NEW DELHI - Nearly six months since the first Covid-19 case was detected in India on Jan 30, the country finds itself grappling with a shortage of doctors and healthcare workers as the number of coronavirus infections continues to post record daily highs.
This shortage is being felt most acutely in regions where the number of Covid-19 cases has seen a rapid spike. In Bengaluru Urban district, which includes the city of Bangalore, the number of active cases has increased more than eightfold from 3,916 on June 30 to 33,816 as of July 27. This has forced the state government to set up Covid care centres (CCCs) with support from hotels and private hospitals, but these centres remain severely understaffed.
Dr R. Ravindra, president of the Private Hospitals and Nursing Homes Association in Bangalore, told The Straits Times there is a shortage of around 6,000 doctors and 15,000 nurses in the city, with specialists such as anaesthesiologists particularly in high demand.
"Looking after critical patients, such as those on ventilator support and those who need continuous monitoring, has been challenging with the limited staff available," he said.
People who can handle and manage the specialised equipment used to look after these patients are needed, he added.
Dr Ravindra is the medical director of Suguna Hospital, which has 40 of its 80 beds reserved for Covid-19 patients, with another 40 beds in a nearby CCC also under its watch.
He said many doctors in the city's private hospitals have not shown up amid the pandemic, including some who are older than 60 and those who suffer from co-morbidities.
"Some of the younger ones are also reluctant to work because they are living with young children or with elderly parents and some have just disappeared because of a fear of the coronavirus," he said, adding that even the prescribed ratio of one nurse to 50 patients at the CCCs has been difficult to meet.
India has always had a shortage of doctors. It has a registered doctor for every 1,456 individuals compared with the World Health Organisation's recommended ratio of one for every 1,000 individuals.
The pandemic in India has put its inadequate medical staff under even greater stress. India is currently placed third on a list of the worst-hit countries, with more than 1.5 million cases and 33,425 deaths.
Recruitment of additional workers has not been easy, given the dearth of available talent.
In Pune, a city in the state of Maharashtra that has also seen a surge in the number of Covid-19 cases, the local municipal corporation is yet to fill its requirement of 50 specialists on a contract basis for six months, comprising 10 critical care physicians, 20 physicians, 10 paediatricians and 10 intensive care unit physicians.
An advertisement on these vacancies issued by the Pune Municipal Corporation (PMC) on May 13 failed to draw candidates, given the poor salary of around 82,000 rupees (S$1,511).
The pay was revised to 225,000 rupees per month, matching those offered by other municipal corporations, and another advertisement reissued on June 29.
Only nine showed up for the walk-in interviews and were hired. "It has been difficult to find specialists," Dr Ramchandra Hankare, head of the PMC's health department, told The Straits Times. "We are trying our best to recruit specialists."
Dr Devi Prasad Shetty, the chairman and executive director of Narayana Health, a network of hospitals, told The New Indian Express this month that the country needs 50,000 more doctors to reduce Covid-19 deaths and suggested tapping the services of around 25,000 young medical specialists who have completed three years of training in clinical specialities but are waiting to be inducted professionally as their final exams have been delayed because of the pandemic.
The Medical Council of India (MCI), which regulates medical education in the country, had asked institutions to conduct these postgraduate exams by June 30 and also relaxed norms for the practical exams.
But Dr Shivaji Dev Barman, the president of the Federation of Resident Doctors' Association, told The Straits Times many resident doctors across the country are still waiting to appear for their final postgraduate exams as only some states have concluded them.
The tenure of these resident doctors, meanwhile, continues to be extended, given the delay in holding exams that are mostly held from April to June.
"We had asked the MCI to direct institutions to conduct the final postgraduate exams as early as possible or to promote them based on internal assessments and appoint them as senior resident doctors, which will allow them to work as specialists," he said.
Undergraduate medical students waiting to start their one-year internship at hospitals because of the delay in their exams could similarly be assessed online or on the basis of their earlier performance.
Thousands of medical students across Europe were fast-tracked into early service earlier this year to reinforce health systems struggling to cope with the coronavirus outbreak.
