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Monday, May 10, 2021

Not just the coronavirus, the government’s ineptitude has brought this tsunami on us

Oxygen, vaccination, more beds and firmer enforcement of COVID-19 protocols can help us weather this crisis.

Written by Farokh E Udwadia |
Updated: April 28, 2021 9:14:01 am
Equally responsible is the ineptitude and mismanagement of those who govern us and have the responsibility to safeguard our health and welfare. (Illustration by C R Sasikumar)

The present pandemic has devastated our poor country and anguished its people. There are two reasons for this debacle. The first is the dreaded, deadly coronavirus, which has perhaps mutated and become even more infectious. Equally responsible is the ineptitude and mismanagement of those who govern us and have the responsibility to safeguard our health and welfare.

When the infection rate in India had significantly decreased last December and early January of this year, our netas congratulated themselves proclaiming to us and the world their efficiency in controlling the virus. Could they not realise that the second wave of infection was well-nigh inevitable? All countries in Europe, the UK, the Americas, and even developed countries in Asia such as South Korea and Japan, suffered a second wave, some even a third wave, and very often the second wave was worse than the first. Had we anticipated this, we could have buttressed our defences and increased our resources.

Perhaps the powers that be felt that we are God’s chosen country and this could not happen to us. But we are not God’s chosen country for more than one reason. So, not only do we have a disaster, but we are faced with a veritable, continuing tsunami.

To make matters worse, we allowed the Kumbh Mela, where lakhs and lakhs of people intermingled, spreading the virus, and then returned home further spreading the virus. The authorities in the northern states reassured us that all those who returned would be screened, tested, traced, isolated. Who are they trying to fool? The gullible people of our country, of course.

As the virus is tearing through our country, we witness election rallies where thousands of people day after day, standing shoulder to shoulder, without masks, listen to our netas without masks, spitting out words (and perhaps some coronaviruses) for over an hour. More infections, more misery.

Also, note the poor planning of the vaccination programme. Is it not elementary that the supply of the vaccine should relate to the demand? If indeed this were so, why is there a shortage of vaccines in many vaccination centres, with long queues of people waiting in the hot sun — more spread of infections, greater misery. Again, how large-hearted we all are! What largesse we possess to give vaccines to neighbouring countries, forgetting the agony of people in our own country, forgetting that charity begins at home.

What, indeed, should we do now? As one who has treated many ill patients over many years, let me give the following suggestions.

First, treatment. Beg, borrow, steal, pay even a ransom to get more oxygen, transport it, and make it available to patients. This requires excellent logistic planning. We are fighting a war, and no war has ever been won without excellent logistic support.

Second, there are only three drugs of importance: Most crucial is oxygen (yes, oxygen is a drug); Dexamethasone administered to those requiring oxygen. If given when the oxygen saturation is satisfactory, the drug may well do harm. Finally, blood thinners to prevent and treat clotting within vessels.

Third, we need critical care for the very sick and more beds to treat more patients.

No other drug has been proven to be effective against the disease. The anxiety and urgency to stock remdesevir, in my opinion, is not warranted. This drug is no cure, it does not reduce mortality — it only shortens by 5 to 6 days the duration of the illness. Use it if you will, but let us transfer this anxiety and urgency to getting more oxygen, please.

Vaccination is the key to victory against the disease. It is important to plan the logistics, project deadlines and ensure they are met and fix one price for the vaccine after negotiations with the manufacturers. Different prices will cause confusion. It is also necessary to set up many, many vaccination centres and augment the supply of any vaccine of proven use and safety. All people above the age of 20 must be vaccinated

Set up wardens, police cars in every crowded place in all cities to ensure that masking and social distancing norms are observed. Do not just fine, but jail for a few days, those who ignore this directive. Discipline needs to be enforced on an undisciplined people.

Major lockdowns are of no use but lockdown enclaves within a city found to be rife with infection and disease. Target people within these enclaves for priority vaccination. Test, trace, treat those within.

The television channels mouth platitudes. Where words most abound good sense is seldom found. There are, of course, a few exceptions to the above. I salute these.

Please reduce or stop the daily conclave of doctors who give the same answers to the same questions. There is surely a better way to update and educate the public. A look at how the BBC does this may give a few ideas.

Prime Minister Narendra Modi and his task force are busy fighting the pandemic. I would urge them not to just look at the statistics given to them, or just view the TV channels for the news. I urge the Prime Minister and a few of his colleagues to spend at least one day visiting the hospitals in Delhi to directly hear the dying gasps of patients deprived of oxygen, to see the despair of relatives watching their loved ones dying waiting for a bed, waiting for oxygen that never comes.

I am old and, therefore, hors de combat, but I have trained many of those who are fighting the disease at the frontline, not just in Mumbai but in other cities as well. I am anguished for their safety, yet I know that they will do their duty with courage and sacrifice. All those doctors and nurses fighting at the frontlines are the true heroes of our country.

Oh cry, my country cry, but I know we shall win and smile again. We need to fight as one; we need great qualities of both head and heart, and we have them. We need God’s blessings; we need his help, remembering however that God helps those who help themselves.

This column first appeared in the print edition on April 28, 2021 under the title ‘In battle to breathe, next steps’. The writer is emeritus professor in medicine, Grant Medical College and the JJ Group of Hospitals; consultant physician, director, Intensive Care Unit, Breach Candy Hospital; Consultant Physician, BD Petit Parsee General Hospital, Mumbai.

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