Southern Indian states show resilience in Covid disaster

As Covid-19 ravages the country, doctors in the city of Vellore in Tamil Nadu, southern India, are prepared for the worst.

Coronavirus has overwhelmed The healthcare system in large areas of India is moving south.

Jacob John, a doctor at the city’s Christian Medical School, said his hospital is close to a “critical point.” Its more than 900 beds have been filled, the hospital was forced to reject patients and almost exhausted its oxygen supply.

But when India’s disastrous second wave hit Tamil Nadu and other southern states, places like Vellore were able to withstand the worst anger.

They do this in large part due to the investment heritage of primary and public health care in the southern states, which are among the wealthiest and most developed states in India. Experts say that in many other parts of India, the crisis has brutally exposed the chronic neglect of health care.

Tamil Nadu has reported more infections than any other state, with 22,000 cases and nearly 500 deaths per day, while 900,000 active cases in the five southern states of India account for half of the country’s current total.

“This is a difficult situation. We don’t have enough ICU beds, and there are some patients we can’t accommodate when they come in,” John said. “I’m not saying that we are perfect… but when all the dust settles, I believe these investments will save lives.”

Before the second wave hit the south, the medical system in many other parts of the country was overwhelmed, including the capital New Delhi and India’s most populous state of Uttar Pradesh. The patient died due to lack of oxygen, the crematorium was overwhelmed, and the body was dumped in the river.

Southern states have also experienced tragedies, but experts say that facts have proven that they are more resilient.

“Because you have a fairly well-developed medical infrastructure, horror stories are not as shocking as in other states,” said Ratan Jalan, the founder of Medium Healthcare Consulting and a former healthcare executive. “This protection is working.”

The southern states of India account for approximately 250 million of the country’s nearly 1.4 billion population.

Kerala and Tamil Nadu, especially the outliers in the health care sector, are ahead of indicators such as infant mortality. In addition to Karnataka, they also have more hospital beds and medical schools. In the sustainability rankings released by the United Nations and government think tanks last week, the southern states of India topped the list.

“In Tamil Nadu, people don’t have to do the same singing and dancing to get hospital beds as they do in Tamil Nadu. [some other parts of India],” said Lesley Branagan, an anthropologist who studies health care in India. “This spirit of equality has existed for decades. ”

Although the response of states such as Maharashtra in the west was also praised, none of the states received praise. More praised Kerala was the first country to detect Covid-19 cases in India last year.

It was so effective in the early containment of the first wave that the number of reported cases dropped to zero in a few days in May 2020. The number of cases surged to more than 40,000 per day last month, but it has since halved. The daily death toll has climbed to nearly 200.

Experts said that Kerala and Tamil Nadu have already established a network of primary care workers to help patients find treatment to solve the crisis. They also created a “war room” to allocate resources such as oxygen to avoid a devastating shortage.

The high caseload in the states also reflects better testing, which experts say highlights greater transparency. However, they pointed out that underestimation of the number of infections and deaths is everywhere, and the response in parts of the south, including Telangana, has been affected by a lack of clarity.

The southern states and Karnataka entered lockdown last month, and the number of cases has declined.

Bangalore is the capital of Karnataka and the technological center of India. It still has more new cases than other major cities.

According to Ravi Mehta, the intensive care supervisor, in late April, the city’s Apollo Hospital opened a 30-bed COVID-19 ward, which was full within 90 minutes.

It expanded to more than 100 beds, all beds were occupied, and appeared within three hours of oxygen depletion last month.Mehta said that the pressure has eased, but the hospital’s intensive care unit is still overcrowded and is now dealing with patients with severe complications, such as Black Fungus infection.

“Within a month, [went] Crazy,” he said. “We must now clean up the mess and provide the best possible care for those who are still struggling. “

However, the apparent success of the South has concealed severe inequality within the region, and poor areas have fewer access to services.at least Two dozen Last month, a hospital in rural Karnataka ran out of oxygen and the patient died. In the southern tourist center of Goa, Patient score Died due to lack of oxygen.

Reuben Abraham, chief executive of the IDFC Institute think tank, said that Tamil Nadu and Kerala have been in lockdown for too long, which has weakened their response.

“Everything depends on peak load [that a system can withstand],” he said. “No matter how good your health system is-I don’t care if it is Switzerland, Kerala or the United States-beyond this peak load, the system will collapse. “

PV Ramesh, a doctor and former senior civil servant in Andhra Pradesh, said that this crisis should force the nation to reflect on the failure of national healthcare.

“This is seen as an oxygen supply crisis, not a fundamental governance crisis,” he said. “When the waves weaken… everyone will be business as usual and will not learn any lessons.”

The latest coronavirus news

Pay attention to the on-site reports and analysis of the global epidemic and rapidly evolving economic crisis by the Financial Times Here.