During the initial months of the Covid-19 pandemic, Nanded had leaped into the limelight when Sikh pilgrims, who had come to the district for a pilgrimage and then got stranded due to the lockdown, started testing positive once they went back to Punjab. One of the larger districts in Maharashtra, Nanded has reported more than 16,000 cases and 426 deaths till now.
District Collector Dr Vipin Itankar, who himself contracted Covid-19 and recovered subsequently, tells the Indian Express about Nanded’s future roadmap in terms of development of medical infrastructure
Initially, Nanded was in the green zone for a long time, in terms of Covid-19 cases, but then slipped into the red zone as cases started rising. How has the district fared so far in the pandemic?
Nanded was in the green zone for a long time despite being surrounded by Aurangabad, Telangana and Andhra Pradesh, all of which were in the red then. The first case of Covid- 19 came to Nanded from these places. As a district, Nanded has its own set of challenges – it has tribal blocks, it has its remote locations. So, when the pandemic started, it was a challenge for us to control it. My training as a doctor and my first-hand knowledge about the medical infrastructure of the district helped us ensure that we were better prepared to deal with the pandemic.
At the start of the pandemic, our case fatality ratio (CFR) was as high as 5.5 per cent. Analysis of the results showed that this was mainly because of the psychological barrier people had towards seeking timely medical help. Patients came to us when their oxygen saturation levels were as low as 60-70 per cent, when precious little could be done for them.
Our main challenge was to encourage people to seek help and assure them that they will get medical help at the right time. Once the fear was addressed and people were allowed to go for home isolation, our CFR came down drastically. At present, our CFR of 2.5 is lower than that of the state’s 2.8, and we aim to bring it down further to the national average of 1.2
As for the many Sikh pilgrims who tested positive in Punjab (after going back from Maharashtra), the source of infection could have been from anywhere. When they were in Nanded, we had carried out regular medical check-ups but soon…. some of them tried to leave without permission and we caught the driver. When the government allowed them to go back, their bus took them through areas which were hotspots. The source of infection could be anywhere.
How has home isolation helped you in terms of maximising the use of available medical infrastructure?
Hospitalisation is not a pleasant experience for anyone. I, too, had the same experience when I had tested positive and had to be hospitalised. During the initial days, there were cases of asymptomatic people complaining about the food quality at Covid care centres or running away. The district authorities decided to tackle this challenge by allowing them to stay at home. Patients who could opt for home isolation were allowed to do so. They were given the complete home isolation kit, with charts and log books on how to take medicines. Call centres were asked to keep in touch with the patients and in case of danger signals, they were to be hospitalised immediately.
This helped patients recover as being in a familiar environment helped them psychologically. Also, for district authorities, it helped them keep beds vacant to cope with any emergency. At present, we have 170-180 vacant beds in the dedicated Covid hospital. As these beds were empty, the more serious patients, who came early, were able to get timely treatment. This has helped reduce the mortality rate substantially. Recently, the chief minister also praised the district’s home isolation programme.
You had tested positive for the virus and earned praise for getting treated in a government hospital. Do you think the Covid-19 crisis has re-emphasised the need to invest in health infrastructure? Also, how did your training as a doctor help you tackle the crisis?
I have studied in government medical colleges and so, when I tested positive and developed respiratory symptoms, there was no other option but to seek treatment there. I have first- hand experience of government healthcare and can vouch for its efficacy. My wife, who is a radiologist, also chose government healthcare for delivering both our children. Given the affordability, its government medical facilities which can provide succour to the majority. Proper investment in such infrastructure is necessary and the ongoing pandemic has told us the same.
When the pandemic broke out in Nanded, my training as a medical doctor helped me emphasise on oxygen beds and getting the necessary infrastructure ready in time. This investment is for the long term and will help us even when the pandemic is past us. We have ample oxygen supply, biPap and other machines, which will help us in the long run.
How do you plan to make a district like Nanded ready for challenges in the health sector?
The pandemic has alerted us about the need to be ready to face any situation and the importance of healthcare. Our guardian minister Ashok Chavan has assured us that funds will not be a problem, and we have prepared a road map for the district in the long run. The three main arms that we will be working on are infrastructure, facilities and HR. The last will involve recruitment and will involve the Mantralaya, while the rest will be dealt with at the district level. We will ensure all the primary health centres and taluka-level hospitals have the necessary infrastructure to function as good healthcare providers.
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