Lt Col (Dr) Inam Danish Khan,
Dr Shashi Sudhan
India is fighting hard, despite being dominated by an unprecedented second Covid-19 wave. India’s second wave is akin to Rogue waves in maritime parlance notorious for sudden shocks to larger ships at high sea. Yes, people were dying everywhere and there was a crisis of beds, oxygen, drugs, vaccines, ambulances, healthcare professionals and cremation avenues. Nevertheless, we are a nation of 1.37 billion plus and we fight with all we have, with a ‘Never say die’ attitude. There is a positive change in ideology, healthcare capacity building, international camaraderie and overall policy execution in all key result areas. And in a month’s time from the worst hit from Covid, daily cases have declined, active cases have reduced, ventilator beds are available, oxygen is available, Covid second wave curve is getting flattened and hope is beginning to sprout yet again.
New Covid Hospitals with ventilator beds for serious patients and oxygen beds for moderately serious patients have been established by national, state, district, municipal and philanthropic organizations nationwide. At the forefront, national level capacity building has been boosted by Armed Forces Medical Services (AFMS) by opening 15% beds including ventilator beds in many hospitals for civil population. Many Armed Forces hospitals are located in different areas of Jammu and Kashmir and thus accessible to the civil population readily. In addition, AFMS has operationalized dedicated Covid hospitals with ventilator and oxygen bedsin key locations such as Jammu, Srinagar,Leh, Kargil, Delhi, Gurugram, Faridabad, Chandigarh, Patiala, Lucknow, Varanasi, Patna, Pune, Bangalore and Ahmedabad, for civil population.Indian Army Medical Corps has established a 250-bedded hospital in Rangret, Srinagar and a 20-bedded centre in Baramulla.Many other AFMS Covid hospitals are being started in all states to ensure uniform healthcare security during the ongoing second wave and possible third wave.Covid Care Centres with only oxygen beds for moderate Covid have been established by the Central Armed Police Forces such as Central Reserve Police Force (CRPF), Border Security Force (BSF) and Indo-Tibetan Border Police (ITBP) have also extended Covid oxygen beds to Indian citizens and ITBP has established a 500 bedded Covid care centre with oxygen beds in Delhi. Army has also started covid care centres in Bhopal, Gwalior, Saugor and Barmer.
Govt of Jammu and Kashmir has 24 dedicated Covid hospitals, of which eight are in Jammu division and 18 in Kashmir division. In addition, new Covid hospitals have been opened in Jammu and Srinagar in association with various agencies such as DRDO. A 500 bedded prefabricated and fire retardant dedicated Covid hospital is under construction in Bhagwati Nagar Jammu under the technical guidance from GMC Jammu. This hospital will have two liquid medical oxygen tanks each with 20 metric ton capacity. A similar hospital is under construction in Srinagar. Further, ongoing vaccinations, Covid curfews and lockdowns also enforced physical distancing and reduced new infections.34 new private hospitals in Jammu and Kashmir have been authorized for vaccination.
Government Medical College, Jammu is spearheading the Covid pandemic efforts adroitly and meticulously. GMC Jammu is a dedicated Covid hospital which has established a new 100-bedded Covid ward in addition to existing Covid wards. GMC Jammu is also hiring 250 nurses to boost healthcare professionals for 24×7 Covid care.With these measures, ventilator beds and oxygen beds are now available in GMC Jammu and other hospitals in Jammu and Kashmir.
Other state Governments are adding bed capacity at all levels.Delhi has 4886 ventilator beds and 16272 oxygen beds on top of which another 1200 ventilator beds and 15000 oxygen beds are being added. The Government of Delhi has established 500 ICU-bed Covid hospital at Ramlila Maidan. Haryana, Nagaland, Assam, Andhra Pradesh have opened new Covid hospitals.Indian railways has 86 operational Covid hospitals. Hindustan Aeronautics Limited (HAL) has also established Covid facilities in Lucknow, Bengaluru and Nashik.
Oxygen demand has risen multifolds leading to oxygen crisis across the country. Oxygen surplus states such as Kerala and Orissa are supplying oxygen to other states.Liquid oxygen, cryogenic tanks, cylinders, concentrators and oxygen generation plants were mobilized to India from more than 40 countries.
Govt of Jammu and Kashmir has been proactive in creating a network of all hospitals for streamlining oxygen supply across Jammu and Kashmir divisions. Seven new oxygen generation plants have been imported from Germany.Two new medical-oxygen plants are under construction at GMC Jammu and 25 in Srinagar.
The upscaling of infrastructure is rapidly adding 40000-80000 dedicated Covid beds pan India encompassing coherent elements of geospatial siting, facility engineering in association with Defence Research and Development Organization (DRDO) and Tata Sons; logistics of medical equipment, and operationalization by a 24×7 dedicated team of doctors, nurses and healthcare personnel war zone against Covid.National and international solidarity has helped control the upsurging Covid-19 crisis and brought it down from mammoth proportions to a seemingly flattening Covid wave. Govt organizations have developed websites and web-applications which provide a real time availability of beds which has streamlined information-education-communication on a mass scale.
Covid-19 mandates Swiss Cheese Modelwherein multilateral efforts are required for pandemic control. Covid-19 pandemic has been caused by a new virus, is being tested by new tests, being treated by new drugs and being prevented by new vaccines. New knowledge is evolving rapidly and is being incorporated in the test-treat-trace-vaccinate strategy. Apart from drugs and vaccines, there is a human element to prevention which lies in universal masking despite vaccination, frequent hand washing and six-feet physical distancing, which are time tested public health behavioural interventions.
The good news
India as a nation has been labeled a Covid disaster by international leadership, scientific community and media houses. India is humbly accepting what went by, nevertheless there is hope for a resurgent and resilient India which is well prepared now on. India is undergoing a sea change with multilateral resource mobilization, robust policy implementation, expansion of bed-capacity, creation of oxygen plants, and fast-tracking of drugs and vaccines. The curve has seen a turnaround, nevertheless emanates ongoing caution for more pandemic waves in future. The focus is shifting from Government to citizenry, for the next pandemic wave can only be abated by individual positive attitude and Covid appropriate behaviour. It’s the duty of every Indian citizen to safeguard his own and nation’s health by following guidelines. The war against Covid may not be over, nevertheless every Indian citizen stands as a Covid warrior armed with knowledge and enthusiasm, high hopes, broad vision and loftier dreams.
(The authors are Associate Professor Microbiology, Command Hospital NC Udhampur and Principal, GMC Jammu).
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