How long the pandemic woes?

Just read about the recurrence of cases in Spain. Looks like covid is going to be with us for a very long time. This brings to the fore a number of questions, which need to be thought about. (Only pertaining to healthcare)

Covid treatment facilities 

Presently the treatment is being done at public hospitals, private hospitals and dedicated covid hospitals. Public hospitals are overwhelmed by numbers because they didnt have much capacity to begin with. Private hospitals are going bust because of increased costs on one hand and capping of charges on the other. And covid hospitals are not working to capacity yet.

Treatment of other disorders 

Other obviously important diseases like monsoon fevers, medical emergencies and surgeries have become difficult to manage because the hospitals are occupied by covid patients. Medical issues like knee replacement,  plastic surgeries, dental problems are prone to be seen as 'luxuries' and completely sidelined. In reality, delay in treatment of these will cause lots of suffering, worsening of the problem and complications. Space needs to be urgently created to start proper interventions for these issues.

Work and livelihood 

In Mumbai at least, the age distribution of medical professionals is very peculiar. Most of the healthcare system in private hospitals is managed by doctors above 50yrs. Public hospitals have younger doctors. But they are all into covid duties. Older doctors in public healthcare have been forbidden to work due to risk of coronavirus infection. Older folks in private practice have been forced to work for their livelihood and government compulsion due to which many have died and there is much fear. Largely medical professionals have not been paid their salaries on time. 

So fear, financial problems,  lack of work, overwork are the avoidable problems being faced by doctors. Plus most private hospitals are facing a financial crisis and may close down in the near future.

What is possible? 

We need to compartmentalize the pandemic and deal with it and that according to me is the only solution. For this to work, following needs to be done

1. Strengthen the covid hospital 

Presently the hospital is mostly empty. Patients need to be directed here instead of occupying private hospital beds. In any case the care is about the same and patients will be saved a great deal of money.

There is severe shortage of healthcare professionals in the field hospitals. Generosity from private sector, expanding telehealth services and creating part time positions is urgently needed.

2. Release private hospitals 

Private hospitals should be released from the compulsion to treat covid patients. They can go back to treating non covid issues. Patients will be served by getting all necessary treatments and private hospitals can be saved from financial collapse.

3. Public hospitals 

Senior doctors in public hospitals should start teleconsultation.  Non affording patients stuck in lockdown at different places can avail of their help.Midcareer specialists should take over the respective departments and start treatment of patients with comorbid covid. For example conducting emergency surgery of covid patients or deliveries etc. This way risk to patient is minimized and the academic program can resume. 

PS

Every medical professional in Mumbai must recognize the covid field hospital as a blessing as it is the only exit strategy available to us. All of us must contribute as much as possible to its setting up and smooth running, with or without payment. Otherwise we are all going to remain in infinite deadlock treating covid which is totally draining our resources and will be unable to return to our usual work. If all of us work by rotation, contributing few weeks time, it can be managed.  It  is quite feasible to take leave from practice for short duration. For now we are also in a position to gain respect because we can contribute voluntarily as per our choice and convenience. However there will come a time when doctors will be publicly shamed for not coming forward and forced to work on unfavorable terms.