May 2021

Dear Members,

Season’s Greetings!

IMA is astonished to see the extreme lethargy and inappropriate actions from the Ministry of health in combating the agonizing crisis born out of the devastating second wave of the COVID -19 Pandemic. The collective consciousness, proactive cognizance, and requests made by IMA and other professional learned colleagues are put into the dust bin, and often without realizing the ground realities the decisions are taken.

In the last few days, IMA has been insisting on the need for complete, well-planned preannounced national lockdown rather than few states declaring complete lockdown ranging for 10 days to 15 days -so as to getting breathing time for the health care infrastructure to recoup and replenish both the material and manpower.

Lockdown will break the chain of devastating spread. However, the Central government had refused to head to implement lockdown resulting in the mounting of new patients beyond lakhs every day and the number of moderate to severe cases are increasing to nearly 40 percent. Sporadic night curfews have not done any good. Life is precious than the economy.

The equitable, accessible, and affordable vaccination for all above at least 18 years were demanded by IMA, based on scientific facts from April 6th onwards and after persistent call on, PM with his innovative qualities assured the nation, the vaccination drive will be started from May 1st. It is unfortunate the ministry has failed to make the necessarily required road map and ensure vaccine stock, resulting in the majority of the places vaccination could not be rolled out for people above 18 years. When the Prime minister’s notification is not implemented scrupulously who is to be blamed? With the un humanistic differential pricing system proposed, the 18-45 age group people are forbidden to get the free vaccination from the central share of 50% and they are placed under the mercy of state governments. The jeopardy of private practitioners and states to negotiate with manufacturers for pricing and stock resulted in exorbitant price rise and vaccine shortage. In 1997 and 2014 India could declare eradication of smallpox and polio, only by adopting the universal free vaccination and not by differential pricing system. When 35,000 Crore Rs were allotted in the budget, with which the maximum required 200 crore vaccine dozes are purchasable, why the central government is shedding its responsibility? Unless the government comes out and implements with willingness and steadfastness for equitable distribution, we will not be able the achieve the goal. In last few days, no vaccine was available in small and medium private hospitals.

The crisis of oxygen is deepening every day and scores of people are succumbing to O2 mismatch supply and it is creating panic both among patients and fraternity. Though there is enough production it is often the distribution is not proper. Most of the private hospitals are not getting oxygen and in every public health care place patients are crowding and suffering to get oxygen in the needed amount. Even after 15 days of the crisis, the government is not seen at the forefront to solve these issues and resulting in people knocking at the doors of courts to get justice, resulting in judicial activism. Health care professional organizations are neither consulted nor the honorable Health minister in this whole pandemic had time to interact with modern medicine professional organizations to solve this issue. Imported oxygen concentrators and oxygen plants are yet to reach the beneficiaries. IMA appeal, as the time is running out with the impending crisis lest we deepen the crisis, solve it on a war footing.

The mutation is a norm for RNA viruses and understanding this needs proper gene sequencing and risk assessment. Unless we make our self-prepared to face this by enhancing testing, we will miss the boat. Tough various mutants are identified yet the real hazard is not explained in actual terms. Dedicate experts shall be designated to study this and propose mitigation measures at the earliest. IMA suggested for enhancing testing and tracing, but it is decreasing.

The transparency in reporting and making registry is not carried out. We have lost 756 doctors in the first wave and in the second wave more than 146 doctors have died within a short period. Hundreds of deaths happening in big hospitals are shown as non-COVID deaths and crematoriums are showing houseful boards. RTPCR negative, but CT positive cases are not counted. Why we are trying to hide actual deaths? If the public comes to know about the actual deaths, their seriousness to adopt COVID-appropriate behaviors will rise. More so the benefits of insurance are also denied to the victims of this pandemic when the death is not officially certified.

The shortage of needed drugs for treating COVID including steroids is mounting in many places. Though exporting is stopped off late, production is not enhanced to the level of need, resulting in black marketing and hoarding. More painfully spurious drugs are on the road. Price capping and systematic tracking with surveillance were suggested as a means, but the government is not interested in capping the price and remove the GST. Masks, PPE Kits, and lifesaving drugs are under GST, and rampant price rise is happening every day.

Manpower shortage is dealt with knee jerk reactions, then with progressive inclusive planning and consultation with suffering junior doctors. Most of the inputs offered to augment manpower were not adopted by the Government.

Violence against doctors and health care professionals is increasing. When a death occurs not due to disease but lack of infrastructure, the affected people are expressing their anger by vandalizing hospitals and health care professionals. Who is going to control this? Our demand to bring in Central law against hospital violence tagged with IPC provisions and declare hospitals as protective shown couldn’t evoke any palpable response from Government. We once again reiterate, if the violence is not controlled and a safe environment is not created for doctors to work with peace, it is going to be a disastrous situation on the health care outcome.

IMA demand, the entire health care administration shall be revamped with Indian Medical Service (IMS) cadets who are well versed with the technical and administrative skill for effective execution of health care.

We also demand to establish a new integrated Ministry to serve in this pandemic with a dedicated, proactive, vibrant, innovative, and altruistic Minister and alleviate the fear of people by leading from the front. We propose for augmentation of infrastructure, materials, and manpower by enhancing health care budget to be raised from 1% of GDP to minimum 8-10 % OF GDP, and judiciously use the earmarked budget amount for ensuring equitable and affordable Universal vaccination.

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