'Cases will keep increasing in the next few weeks'

'And that means all of us have to be very careful.'

The healthcare system in India has collapsed, unable to take care of the more the lakhs of covid patients all over India.

The reality is, there are not enough hospital beds, ventilators, not even oxygen.

In an interview with Shobha Warrier/Rediff.com, Dr Anant Bhan, a global public health expert, analyses the situation India is in right now.

You tweeted, 'It's not the virus variants and mutations the reason for the rise in Infections. It's the variants of ineptitude and abdication of public health- thinking by our decision makers.'...

It is easy to blame the variants and mutations. We could have taken a lot of learning from last year when the number of covid cases rose. But we were not prepared well in ensuring the capacities in the hospital, ensuring drugs to the patients, etc.

Then, we could not have allowed all those large congregations at religious events and mass political rallies to happen. It was a failure on the part of the Election Commission and political parties. They should have recognised that it was a huge risk to take.

Now, we are seeing a situation where there is a rise in the infections which is steeper than what we had experienced last year.

After the first wave, many experts including you had said that there was an urgent need to look at our public healthcare system which couldn't handle the virus cases. With the second wave, we see our healthcare system collapsing completely...

It is unfortunate, but then that is the truth. Lessons were not learnt from last year's experience and we allowed the cases to rise.

The situation is such that there are many, many, COVID-19 patients who need ICU care, ventilator care and oxygen, but are struggling to get them.

Along with this, the other patients (with non-COVID-19 conditions) who need care have become less of a priority. Everything now is COVID-19 care only. So, we are forgetting those who need regular care and attention. Because the priority is covid care, hospitals are not in a position to take care of the other patients.

Our healthcare system does not have the capacity to cope with such a situation. When we cannot even handle even the COVID-19 patients, how are we to take care of both COVID-19 and other patients too?

We have reached a situation where the high courts had to ask the Centre to 'beg, borrow or steal' oxygen cylinders...

That depicts how dire the situation is. Everybody is scrambling for something as basic as oxygen.

This is a significant second reminder after last year's viral attack that it is important to address the fundamentals, and we need to do it on a priority basis.

By fundamentals, I mean we need infrastructure, we need labs, we need staffing, we need health policy, epidemiology, lab expertise, we need good quality data collection, a transparent mechanism for sharing data, and we also need to ensure that different health systems are working cohesively in both public and private sector.

People who need care should not have to struggle for that, and the ability to pay should not be a factor. Quality healthcare should be available to all.

What is important right now is, we need to ensure that immediate needs are fulfilled. But more important, we should learn from this experience.

In India, healthcare is moving more and more into private hands....

We can have a separate debate on public versus private healthcare. But that is a reality in the health system right now in India.

Fundamentally the government needs to invest in health systems, which means strengthening of the public health sector. The private health sector is anyway, there. But what we cannot allow is for the private health sector to go unregulated.

The government should ensure regulation and also certain standards in the private healthcare sector. The government should see to it that the private players do not over charge patients. This has to be done along with strengthening the public healthcare system, and ensuring that it is also held accountable for providing quality care.

On the lines of the NHS in the UK?

That would be ideal, but at this point of time, it is going to be difficult as we already have a private healthcare system that is spread-out and well established.

Do you think the reason behind the devastating second wave was because everybody, from the policymakers to the public became complacent after the first wave subsided that the virus had disappeared from this land?

Yes, everybody was complacent, both the public and the government. We all felt too early that the worst was over, and we quickly went back to doing so many things we were doing earlier. A lot of social events started happening and people moved around without masks.

This wave was inevitable with more infections as we have seen in many other countries. The rises in number of cases show that too many people were out there who were potentially at risk but had not taken enough precautions.

Do you think people should have been made aware of the way the virus behaves, that they should expect multiple waves?

Yes, there should have been better health communication. Though all of us are still learning about the virus, it was known that we needed to take precautions.

That was not followed across the country on multiple occasions by everybody.

Some of the scientists I spoke to say that the hurricane has only started. Do you feel what we are seeing now is only the tip of the iceberg?

The data modelers are predicting that the numbers will go up in May unless something drastic happens. It looks like the number of cases will keep increasing in the next few weeks and that means all of us have to be very careful.

The criticism against the new vaccine policy is that it is pro-capitalist...

The question mark is, how do we manage equity in the distribution of the vaccine.

There are many, many, people in the country who cannot afford to pay for the vaccine.

We also do not have a strategy to see that the vaccine is reached in every part of the country.

There is no clarity about who gets the priority. For example, when a private hospital is ready to pay Rs 600 and the state government Rs 400, who gets the priority? Does that mean the hospital gets priority over a state government that will pay only Rs 400?

Then, except India, almost everyone as the end recipient in the world gets the vaccine free. We say that we are one of the largest producing countries; this is also a country that has wide inequity.

In such a country, access to vaccine should not be based on payment. This is another big question mark regarding the new vaccine policy.

• THE WAR AGAINST CORONAVIRUS

Feature Presentation: Ashish Narsale/Rediff.com