Albus Dumbledore once said, “Don’t pity the dead Harry. Pity the living.” And in today’s scenario, these words ring true. Have you ever sat down and wondered what the situation of the people who hold the string between life and death is? The people who are burdened to give you the news of your loved ones passing, those who put their lives on the line day in and day out, trying to save the lives of numerous people, all while scarcely having a break for themselves.
HEALTH CARE INFRASTRUCTURE
Before the pandemic, the most alarming situation was saving the lives of the ageing and ailing population, which required more medical attention by nature. It did not require an excess of medical staff or even the need for more medical equipment. With the Covid-19 pandemic continuing to claim the lives of people of all ages, India has faced one of the biggest crises in years.
With the continued lack of medical funding and the second wave surging in India, the most concerning factor is how to stop the spread of the pandemic. With only 8.5 hospital beds and eight physicians per 10,000 people, the country’s healthcare sector is not equipped for such a crisis. Moreover, the significant inefficiency of the healthcare infrastructure, dysfunction, and acute shortage of basic amenities like hospital beds, oxygen cylinders, and even life-saving drugs is raising a cause for panic.
Today, the most worrying factor remains how fast daily cases are growing and how the graph shows no clear sign of approaching a peak yet. The daily case trajectory is now over 62 per cent. From the 21st to the 23rd of April, India has recorded over 9.5 lakh cases leaving countries like Brazil and the USA in the dust. At this rate, with the continued surge in patients, a million people may be infected in less than ten days.
According to the WHO, the average positivity rate for a specific area is only 5%. However, over 230 of the 718 districts in India have shown at least a 15% positivity rate. It ended up taking almost 30% lives of those infected in its tow.
The number of healthcare workers who lost their lives in the line of duty is recorded to be over 800. The compensation promised for their families is nowhere to be seen. The doctors and nurses are doing over 18-hour shifts per day and still aren’t able to do much for their ailing patients due to a lack of medical resources and information regarding the new strains of coronavirus emerging all over the country.
The Government still seems adamant about not imposing a complete lockdown with concerns for the economy, still hit by the March 2020 lockdown. The situation of low-income families who will lose their livelihood and any amenities provided to save the lives of their loved ones also needs to be considered.
One of the most complicated tasks associated with a global pandemic is the efficient deployment of the vaccine, which requires smooth coordination on several different levels. With the vaccination drive launched on the 16th of January this year in India, 109 million have received their first doses and 17 million complete inoculations. These statistics were seen to be valid until the surge in covid cases started.
The vaccination drive took place in three stages, inoculating the doctors, frontline warriors, and people over 60. The second stage was vaccinating all people over the age of 45. The most recently announced news is the registration of people over 18 to be given the Covisheild and Covaxin. The Government has also made it clear that people can buy the vaccine at the MRP of ₹600. The state government can buy its doses from the companies directly.
With the surge in cases, the Serum Institute of India (SII) finds it challenging to keep up with the demand. The Government has also stopped Vaccine diplomacy or Vaccine Maitri—giving free vaccines to different countries in the name of diplomacy—to meet the pressure of the supply and demand chain.
Experts strongly believe that with the threat of mutant variants of Sars-CoV-2 and a surge in most parts of the country, the vaccination drive needs to be accelerated strategically, so many people are administered the vaccination and safety precautions. It has been recommended that the vaccination be accelerated in the states where elections will be held soon. But due to the shortage of necessary amenities, it is nearly impossible to meet the demands at the moment.
UNBIASED VIRUS, BIASED REPERCUSSIONS
Stigmatisation towards those infected, suspected to be infected, or vulnerable to the virus followed the outbreak of Covid-19. There are instances of infected patients being blamed for their “carelessness”, which escalated the pandemic. Often, recovered individuals continue to face the brunt of this misconception through social media posts, barred entry into residential complexes, and ostracisation. Medical workers, religious and ethnic minorities, are mislabelled as the “carriers” of coronavirus by associating their social identities with the pandemic.
While arrangements were made for the safe return of students and tourists in foreign nations, the migrant workers were left neglected. Their cruel treatment worsened the mass exodus of workers returning to their hometowns with inadequate food and supplies. Sometimes the labourers were even sprayed down with disinfectants, fearing that they were carrying the virus.
Northeastern Indians faced increased racism because of their facial similarity with the Chinese, as Covid-19 was first detected in Wuhan. They were labelled “corona”, were spat at, denied employment or housing, and struggled to access medical treatment.
Following the Nizamuddin Markaz Centre’s meeting, the Muslim community was widely perceived as the spreaders of Covid-19, some even calling it “corona terrorism”. The sensationalisation of news and imprecise reporting kindled the already existing religious hatred in the country, strengthening prejudices and intolerance.
The coronavirus warriors—doctors, nurses, police officers, and public workers—are subject to undue exclusion by their landlords, families, neighbours and even taxi drivers because of their exposure to Covid-19 patients. Many resorted to sleeping in staff rooms and washrooms after being forced to leave their homes.
MetS RISK AND WHAT IT MEANS FOR ETHNIC MINORITIES
There is also a racial bias in medical research and healthcare practices that could affect ethnic minorities on a larger scale. Metabolic syndrome (MetS), which increases an individual’s health risk, plays a crucial role in the severity of the pandemic as experienced by certain ethnic groups. But the use of Body Mass Index (BMI) as an indicator of weight overshadows the MetS risk that affects only particular groups of people.
BMI is calculated by weight relative to height, and a BMI only above 30 is considered unhealthy. However, some medical professionals have brought to light the genetic factors improperly considered with MetS, which could be critical in South Asians developing medical conditions at fat levels lower than normal. People from BAME (Black, Asian and minority ethnic) backgrounds could potentially face worse consequences of the pandemic.
An official review by the UK Government mentions a racial bias in identifying and treating patients from ethnic minorities. An individual with a normal BMI who is metabolically unhealthy, over ten years, is three times more prone to all-cause mortality and cardiovascular problems than an individual with a normal BMI and healthy metabolism. But the present risk assessment tool does not measure metabolic health directly, which leaves people from BAME background at significant risk.
HOW TO IDENTIFY MetS RISK
Medical expertise highlights five factors that can identify risk from Covid-19 as well as a heart attack. These include pre-hypertension or hypertension, pre-diabetes and Type 2 diabetes, high blood triglycerides, low HDL-Cholesterol, and an increase in waist circumference. An individual having at least 3 of the mentioned factors are at MetS risk and are more prone to Covid-19 mortality.
Many lifestyle habits contribute to MetS risk. These include lower consumption of fruits and vegetables and a diet high in sugar and carbohydrates by South Asians. They are also prone to lower genetic cardiorespiratory fitness and require 233 minutes of moderate activity per week as opposed to a white European requiring 150 minutes to alleviate cardiometabolic risk.
Vitamin D deficiency linked with severe effects of Covid-19 is more common among BAME individuals. At present, the paper states that Vitamin D is not measured in primary care routinely. Sun exposure and sufficient nutritional care are necessary for better immunity to combat the virus. Vitamin D also may help prevent exaggerated inflammatory responses in Covid-19 patients.
Thus, individuals or groups of people perceived to be the source of the pandemic are stigmatised. Discrimination only contributes to the pandemic as people who are excluded based on incorrect assumptions are less willing to get medical attention, get tested or receive help from others. The continued rejection of people associated with Covid-19 bears consequences worse than the virus itself in mental and psychological distress and social barrier amongst communities. While the virus affects all people regardless of their many identities, certain groups disproportionately suffer more.
COVID-19 PREVENTION: METHODS AND MYTHS
Coronavirus primarily spreads through infected droplets and aerosols amongst people. An infected person emits aerosols through breathing or communicating, and these particles can linger in the air for up to 3 hours. A person must wear a mask in the company of others not to become infected or reinfected. Masks made up of at least two layers of washable and breathable fabric is effective. N-95 masks are effective but must not be stockpiled to prevent a shortage for the use of healthcare workers. Surgical masks are preferable while caring for an infected person. Gaiters and bandanas are poor alternatives to multi-layered cotton masks.
As per a CDC lab study, double masking or using tight-fitting surgical masks reduced spread through aerosols by 95% instead of no masking. One must not use a mask while exercising; it is conducive to the growth of microorganisms and makes breathing difficult. Maintaining a physical distance of 1 meter is more effective. WHO has claimed that swimming pools are safe as coronavirus does not spread through water; however, maintaining physical distance is essential.
Regardless of whether an individual is recovering from Covid-19 or is vaccinated, they must wear masks and practice social distancing as they still possess the potential to spread the virus. Herd immunity, where 60% to 70% of the population is immune to disease, thereby curbing its spread, is achieved through vaccination or natural infection. However, the latter entails the death of many. Therefore, getting vaccinated as soon as one is eligible is essential to acquire herd immunity.
As per the new definition by CDC, close contacts are individuals an infected person had been in contact with for 15 minutes within 6 feet of the person over 24 hours. They are at a higher risk of infection, and it is critical to identify close contacts and take necessary precautions to prevent the spread of the virus.
Social distancing is vital to slow down the spread of the virus and lessen the burden on the healthcare system. It could help the many critically ill patients who require sustained medical attention. And informing healthcare providers before visiting can help them prevent the spread of the virus.
As per CDC, there is a 1 in 10,000 chance of getting infected from a contaminated surface through a single contact. However, touching an infected surface, followed by touching the mouth, nose, or eyes, can help in spreading the virus. Therefore it is imperative to follow all the safety precautions by disinfecting frequently used surfaces. It is better to wash hands and use a sanitiser before and after than wear gloves during errands. Disease spreading through shoes and mail is low, but they can be kept away from infants as a precautionary measure.
FOOD AND DRUGS
Vaccines against pneumonia protect against respiratory illnesses and specific bacterial infections. But, they do not offer protection against Covid-19. Hydroxychloroquine cannot treat Covid-19 or its adverse effects as per clinical trials. While vitamin and mineral supplements contribute to one’s well-being, there is presently no evidence that they can successfully treat Covid-19. Corticosteroids must be used only for critically ill Covid-19 patients as they may produce complications in non-severe cases. Antibiotics do not work against viruses and are only effective in treating if bacterial co-infection accompanies Covid-19. Rinsing one’s nose with saline or consuming garlic and pepper does not offer protection against coronavirus.
Groceries and takeout containers need not be disinfected as the items can absorb the chemicals. The risk of infection through food and packaging is relatively small. Once again, washing hands after handling them is the reliable course of action.
It is improbable at present for pets to spread Covid-19 to humans. However, humans can spread the virus to pets. To reduce your pet’s risk of infection, limit their interaction with people or animals outside your home and maintain at least 6 feet of distance from other people and animals. If you are sick and must care for your pets, wear a mask and wash your hands before and after handling them. The use of masks for pets is harmful. Do not use cleaning agents and sanitisers on them as well.
Amidst the second wave and the vaccination drive, it is essential not to overwhelm our healthcare infrastructure. By following verified protective measures and preventive care, we can unburden the healthcare system. And crucial to successfully tiding over the pandemic is to operate without bias so that everyone gets the medical attention and emotional support they need.
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Written by Ramya S Prakash and Deepthi Priyanka C for MTTN
Edited by Kaavya Azad for MTTN
Featured Image Credits: UNSW Newsroom, Shutterstock
Sources: BBC News, Centers for Disease Control and Prevention, CNBC TV18, Fortune, Frontiers, Harvard Health Publishing, Medical News Today, Mint, Observer Research Foundation, Scroll.in, The Economic Times, The Hindu, The Indian Express, World Health Organization.