Impact of COVID-19: A Tale of two States
What started as an epidemic in China has now become a global pandemic, with over 200 countries affected. In India, the Covid-19 virus has created a health-care crisis. As the cases are increasing exponentially on a daily basis, the curve doesn’t seem to flatten, the demand for medical care is at its peak. The domino effect of Covid-19 and the slowdown of the economy is pushing the country into further debt. In this blog we take a look at, the tale of 2 states, Maharashtra and Kerala and the economic impact of Covid-19 on the healthcare system of these two states.
Disclaimer: The purpose of this blog is only to understand the economic impact of Covid-19 on the health care sector. The population density and socio-economic status of these two states are very different, therefore, they cannot be directly compared.
On 26th March 2020, a day after the national lockdown was announced, the number of covid-19 cases reported in Maharashtra and Kerala were 122 and 120, respectively. Both the states had similarities in terms of concentration of positive cases in a few districts and people coming in from the middle east. Both the states started carrying out extensive testing and quarantining those who were tested positive. But despite this, 18 days into the lockdown, the number of cases in Maharashtra jumped to 1982 (along with 149 deaths). On the other hand, Kerala had 374 positive cases and 2 deaths, most of whom had recovered. Maharashtra, which started out with the same number of positive cases as Kerala, has since seen a jump nearly sixteen times in the number of infections whereas the southern state was looking at bending the curve.
Mumbai became the epicenter of Covid-19 in the state of Maharashtra. The city had the highest fatality rate in the country. The public health sector was not equipped enough to treat the alarming number of patients. The cost of treatment in private hospitals went upto Rs. 1 lakh per day, which the common man could not afford. The Maharashtra government issued directives to cap treatment charges at private hospitals to prevent overcharging the patients. There was also a shortage of medical staff, therefore a team of doctors and nurses were sent from Kerala to meet the rising demand for medical care.
Compared to the national average, the reasonably high testing numbers in Maharashtra, which has also seen more deaths indicates that the surveillance in the state might not be adequate. Experts say that the city could be detecting cases late, leading to deaths. This virus has had a negative impact on the health care system, which consequently seems to be providing late and inefficient treatment in case of severe illness.
As the Covid-19 cases mounted, hospitals started turning away patients, new directives came into force to deal with the growing number of patients. In order to decongest hospitals, all the asymptomatic patients without comorbidity were shifted to Covid Care centers and hospitals were to ensure that no admission is granted to asymptomatic positive patients without comorbidity. There was a deleterious effect on the rest of the medical facilities. Data shows that the tuberculosis treatment, cardiac emergencies and the ongoing immunization drives, all faced a steep decline during the lockdown. Many people did not have access to timely medical support because of the lockdown and overcrowding at the hospital. All in all, this pandemic disrupted the normal functioning of the health care facilities. A higher spend on medical and public health is resulting in the shifting of resources from their heads or dipping into borrowings from market or central government. The Maharashtra government has announced paying salaries to government staff in two installments. The slowdown of the economy is putting the state in further debt.
In Kerala, the fight against covid-19 is comparatively more successful. From being one of the worst affected states to now achieving a low rate of spread, high recovery, and low fatality, the Kerala model has been recognized throughout the country. Kerala started their fight against covid-19 by commencing large scale testing and screening process well in advance. Under the guidance of the health minister, K.K. Shailaja the state was able to control the impact of the virus.
Travelers and other infected people were tested on a large scale and isolated if found positive. Contact tracing of each active case also began. These contacts were put under home quarantine (which means they had to stay at home for 14 days) so that all the people that came in contact with the infected person stayed isolated and did not spread the infection. The suspected Covid-19 cases were isolated very swiftly and effectively in Kerala. Kerala involved the local panchayats on a large scale in order to make the process of contact tracing possible. If the public itself is involved in public health care system, then nothing is impossible.
The home-quarantined people were extended full support. Food and medicine were delivered to their homes. They were supported socially and mentally, by the support teams which were employed for this purpose. If the quarantined people felt alone, trapped or were unable to step out, counsellors were employed to provide mental support. Moreover, free meals were provided to the migrant workers in thousands of homes. Despite, all these measures the number of cases in Kerala is still increasing, but at least this increase is steady and controlled.
Even though Kerala devotes 5% of GDP for health care, funds were required to meet health care facilities. Initially, Kerala and Tamil Nadu had asked Centre for fiscal grants to fight the Covid battle as cases were on the rise every day. With the states’ finances stretched, the revenue spent on other health care facilities have tightened.
In conclusion, with this covid-19 crisis, we were thrown a curveball, catching us all off guard. Maybe the pandemic was just universe’s way of reminding us to look around and identify what needs to change. Both Maharashtra and Kerala are trying their best to deal with the situation at hand. The steps taken by the two states differ according to their requirements, but the common goal is to contain the virus.
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