Preparedness to Face The Covid-19 Pandemic – is India Missing The Mark?

Abstract

The Corona Virus Disease (COVID-19) caused by SARS Co-V 2 in late 2019 has resulted in a pandemic infecting more than 8 million across the world with nearly half a million lives already lost. In Wuhan, the epicentre of the disease in China and in Singapore, after an apparent suppression of the pandemic, there has been a rebound of cases. India, despite being on lock down for more than two months witnessed a rise in cases, and this is likely to dramatically worsen as lock down has been released. As part of the preparation for the management of COVID-19 cases, efforts are in full swing and the need to augment the invasive mechanical ventilation (IMV) capacity seems to be a part of the strategy. It is clear that only around 5% of those infected will require critical care and a proportion of them may end up on IMV. More importantly, the outcome in those ventilated is poor- 60% mortality in the best case scenario and as bad as 97% in the worst. IMV is expensive and requires skilled manpower, which cannot be created in a short span of time. On the other hand, 14% of the COVID-19 patients may require admission and only good supportive care, primarily oxygen therapy and non-invasive ventilation. Appropriate preparation to provide good supportive care is crucial. This could avert or reduce the need for IMV and is likely to save more lives. Such a model of cost-effective care is more appropriat for India and this may be something that other resource limited countries could emulate.