COVID-19: A Global Pandemic Threat And Strategies Adopted By Different Countries
COVID-19 is a global pandemic threat as declared by WHO. With more than 17 lakh COVID-19 positive cases and over one lakh deaths worldwide, the disease is spreading exponentially. The USA has the highest number of COVID-19 positive cases, while India has over 8000 COVID-19 positive cases with a mortality rate of about 3%.
WHO advised every country to follow the model of “Find, isolate, test and treat every case and trace every contact; ready your hospitals; protect and train your health workers”. Different countries adopted this model according to their capacities and almost every country reformed their healthcare sector policies to ensure greater government control over private hospitals. Spain has nationalised all its private hospitals and healthcare providers in the country to fight the spread of coronavirus when cases were 9,191 and related deaths 309.
It also mandated that all the final year students of medical colleges will provide healthcare service after necessary training. The US Senate passed emergency bills, which provided for free coronavirus testing and financial help for treatment, 12 weeks paid sick leave, unemployment allowances, and food assistance for vulnerable populations; it was followed by the historic $2 trillion economic stimulus package bill. But, initially, people skipped tests due to the high cost of coronavirus tests and treatment in private healthcare facilities.
India’s Response To COVID-19
On January 30, India reported its first COVID-19 positive case in Kerala. Transmission escalated in March, with confirmed cases crossed 100 on March 15 and 1000 on March 28. The government of India invoked the Epidemic Disease Act 1897 and classified the pandemic as “notified disaster” under the National Disaster Management Act 2005. It was followed by a complete nationwide lockdown for 21 days starting from March 24, which has now been extended by another 15 days.
Our motto is ‘prevention, prepare and not panic’. The lockdown reduced physical contact to prevent the spread of the coronavirus. It was followed by tracing, isolating and testing all the anticipated cases with travel history. However, people concealed their travel history and didn’t come forward for tests; many even escaped from the quarantine centres. The reasons for such lack of cooperation may be different, varying from poor hygiene and maintenance of government hospitals to the fear of high treatment expenditure or ignorance/misinformation.
To ensure people’s cooperation, two conditions should be fulfilled: first, the COVID-19 tests should be made free of cost in all testing centres—both private and public, because Indians have a habit of availing private healthcare facilities more often. In India, the private healthcare facilities are allowed to charge ₹4500 per test, which makes the private laboratories nearly inaccessible to the poor people. The SC has directed the centre to make provision for refund of the amount charged for the test to the people and make healthcare facilities more affordable.
Secondly, the treatment of COVID-19 should be made free of cost, both in private and public hospitals, as the high healthcare expenditure is a major cause of people opting out of tests and treatments, even during normal times. Due to the loss of livelihood in the crisis, most people can’t afford the expensive treatment and hence, will hesitate to get COVID-19 tests. They may choose an alternative remedy, circulating through misinformation on social media, or ignore the symptoms for a common cold or seasonal flu. Moreover, their priorities are to have access to food and other basic necessities during the lockdown period, which has been extended by many States.
India Needs Public Healthcare To Fight COVID-19 And Beyond
According to WHO data, Spain has 3 hospital beds and 4.1 doctors for every 1000 persons; for India, the corresponding data stands at 0.7 hospital beds and 0.8 doctors for every 1000 persons. Still, Spain has to push for the nationalisation of all private hospitals due to the coronavirus pandemic.
The Indian healthcare sector has private and rich bias-ness. The private sector consists of 58% of the hospitals in the country, 29% of beds in hospitals, and 81% of doctors. The cost of private healthcare is about four times greater than the country’s public healthcare.
Still, the majority of the population prefer private healthcare facilities. In Mumbai, hospitalisation cost for one patient was reported to be ₹12 lakh for coronavirus treatment, and everyone can’t afford this—even Ayushman Bharat provides insurance coverage up to ₹5 lakh for each family.
With the economies frozen to beat the coronavirus, the world may see the deepest peacetime recession since the 1930s Great Depression. According to ILO, about 40 crore Indians working in the informal sector are at the risk of falling deeper into poverty due to the coronavirus crisis which is having “catastrophic consequences”. During and after the crisis, most of the people will remain unemployed. The CMIE has estimated the unemployment rate to be 23%. It will take time before the economy will get back on track and people gain employment.
As high healthcare expenditure has remained a major cause of poverty in India, the crisis may push many people into a vicious cycle of debt and extreme poverty. The poverty rate is very high in India, 29% (Rangarajan Report).
The coronavirus crisis will make poverty “hereditary” in India unless the governments respond to the crisis more proactively to address these concerns. It may also push many people to suicide, or cause even more deaths related to the inaccessibility of healthcare facilities due to low purchasing power of people. The middle class will be affected more by the loss of jobs and will be pushed into poverty, in both urban and rural areas, as they opt for private healthcare services more frequently.
The common Indian can neither afford the paid tests nor pay the high expenses of treatment in private hospitals. And if these cases remain unidentified, it will be a persistent national threat, as COVID 19 is a highly contagious disease. We should also remember that how the government responds to this crisis is going to shape the future of the poor in India; the quality and affordability of public services will depend upon the actions that are taken during this crisis.
All these issues can be addressed by an act of the parliament or an ordinance by the president. The law shall provide for nationalisation of healthcare sector, including tertiary services for a period of no less than three financial years, which can be extended by a subsequent act of the parliament if such conditions persist. The question remains, is there a political will?