It's a war-like situation, we should be ready to ramp up infrastructure when needed: Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute

The heart specialist said that we don't know which vaccine will work or is full-proof yet. However, producing any vaccine in the country is not an issue as India is the biggest vaccine manufacturer in
E-expressions webinar
E-expressions webinar

It is a war-like situation where we should be ready to ramp up infrastructure and facilities rapidly if the need arises, said Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute, talking about the war against COVID. "Nobody expected that we would need such vast infrastructure until this pandemic, even the west which spends way more could not cope with the infection. It drew attention to how healthcare is the most important. Healthcare workers are ready to sacrifice their lives for saving lives and indigenous manufacturing/production is getting ready for it. As a country, we have been devoid of such policies. Aatmanirbhar is good, but it should have been there earlier, for that we need policy revamps that are entrepreneur-friendly, research, innovation-friendly in order to create better infrastructure," the cardiologist added while speaking about how COVID-19 has exposed our healthcare system and what needs immediate fixing.

He was in conversation with The New Indian Express' Editorial Director Prabhu Chawla and senior journalist Kaveree Bamzai during TNIE's e-expressions on the topic: 'How to fix India's Healthcare system'.

Speaking about the availability of vaccines, Dr Seth said that we don't know which vaccine will work or is full-proof yet. "Logistics need to be worked out first. Producing any vaccine in the country is not an issue as India is the biggest vaccine manufacturer in the world. But we need to look at how many months of immunity it offers. Till we figure out all this, we cannot promise anything. However, it will still take a year and a half to complete for a country our size — mid of 2021 we could have something after all the trials are done and approved," he explained while responding to Prabhu Chawla's question about the race for a COVID vaccine around the world.

Speaking on how much we know about the disease after six months and how we should learn to live with it, he added, "It's an unprecedented form of infection by a very new virus and we are coming up with new learnings every day. Think of a non-living particle that has so much power that it has brought the world to a standstill. We could have never imagined it. Science is still researching, the largest number of papers that came out in a short time is on COVID-19. Six months on there are certain facts we have got correctly, but there's still a lot that we don't know. What we do understand now is the symptoms and what precautions can be taken to avoid it. What we don't get it is the proper treatment, still, a long way from its cure and prevention in terms of immunity, how long it will last, how long the virus will be with us."

He goes on to emphasise the importance of wearing masks and maintaining physical distance, "The issue around wearing masks is that it is first my own responsibility to protect myself and also at the same time protect others. Appropriate masking which includes covering our nose, mouth and not just hang a mask around the neck like an ornament, is important. We owe it to everybody else — it is a civic duty — it is a criminal offence to not mask yourselves in public places. In a lab-based controlled atmosphere it has been observed that the droplets can spread to 6 feet but what if there's a wind behind you? It may travel further. Distancing is to be as far away and not close to each other."

Responding to Prabhu Chawla's query about the healthcare infrastructure being enough now after six months of dealing with the virus, Dr Ashok said that the treatment options have increased, guidelines, protocols have become more refined. "We can now treat our patients more systematically, we know what time to use which drugs. We could create more beds, ventilators until the unlocks began happening. Earlier, 100 per cent of the COVID patients would get admitted because of the lack of understanding, now the majority are being treated in isolation at home after indicators which made us understand who needs admission. We have available beds now and they are being used by moderate, severe patients who need admission. I would say that the early lockdown helped as we can see in the west their infrastructure got overwhelmed and numerous deaths occurred. Patients flooded hospitals, queues at cemeteries for bodies to be buried. And we realised that we should not follow that route and impose an early lockdown, which taught us a lot more about COVID. It helped us to ramp up production of PPE kits, masks, which even the west suffered, with a lot of doctors catching the virus," he said.

 
The cardiologist specified that the worst might seem like it is over but we still have a long way to go. "We should put in efforts to ramp up infrastructure, think a month or two in advance or we will always be falling behind. Every state is in a different stage of the disease. With the dense population like in our country, individualised to a region and area, policies need to be reviewed and developed from time to time. We cannot be too intelligent about this virus, we cannot believe we can understand all requirement at one time. Review needs to conducted regularly and we should get experts to chart out a different path with time. The concern of the moment is that we haven't reached the peak yet, we are still at an upslope. When we will see that peak is something we don't understand. The first peak has not arrived yet. We haven't tested enough initially and there are chances that we don't know how many cases will turn up in smaller towns eventually," he explained.

He added that it is a fact that more people die from other illnesses, non-communicable diseases such as cancer and heart attacks. Nationally, 7000 patients die from a heart attack, 1000 die from COVID currently, he added. Speaking about how people are scared to visit hospitals for other ailments, Dr Ashok added, "As we unlock, patients still fear, they ask to postpone procedures until COVID goes away. If you have an illness that needs immediate attention please don't ignore your symptoms. However, a routine trip to the hospital can be avoided at this stage. Non-COVID patients need treatment, they have equal right, there should be no action that creates a difference between these categories."

Finally, Dr Ashok pointed out that when a country is healthy, is when the nation grows. "We have neglected healthcare enough, but we need to focus on it now, it is of utmost importance," he said. He concluded with one last tip for people, "Precautions will save you. If you want to see the normal and get back to it, you have to follow the protocols of wearing masks and maintaining physical distance now."

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