experts to nine states and territories and suggested that the COVID beds be remodeled for dengue patients. Mandaviya inadvertently highlighted one of the main shortcomings of India’s pandemic response—the significant lack of cases and deaths. “Since testing is the most important step in identifying dengue, these deaths will go unreported and the disease will continue to be under-reported,” he said. Epidemiologists say that the actual Covid death toll in India could be between 1.3 million and 5 million. , with even the most conservative estimate its numbers more than double that of the US, by far the highest recorded in the world. That’s three to 10 times the official count, a claim denied by India’s government, which has used a consistently low death rate of 459,000 to defend its pandemic response. But unless India learns from its wrong steps, it can repeat them when the third wave hits. As a priority, it should increase investment in public health, strengthen surveillance systems and significantly improve vaccination. Its 1 billion-shot milestone last month was a significant one, but when you consider that just 24% of India’s 1.4 billion population has been fully vaccinated, while 54% got a single shot, it’s clear. That’s again a very long way to go.
Daniel K. Experts at the Inouye Asia-Pacific Center for Security Studies say the government needs to do more. Public health officials should procure and stockpile additional essential medical supplies and learn to manage health emergencies very quickly in anticipation of future outbreaks of COVID-19. It is not a good sign that it has taken months for the administration to understand the gravity of the dengue outbreak.
India must also strengthen its health security to avoid another mass movement of migrant workers who left millions of cities during the pandemic, when their jobs and housing disappeared, and the virus spread to villages across the country. took it with him. It should also take seriously the urgent need to increase the number of health care workers to meet World Health Organization guidelines.
The consequences of moving slowly on these reforms are too big to ignore. India has already slipped to 101st out of 116 countries on the Global Hunger Index, below countries like Myanmar and Pakistan, while unemployment has risen, especially in the hinterland. Even as its economy shows signs of improvement with a consumption-driven festive season, it will take a lot to ease the pain of the most vulnerable, who need food, jobs and housing. Here’s hoping this dengue outbreak rings alarm bells for the government.
Ruth Pollard is a columnist and editor with Bloomberg Opinion
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