I lost my father to Covid-19. He was in ICU for 22 days, of which the final 12 days, he was on invasive ventilator support. Based on my experience, these seven recommendations can significantly reduce Covid-19 deaths.
Elderly people and those with comorbidities must be tested on a priority basis. The wait time for an RT-PCR test result, even for the elderly, in Bengaluru, over the last few months, has been three to five days while in north India (Delhi, Jaipur) it has been 18 to 24hrs. Early detection allows early medical intervention, when the viral load is still low, thereby improving outcome.
A centralised and real-time hospital bed and ambulance discovery system is needed. It took us nine hours to find an ICU bed with ventilator support. During this time, my father was in the ER where his NIV oxygen requirement increased from 4L/min to 15L/min. The disease spreads extremely fast in the early days for vulnerable patients and doctors should be able to identify and refer patients quickly based on facilities available and budget constraints.
Politicians should stay out of regulating medical care and focus on building infrastructure. Maharashtra recently passed an order limiting oxygen flow in severe cases to not more than 12L/min. At that rate of oxygen flow, my father would have passed away in ER on the first day of hospitalization--denying him 22 days of life support when he was, at times, on 80L/min oxygen flow and showed chances of recovery several times. Both central and state governments focused on purchasing ventilators but not on building the oxygen support infrastructure. Technologies such as on-site PSA oxygen generation that harvests oxygen from the atmosphere can significantly improve oxygen support availability.
Reasonable price caps are required to ensure the affordability of medical care. I paid Rs 10,500 to shift my father in an ambulance with oxygen from the emergency room to an ICU bed in a hospital 25 km away, at 1:30 AM. The drive took less than twenty minutes. This price tag might be out of reach for a majority of the population and needs to be regulated.
There is an absolute need to block bad practices in medical research. Several firms have been pushing for experimental medicines, plasma therapy and monoclonal antibody treatments without proper or sufficient research. My father’s doctor pointed to ICMR’s PLACID trial to indicate that plasma treatment does not work in my father’s case. Doctors need to be more forthcoming in informing patients and their families if they are treating them with experimental medicines or if the patient is part of a medical trial --particularly if the patient is part of the placebo group.
Covid-19 hospitals need to implement strict isolation of Covid-19 and non-Covid-19 patients, caregivers, and facilities. I too had tested Covid-19 positive at this time. Yet, I was required to visit the main entrance and billing facility at both hospitals to pay bills – even after I had clearly informed the hospital staff that I was Covid-19 positive. These billing counters are also visited by several other vulnerable people including the elderly and pregnant women.
Public awareness campaigns about wearing masks need to be increased. My father had not stepped out of the house in the 45 days prior to testing Covid-19 positive. We had taken precautions as we knew that my father was vulnerable. When we tested positive, no one in my family, including my father and I, had any symptoms – we had tested proactively. We were tested at home and isolated ourselves as we learned of another case in the apartment block. However, several of our neighbours walk or jog, even now, without wearing masks.
My father retired after having worked for more than three decades at BHEL R&D, India’s foremost research centre in Electrical and Electronics Engineering. He had faith in both god and science and integrated them into his life. His passion for science had a tremendous impact on my brother and me and helped shape our minds.
We have had months to make the required changes and a lot has been achieved. But clearly more can be done to reduce Covid-19 deaths.
(The writer is the founder of an investment start-up)