International Journal of Medicine

and Pharmaceutical Science (IJMPS)

ISSN (P): 2250-0049; ISSN (E): 2321-0095
Vol. 12, Issue 1, Jun 2022, 79–86
© TJPRC Pvt. Ltd.

COVID-19: THE INDIAN HEALTHCARE PERSPECTIVE

MEGHNA MISHRA1, DR. MAMTA BANSAL2 & MANDEEP NARANG3

1
Head of Digital & Strategic Planning, Shanti Mukand Hospital, Delhi and pursuing Masters of Hospital Administration
(4th sem) from SGRRU, Dehradun, Uttarakhand, India
2
HOD & Associate Professor, Shri Guru Ram Rai University, Department of Hospital Administration,
Dehradun, Uttarakhand, India
3
Assistant Professor, Dept. of Hosp. Admin., SGRRU, Dehradun, Uttarakhand, India
“Converting Punishment into Prize”

Original Article
ABSTRACT

While the onset of COVID-19 pandemic shook the entire world completely, problems were multiple times higher in case
of India due to its long-standing urban and rural healthcare divide, socio-cultural beliefs and traditions, shortage of
medical supplies as well as healthcare workers and a myriad of administration challenges. In spite of all these odds,
India fought COVID in a spirited, coordinated and efficient manner, led by the government at the Centre and the States
and amply backed up by the industries and individuals – so much so that today the country stands far more resilient,
prepared and pragmatic in dealing with its future challenges – medical and otherwise. The research paper encapsulates
India’s story of courage and conviction in fighting COVID.

Subject(s) under which the journal should be included:

COVID Management, COVID in India, Hospital Administration, COVID impact and recovery

KEYWORDS: Aarogya Setu, COVID-19, Government’s Response to COVID-19, Indian Healthcare, Pradhan Mantri
Garib Kalyan Package.

Received: Mar 16, 2022; Accepted: Apr 06, 2022; Published: Apr 22, 2022; Paper Id.: IJMPSJUN202208

INTRODUCTION
India’s Healthcare Legacy

India has remained the mother of medical and surgical innovations since time immemorial. Ever since the Vedic era
(5000 B.C. onwards), she has been at the forefront of discovering, defining, and developing the original science and
art of healing and healthcare like no one else. From Charaka Samhita to Sushruta Samhita[1] (the source codes of
medicines and surgeries), from Ayurveda to Yoga (the most comprehensive frameworks of health, cure, and
wellness across mind, body, and soul),from Panchakarma(internal and external purification) to Tridosa as
characterized by the Vata (wind), the Pitta (bile)and the Kapha (phlegm)} and their state of equilibrium to derive

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80 Meghna Mishra, Dr. Mamta Bansal & Mandeep Narang

the scientific causation process of the physical, physiological and pathological basis of any disease. In brief, a plethora of
original contributions made in the field of health and wellness are credited to India.

Evolution of Healthcare Infrastructure in India and its Current State

India has made rapid strides in modern healthcare systems and infrastructure post-independence. There have been
considerable developments in the health sector in the last seven decades starting from setting up of a Health Ministry;
establishing health as one of the priority sectors in the five-year plans for the government; building nation-wide primary
healthcare centres, hospitals, and medical colleges and promoting healthcare infrastructure; professionals, awareness,
technology, and state insurance schemes - the list[2] is endless. Despite this, some chronic issues like thick population
density, socio-economic divides, poor literacy rates, etc., continue to weigh heavy on the sub-optimal health indicators for
the country.

Today, Public Healthcare in India is delivered through primary healthcare centers [3] (PHCs) and sub-centers run
by doctors and paramedics. At the same time, secondary and tertiary care is rendered through more equipped and advanced
forms of healthcare establishments such as community health centers, district hospitals, and medical colleges, primarily at
district headquarters.

On the other hand, private healthcare[4]infrastructure and services are primarily concentrated around tier-I and tier-
II cities, bringing a far superior experience to both outdoor and in-patients in terms of quality of care and treatment, albeit
to a privileged few.

India’s primary challenge is the stark difference between rural and urban India in healthcare delivery quality,
availability, and timeliness. That is why the disparities and the challenges to equitable, accessible, and quality healthcare
get exposed when compared geographically. The onset of COVID-19 was one such event that tested this inherent, systemic
deficiency to the hilt.

Back Drop of the Pandemic – Peculiar Nature of the Challenge faced in India

While COVID-19 spread its dread and devastation quite unselectively, India was faced with a few additional challenges
specific to its cultural and social context[5] illustratively:

 It’s unbridled love for socializing, dining, and gathering on every occasion and even otherwise

 Culture of frequent celebrations in groups

 Enjoying together on festivals across the year, twice a month on an average

 Lack of awareness and scant respect about health and hygiene, especially among the poor and the illiterates

 A large section of the society still riddled with unsubstantiated beliefs and herd mentality on infections and
vaccines

The Out Beak of the Pandemic and its Severe Impact in India

While every country was struck hard by the outbreak of the coronavirus in terms of its magnitude and severity, gaping
demand-supply gaps, and widespread disruptions in trade, manufacturing, and services, its effect was multiple times higher
in India, as the economy was already in a downward spiral as evidenced by its major macroeconomic indicators like GDP

Impact Factor (JCC): 8.9887 NAAS Rating: 4.14

Covid-19: The Indian Healthcare Perspective 81

growth rate of 4.7% registered in 2019 (the lowest since 2013), high unemployment rate, the decline in industrial output of
core sectors (the worst in 14  years), stagnancy in private sector investment and reduction in consumption expenditure for
the first time in several decades.Besides, the informal sector of India, which is the largest in the world, employs nearly
90% of the total working population and contributes significantly to overall GDP (~45%) was already under tremendous
strain due to demonetization in 2016GST in 2017.

There was no prior knowledge (and hence, preparedness) on the medical front about the virus and its deadliness,
unlike many advanced countries when the deadly virus hit India in March 2020. The lack of medical supplies - oxygen,
beds, ventilators, plasma, medicines, injections, tremendous shortage of healthcare workers, doctors, nurses, severe
administration challenges in managing ICUs, hospital wards and outdoor patients, prioritizing admissions and treatments of
old over young, comorbid over healthy, amid the utmost panic, anger, fear, and deaths and the consequential migration of
millions back home[6] was quite monumental and overwhelming for India. To worsen the situation further, the ferocity of
COVID Wave-2[7] (Mid-March, 2021 till May2021) disarrayed the entire nation completely. Delta variant, the perpetrator
of this wave in India, brought a range of allied health conditions like Black Fungus, apart from psychological disorders like
depression, negativity, mental and psychological disorders. It was also a heart-wrenching sight to see caregivers and
healthcare workers[8] themselves falling in heaps during this wave.

Wave 1

Wave 2

India COVID-19 density map – May 18, 2021 India’s pattern of COVID-19 spread (Wave 1 and 2)

www.mohfw.gov.in

www.mygov.in/covid-19

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82 Meghna Mishra, Dr. Mamta Bansal & Mandeep Narang

India’s Response to the Pandemic

Undeterred by the shock and grip of the pandemic, India astonishingly turned herself into one strong team to put up a bold,
concerted and spirited fight - managing people and their families who were falling sick and dying, supporting businesses
which were getting shut, supporting poor, homeless and orphans, using voice-based messaging on every call to convey
strength and solidarity across the nation and reassure millions, activating MyGov Corona Newsdesk, effecting digital
benefit transfers in the wake of homeless and jobless and distributing rations at the needy homes, converting hotels and
playgrounds into make-shift hospitals, extending credit and insurance digitally, providing online education for schools,
colleges and universities and permitting/ promoting work from home and work through VCs, emails and other online
mediums, alumni and friend circles coming alive in supporting the distressed, celebs and the rich pouring financial and
medical help in their individual capacities and propagating telemedicine route to cure home quarantines– the list[9] is nearly
endless, scripting an incredible and indelible story of courage and conviction.

To control the severity of the deadly virus, the complete lockdown was imposed in March 2020, allowing only the
functioning of essential services. Along with it, restrictions were put on domestic and international travel and mandatory
quarantines on entry from an international port and between metropolitan cities. The monumental effort of “Janata
Curfew” and subsequent lockdown [10]enunciated by Prime Minister Narendra Modi set the tone of a spirited fight against
the pandemic amongst each Indian. They helped the country to get better equipped in tackling the coronavirus outbreak.

Following the economic impact of the lockdown, PM Modi turned the pandemic narrative on its head when he
announced that Corona should be seen as an opportunity to be self-reliant or “Atmanirbhar” that focused on “economic
self-reliance” and promoting domestic product manufacturing (“make in India” mission). In line with this, the ₹20 trillion
Atmanirbhar stimulus package[11]was announced by the Finance Minister in May’2020. Besides, a ₹1.70 trillion relief
package was announced under Pradhan Mantri Garib Kalyan Yojana to assist the vulnerable population, rural community,
and informal sector through direct benefit transfer in their bank accounts.

While devising and implementing its unique model against the onslaught of the virus, India also adopted a slew of
global best practices [12] to contain the spread of COVID-19 successfully. This included a robust framework of detection,
containment, and treatment; developing and disseminating well-laid guidelines for the public; conducting comprehensive
testing and contact tracing; and supporting people in quarantine.

The government’s efforts to help the vulnerable sections, the victims and the families were delivered in a mission
mode by expediting benefits through Ayushman Bharat, National Digital Health Mission, PM Jeevan Jyoti Bima Yojana,
and Insurance cover for COVID Health warriors under PM Garib Kalyan Package. These efforts aimed to make healthcare
and protection affordable and accessible for the entire population and, at the same time, offer scope for private players to
widen their reach and presence.

Ministry of Health and Family Welfare and the healthcare industry swung into a comprehensive action plan in
tackling the pandemic, including dedicated COVID-19 hospitals, isolation centres, and tech-enabled mapping of resources.
The Aarogya Setu[13] mobile app was widely used, which assisted in syndromic mapping, contact tracing, and self-
assessment. Aarogya Setu and many such technology apps strengthened India’s fight against the pandemic, including
delivering essential items in containment zones, teleconsultations with patients, bed management, and real-time monitoring
and review by the authorities.

Impact Factor (JCC): 8.9887 NAAS Rating: 4.14

Covid-19: The Indian Healthcare Perspective 83

However, the most significant relief and turnaround story started with India’s vaccination programme [14], which
began catapulting the mood and condition of the country en masse. With a provision of ~₹9.5 billion for vaccine
development, India started tonight against COVID-19 in an Atmanirbhar (self-reliant) fashion. The first product for the
vaccine that was approved in January 2021 by the Drugs Controller General of India was Oxford–AstraZeneca vaccine,
manufactured by the Serum Institute of India with the market name, "Covishield," while the next in line was BBV152
marketed as “Covaxin” which was developed by Bharat Biotech, in association with the Indian Council of Medical
Research and National Institute of Virology.

At the same time, the private healthcare sector[15]also rose to the occasion in the country’s fight against the
pandemic while augmenting their capability to deliver COVID hospitalization and treatment under Pradhan Mantri -Jan
Aarogya Yojana (PMJAY). They provided all the support that the government needed, such as testing, isolation beds for
therapy, medical staff, and equipment at COVID-designated government hospitals and home healthcare. Several private
healthcare providers picked the mantle and started building outdoor and indoor treatments facilities and equipping it with
proper medical supplies and healthcare workers.

India Post-Pandemic: the Gains, Lessons Learnt, and the way Forward

India has done better than many, in fact, better than any. Notwithstanding, there are a lot of lessons that the pandemic has
taught us as we move forward confidently.

First and foremost, the country has learnt to imbibe an irreversible sense of health and hygiene[16], fitness and
immunity, protection, and insurance the hard way.

Secondly, the acute shortage of health infrastructure and medical supplies faced, especially in villages and tier-II
and III cities during the wrath of the pandemic, has made the country work on shock-proofing its healthcare system to ward
off such situations in the future. On the one hand, hospital chains and specialty healthcare centres[17]are keen to augment
their capacities in Tier II and III cities. On the other hand, many hospital chains have started expanding in these cities by
setting up small clinics and associating with reputed local doctors. This complements the government’s ongoing efforts to
enhance beds and related medical infrastructure, especially in villages and small towns.

Due to the sheer magnitude of the pandemic, there has been a marked increase in the awareness of health
insurance products[18] as more and more people are purchasing life and health insurance with each passing month.

Finally, India has taken an unassailable lead in its digital adoption across businesses and daily lives that was thrust
on us during COVID times. From purchasing groceries to consulting a doctor, paying bills to attend a VC, learning guitar

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84 Meghna Mishra, Dr. Mamta Bansal & Mandeep Narang

to practicing yoga, digital has become the new normal for most. It’s only a matter of time before much of our work and
lifestyle begins to embrace digital[19] as its new normal.

The above research bears testimony to India’s historic fight against COVID in every possible dimension of its
response and recovery. Not just that, it has proverbially converted the punishment into a prize on every front – be it social,
medical, or economic.

Thank you COVID, India just got better!

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Impact Factor (JCC): 8.9887 NAAS Rating: 4.14