India’s Healthcare Condition

Long before the virus invasion into India, the nation already suffered from a devastatingly poor healthcare system. With more corrupt systems in Public (government owned) hospitals where only miserable think of going while the middle or upper  middle and upper classes always seek for the genuine treatments at heavily priced private hospitals. Middle class economic sectors do end up with long term bank loans.

We’ve seen many cases in the past where private hospitals literally looted patient’s families, in some cases the patient was already dead while reaching the hospital and yet doctor’s kept the dead bodies for treatment and kept fooling the family by saying “we are doing the treatment and trying our best to save the patient”. All this was done just to add up bills for the families and friends of patient.

There’s a saying about doctors worldwide that they are a form of god who saves lives but this thought is questioned when some doctors commit the hideous sins ever known to humanity. This is happening even during the treatments of covid-19 specifically in India where many citizens are falsely reported covid positive and are admitted to expensive private medical institutes who charge hefty charges (8-12 Lakhs INR) from somebody who’s already negative from the virus contagion.

In many other cases where healthy citizens wrongly reported are admitted to hospitals and later their vital body parts viz. heart, kidneys, eyes, liver etc were removed for organ trade benefits. So how these doctors were able to do this and how still many are doing this right under the nose of government administrations. The answer comes to complete absence of investigation of each dead body, these doctors know it for sure that an alleged positive patient when claimed dead would be directly sealed into a body bag by the hospital workers. No policemen and neither family nor friends are allowed to have a sneak peek at the dead body. The dead body in a body bag is directly sent for cremation. This gives an upper hand for corruption and illegal organ trade.

Some 2.4 million Indians die of treatable conditions every year, the worst situation among 136 nations studied for a report published in The Lancet. Poor care quality leads to more deaths than insufficient access to healthcare–1.6 million Indians died due to poor quality of care in 2016, nearly twice as many as due to non-utilisation of healthcare services (838,000 persons).

“For too long, the global health discourse has been focused on improving access to care, without sufficient emphasis on high quality care,” Muhammad Pate, co-chair of the commission that produced the report, who is also chief executive of Big Win Philanthropy and former minister of state for health in Nigeria, said in a statement. “Providing health services without guaranteeing a minimum level of quality is ineffective, wasteful and unethical,” he said.

As the Indian government readies to roll out its ambitious national health protection scheme, the Ayushman Bharat Yojana, by the end of September 2018, the study’s findings are crucial.

“We need to better measure the quality of our health system as a composite entity rather than be merely content with certifying hospitals and laboratories,” said Srinath Reddy, president of the Public Health Foundation of India, a Delhi-based think tank, about the lack of mechanisms for monitoring quality in India. “Some elements of quality, mainly in maternal and child health, are being monitored under NRHM [National Rural Health Mission]. However, composite measures of the health system overall are unavailable,” he said.

Public accountability and transparency on health system performance are two ways to improve the quality of healthcare, the commission recommends.

Commonly used health metrics such as the availability of medicines, equipment and skilled attendants do not reflect quality of care and even “lead to false complacency about progress”, it says, proposing a dashboard of metrics that should be implemented by countries by 2021 to enable transparent measurement and reporting of quality care.

Day to Day Sings & Symptons…DAY 1 to 22

Day to Day Signs and Symptoms of Coronavirus DAY TO DAY SYMPTOMS OF COVID-19 Before proceeding, please note that this general overview is compiled for initial self-assessment only and should vary for each individual. If you are not feeling well, you ought to immediately consult a medical man to possess an accurate diagnosis and proper treatment of COVID-19. The typical daily symptoms are concluded from the study of 138 patients at Zhongnan Hospital of Wuhan University and another study involving 135 patients from Jinyintan Hospital and 56 patients from Wuhan Pulmonary Hospital.

Update: China reports 1,287 confirmed cases of new coronavirus ...

These symptoms are broken down into:

DAY 1 to DAY 2 the start symptoms are almost like the cold with a light pharyngitis and neither having a fever nor feeling tired. Patients can still consume food and drink as was common .

DAY 3 The patient’s throats start to feel a touch painful. Body temperature reads at around 36.5° celsius. Although it’s uncommon, other symptoms like mild nausea, vomiting or mild diarrhea are possible to set in.

DAY 4 Throat pain becomes more serious. Other symptoms like feeling weak and joint pain start to manifest. The patient may show a temperature reading between 36.5° to 37° celsius.

DAY 5 to DAY 6 Mild fever starts. The patients show a temperature reading above 37.2° celsius. The second most common symptom, dry cough, also appears. Dyspnea or breathing difficulty may occur occasionally. Most patients during this stage are easily feeling tired. Other symptoms remain about the same. These four symptoms are among the top five key indications of COVID-19 according to the final report of the initial outbreak conducted by the joint mission of China and WHO.

DAY 7 get more serious coughs and breathing difficulty. Fever can get higher up to 38° celsius. Patients may develop further headache and body pain or worsening diarrhea if there’s any. Many patients are admitted to the hospital at this stage.

DAY 8 to DAY 9 On the 8th day, the symptoms are likely to be worsened for the patient who has coexisting medical conditions. Severe shortness of breath becomes more frequent. Temperature reading goes well above 38°.

DAY 9 is that the average time when Sepsis starts to affect 40% of the patients.

DAY 10 to DAY 11 Doctors are ordering imaging tests like chest x-ray to capture the severity of respiratory distress in patients. Patients are having loss of appetite and should be facing abdominal pain. The condition also needs immediate treatment in ICU.

DAY 12 to DAY 14 For the survivors, the symptoms can be well-managed at this point. Fever tends to urge better and breathing difficulties may start to cease on day 13. But Some patients should be suffering from mild cough even after hospital discharge.

DAY 15 to DAY 16 Day 15 is the opposite condition for the rest of the minority patients. The fragile group must prepare for the possibility of acute cardiac injury or kidney injury.

DAY 17 to DAY 19 COVID-19 fatality cases happen at around day 18. Before the time, vulnerable patients may develop a secondary infection caused by a new pathogen in the lower respiratory tract. The severe condition may then lead to blood coagulation and ischemia.
DAY 20 to DAY 22 The surviving patients are recovered completely from the disease and are discharged from the hospital.

STAY HOME & STAY SAFE

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Hyderabad’s high COVID-19 positivity rate worries experts

Telangana State Disaster Response and Fire Services Department workers sanitise the area surrounding Charminar in Hyderabad, to prevent the spreading of COVID-19

Report points to abysmally low testing rates in the State of Telangana Amidst apprehension that COVID-19 community transmission may be under way in large urban cities, Hyderabad’s high COVID-19 positivity rate (32.1% on June 23), the highest among major infected cities in India, coupled with low tests per 10 lakh population compared to other cities has been repeatedly red-flagged by worried Central government experts.

Pointing to the abysmally low testing rates in Telangana, the report ‘Testing Status: Hyderabad and Telangana’ accessed by The Hindu notes, “Only 1 out of 19 private labs in Telangana is conducting more than 500 tests per week and testing in Telangana is heavily focussed on Hyderabad. Tests per 10 lakh population in other highly infected districts (Ranga Reddy, Sangareddy, Warangal Urban and Jagaon) is extremely low.”

The document adds that Telangana has the highest positivity rate (June 10-23) in India (27.7%) and consistently ranges from 20 – 40% daily with the lowest tests per 10 lakh population (June 10-23) in India.

“All COVID-red States are being closely monitored and have been instructed to hike testing. Testing is vital to map out the growth and concentration of the virus in the general population. Several States have been instructed on this multiple times,” said a senior government official with ICMR who added that letters were issued to all States recently asking them to ramp-up COVID-19 testing.

The ICMR also has noted that COVID-19 escalation is sharpest in urban cities with Delhi, Gurugram, Mumbai and Chennai, also witnessing significant rise in the spread of the virus and added that Telangana has been repeated told to improve its testing scope and reach.

Bringing in the contrast, a senior health official added that neighbouring Andhra Pradesh is testing over 12,000 persons/day and also ramping-up testing to maintain a low mortality rate. “Andhra Pradesh has 336 TruNat machines and 42 labs for COVID-19 testing while Telangana has 21 machines and one lab,” the official added.

According to the Health Ministry, a Central team led by Lav Agarwal, Joint Secretary, in the Ministry is now in Gujarat, Maharashtra and Telangana to interact with the State officials and coordinate with them to strengthen ongoing efforts for management of COVID-19 there.

The Ministry added that they are expanding the COVID-19 testing labs network across the country, ICMR has inducted 11 new labs in the last 24 hours and the country now has 1,016 diagnostic labs dedicated to COVID-19 which includes — 737 in the government sector and 279 private labs.

“At present, India has Real-Time RT PCR based testing labs — 560 (Govt: 359 + Private: 201), TrueNat based testing labs : 369 (Govt: 346 + Private: 23) and CBNAAT based testing labs : 87 (Govt: 32 + Private: 55),” said ICMR.

‘Bring all helathcare facilities under one umbrella’

Meanwhile, in a statement issued by 26 national and Karnataka-based civil society organisations including Naavu Bharathiyaru Karnataka, All India Drug Action Network, All India Central Council of Trade Unions (AICCTU), Karnataka and Campaign for Dignified and Affordable Healthcare (CDAH), the group has noted that in order to successfully curtail the pandemic, a whole health systems approach is sorely required. This is missing in the current approach where provision of healthcare is seen in a segmented manner. There is a dire need to bring public, private, charitable, medical colleges, corporation facilities under a single umbrella with transparent and well-functioning referral and reporting mechanisms, said the group.

It added that the government could use the COVID-19 situation as a good opportunity to improve the reporting and assisted referral mechanisms from the various public as well private facilities so that the patients are not distressed going from one hospital to another and the treatment given to COVID-19 patients must be in strict adherence to Standard Treatment Guidelines, which should be issued by an appropriate government agency.

 

Record recoveries in India,  highest new cases in 24 hours

Total coronavirus cases in India crossed 4.9 lakh

The number of active coronavirus cases in India stands at 189463 while 285636 people have recovered

The death toll has risen to 15,301

The total number of coronavirus cases in India jumped to 4,90,401 after 17,296 new cases were reported in 24 hours. This is the highest number of new cases reported in 24 hours. According to health ministry’s numbers released today morning, the number of active cases stands at 1,89,463 while 2,85,636 people have recovered and one patient has migrated. A record total of 13,940 COVID-19 patients were declared cured in a single day. The recovery rate has improved to 58.24%.

Covid-related deaths rose to 15,301 after 407 fatalities were reported in 24 hours.

Coronavirus testing facilities have been ramped up across the country with 1,007 diagnostic labs currently offering covid diagnostic facilities, the government said.

Medical research body ICMR has said that a total of 77.76 lakh samples have been tested up to June 25. And on Thursday over 2.15 lakh samples were tested.

According to figures released by the government on Thursday, coronavirus cases per lakh in India stand at 33.39 against the world’s average of 120.21 cases/lakh. Also, death/lakh in the country is currently amongst the lowest in the world with 1.06 deaths/lakh against the world average of 6.24 deaths/lakh, the government said.

A team from Union Ministry of Health and Family Welfare will visit Gujarat, Maharashtra and Telangana this weekend to interact with the state officials and coordinate with them to strengthen ongoing efforts for management of Covid-19.

Maharashtra, the worst affected state, has reported over 1,47,741 cases and 6,931 fatalities. Among other states, Delhi has reported 73,780 cases, Tamil Nadu 70,977 and Gujarat 29,520.

Globally, total coronavirus cases moved past 95 lakh while the death toll has crossed 4.8 lakh. US on Thursday reported record number of 37,000 cases in a day, taking its overall count to over 24 lakh. The country has reported over 1.24 lakh coronavirus-related fatalities.

 

Scaling up of COVID testing centres (Hub and spoke model)

To scale up testing and enhance the reach across the countryCity /Regional clusters have been established in a Hub and Spoke Model to scale-up testing of COVID-19 samples in government institutions across the country. Institutes and Laboratories which have the capacity and expertise for both sample collection, handling/processing (BSL-2 facility) and testing (RT-PCR) serve as the hubs and they involve a number of laboratories which have RT PCR machines and the requisite manpower as their extended Testing facilities.

The Hubs are Government laboratories approved by respective Ministries /Departments (DBT, DST, CSIR, DAE, DRDO, ICAR etc) as per ICMR guidelines. So far 19 City /Regional clusters have been established in Bangalore, Delhi/NCR, Hyderabad, Thiruvananthapuram, Chandigarh/Mohali, Bhubaneshwar, Nagpur, Pune, Mumbai, Lucknow, Chennai, Kolkata, North Eastern Region, Jammu & Kashmir, Ahmedabad, Madhya Pradesh, Rajasthan, Banaras, Palampur and Delhi city.

About 100 institutions have been involved and over 1,60,000 samples tested. Seven DBT Autonomous institutes have been approved as hubs by ICMR and they are performing testing for diagnosis of COVID-19 (RGCB, THSTI, ILS, inStem, NCCS, CDFD, NIBMG). 

They are also functioning as hubs in the respective Cities/Regions and coordinating the efforts with a number of other premier Central and State Government institutions. In addition, they are working closely with the respective State Governments in obtaining samples for testing and are reporting every day to ICMR on their testing results.     Collectively in about 4 weeks, these clusters have done nearly 1,70,000 tests. These clusters will now be scaled to nearly 50 in next 4 weeks and reach remote corners of the country.