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'We're well prepared to handle any surge in COVID-19 cases'

By Namrata Acharya
May 27, 2020 10:10 IST
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'States have done a tremendous job of identifying health facilities for COVID-19 care and equipping them well.'

IMAGE: The staff of the Tezpur Medical College and Hospital thank a young doctor for his contribution in treating COVID-19 patients as he leaves for isolation in a mandatory quarantine facility for seven days, in Tezpur, Assam, May 25, 2020. Photograph: PTI Photo

The National Health Authority, the apex body responsible for implementing India's flagship public health insurance scheme -- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) -- has been playing a key role in managing the COVID-19 crisis.

"We need greater participation from private sector hospitals for both COVID-19 as well as non-COVID-19 health conditions," Indu Bhushan, CEO, AB-PMJAY and NHA, tells Namrata Acharya in an email interview.

How has the NHA stood up to COVID-19?

The NHA is actively supporting the ministry of health and family welfare as part of the government's response.

Experience of the Ebola epidemic in West Africa has shown that a crisis like this needs the entire society's response.

The NHA has focused on how to get the private sector to be more actively involved in its response.

We need greater participation from private sector hospitals for both COVID-19 as well as non-COVID-19 health conditions.

As several hospitals have been converted into dedicated COVID-19 facilities, the need for addressing critical non-COVID-19 health conditions, such as hemodialysis, cardiovascular procedures, and chemotherapy becomes even more important.

The NHA has accelerated its efforts to empanel more hospitals to address these needs.

Since April 1, 2020, we empanelled more than 1,000 new hospitals, mostly private.

We also started an express process of empanelment of private hospitals under AB-PMJAY.

How are you leveraging IT to support the response?

NHA has been actively following the outbreak of COVID-19 in India. We analyse the trends related to severe acute respiratory illnesses (SARI) and influenza-like illnesses on a daily basis.

Any spike in these cases can be a leading indicator of spread of COVID-19.

We report any spike in such cases from our scheme across the country to the concerned states, the ministry of health and family welfare and ICMR (Indian Council of Medical Research) for necessary action.

The NHA has a database of high-risk individuals.

What is your view on the apprehensions about privacy issues related to the Aarogya Setu app?

The Aarogya Setu app has been designed to improve our effectiveness in identifying potential COVID-19 patients, support our citizens in assessing their risk, and tracing contacts of COVID-19 cases.

I believe, the app has played an effective role in that direction. It has also helped citizens in getting information about testing and treatment facilities.

The app has strong security and privacy features in my view.

There are no defined packages for COVID-19 under PMJAY, which is leading to confusion among hospitals about charges. Your views?
How many states have so far come up with such packages and why are some states still slow in devising one?

This is not correct. Based on the national trend of the outbreak of this pandemic and in line with the Government of India's response, in March this year, we designed and notified the packages under Ayushman Bharat PM-JAY for testing of COVID-19, for treatment of COVID-19 and given states the flexibility to fix rates.

Various states are adopting different approaches for involving the private sector.

Most states, including Maharashtra and Jharkhand, have fixed their prices.

Constant follow-up is being done with other states for finalising packages.

Many states are still relying exclusively on public sector hospitals to provide testing and treatment free of cost.

Therefore, even though the number of tests and treatments in various public sector hospitals has been very high, the same is perhaps not optimally being undertaken under PMJAY.

However, as the situation evolves and there is greater demand for COVID-19 treatment, the states will need to ramp up their capacities and the private sector will need to step in.

Reports suggest that the average daily hospitalisation under PMJAY has dropped by over 70 per cent during the COVID-19 lockdown, which means a lot of hardships for non-Covid patients in want of treatment.
How can this problem be addressed?

This is correct. The daily average hospitalisation has come down to around 12,000 to 13,000 now from about 25,000 before the lockdown.

There has been a bigger decline in non-critical and non-elective treatments.

Critical treatments have reduced by about 20 per cent only.

The reason for the decline is lack of mobility and fear of infection.

The supply of hospital services has gone down as many hospitals have temporarily closed or scaled down services.

We are encouraging private hospitals to start operations. The numbers are slowly picking up.

In the last two weeks, there has been increase in hospitalisation rate by about 20 per cent.

Given the rising graph of COVID-19 in India, how prepared is the healthcare infrastructure in India, particularly rural infrastructure, to handle the peak of COVID-19, particularly after the lockdown?

I believe, we are well prepared to handle any potential surge in COVID-19 cases.

States have done a tremendous job of identifying health facilities for COVID-19 care and equipping them well.

They have created sufficient capacity for Covid care and ICU services, including ventilators and oxygen supply.

How long do you think India needs to wait for a vaccine?

The situation is still evolving. Multiple scientists and leading research labs are making efforts to develop a vaccine.

The Government of India is also supporting these efforts through the PM-CARES Fund.

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Namrata Acharya in New Delhi
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The War Against Coronavirus

The War Against Coronavirus