- June 26, 2020
HEAL-Thy Samvaad is a series conceptualised for a healthy discussion on the stemming health issues in our society. This is organised fortnightly on 1st & 3rd Thursday of the month by the ‘healthcare advocacy’ group — HEAL Foundation in association with ICCIDD and with the support of the Consortium of Public Health Impact Partners (CPHIP). The organising body scans the emanating health issues in a fortnight that impact the society, and follows the theme to inculcate health awareness by inviting a Samvaad session. In HEAL-Thy Samvaad session, renowned specialist doctors, distinguished experts from healthcare, educationists, scientists and policymakers are invited to lay bare the in-things of the burning health issues and throw light on the broader spectrum, suggest dos’ and don’ts to the people that might be helpful in combating any health disaster.
Considering the unprecedented global health crisis created by COVID-19 which seems to stay longer as the ongoing disaster is supposed to multiply unless the vaccine is in place, we took a resolution to impart the right information about health and hygiene to the masses, and this is how HEAL-Thy Samvaad was born. The idea is to make the people updated with the ongoing health crisis so that they might be able to adapt with emerging new normal during and post COVID-19 and will get prepared to face the upcoming health disaster with the spirit of zeroing its impact. Therefore, for any health-conscious people and for those having the curiosity to know about the ongoing health issues, it’s a must-attend sort of. We appeal everyone to participate and spread the Samvaad message to the maximum people so as to accomplish the objective of health awareness drive
- June 26, 2020
In HEAL-Thy Samvaad’s Inaugural Episode on Life after lockdown — a new normal with other concerned issues of basic health & hygiene, mental and physical health, stress management and the Adversity Quotient (AQ) and Resilience — doing the rounds of discussion after Sushant Singh Rajput’s suicide was held on 18th June 2020 under HEAL-Thy Samvaad — a series of dialogue on the stemming health issues in our society. This was the inaugural episode of HEAL-Thy Samvaad organised by the ‘healthcare advocacy’ group — HEAL Foundation in association with ICCIDD and with the support of the Consortium of Public Health Impact Partners (CPHIP).
HEAL-Thy Samvaad is a fortnightly series of dialogue to address health issues to be organised on every 1st and 3rd Thursday of the month to discuss the emanating health issues, its prevention and to inculcate awareness around holistic health & wellness to help our society stay healthy. Distinguished health experts have to deliberate on different health issues and answer the queries of the participants related to health and wellness during the session of the Samvaad (Dialogue) to spread a healthy message to the larger spectrum of society.
Mr R. Shankar, President, HEAL Foundation inaugurated the 1st episode of HEAL-Thy Samvaad, elaborating the significance of Samvaad (Dialogue) and its educative benefits. Besides the day’s topic — Life after lockdown – a new normal, the inaugural episode of HEAL-Thy Samvaad focussed on the ‘Adversity Quotient’ and ‘Resilience’ and tried to discover its relevance with Bollywood’s rising star Sushant Singh Rajput’s suicide, and its significance in the lives of the people that how depression engulfs them to the extent that they take away their lives. All the panellist paid tribute to the deceased actor.
While addressing the HEAL-Thy Samvaad and responding to the importance of ‘Adversity Quotient, Dr Nimesh G Desai, Director, Institute of Behaviour & Allied Sciences said, “Adversity Quotient (AQ) is a measure to see how an individual reacts or behaves when faced by a challenge of adversity in life. Therefore, we need to focus on being strong, smart and emotionally resilient. A stronger Adversity Quotient is required even after the lockdown to resist the cases of suicide and depression. We can restrict suicide by talking emotionally to the person in depression. We can also manage the stress level if our AQ is strong.”
Adding further, he said “It may not be 100% true in case of Sushant Singh Rajput, but as far as the drug adherence is concerned, generally, we have seen a tendency of a lot of psychiatric patients discontinuing their prescribed drugs and not adhering to the medication given by the experts and doctors which results in poor management of mental health and may also lead to suicidal tendencies.”
Citing the instance of Samvaad (Dialogue) between Arjuna & Lord Sri Krishna from Mahabharata mentioned in Bhagwat Gita and its significance, Dr C S Pandav, President ICCIDD & former HoD, Deptt of Community Medicine, AIIMS, said, “Samvaad (Dialogue) is a mode of education, which plays a pivotal role in making the people learn and spread the messages widely. The misinformation about COVID-19 pandemic is galore. Now, we are into the pandemic of fear — the pandemic of misery and the pandemic of migrants. Along with boosting bodily immunity, we need to improve our social & economic immunity to face and fight this pandemic. And we must pay respect to our healthcare workers — doctors, nurses and police who are riding the valley of death to save the people from this pandemic.”
The issues of alleviating the fear of the pandemic and making hygiene habit a part of the routine; the importance of food for healthy body and mind; stepping out and stepping safely after the lockdown, were also addressed by the experts and discussed at length.
Deliberating on the importance of right kind of food for a healthy mind and body, Ms Manjari Chandra, Consultant, Nutrition, Max Multispecialty Hospital, said, “Although the fear of COVID-19 is looming large, yet no need to fear rather be cautious and maintain the right diet, focus on indigenous foods, healthy lifestyle, regular exercise and home-cooked foods — these are the keys to stay healthy. We need to follow the regimen of intermittent fasting, which the Indian people have been following from time immemorial and the ancient ritual of cooking food at home with due cleanliness — these are the real mantra to stay healthy always.”
About HEAL Foundation: HEAL Foundation is a not-for-profit organisation and a ‘healthcare advocacy’ group which has been working diligently under its flagship initiative COVIDFighters — dedicated to fighting COVID-19 Pandemic with its various awareness drive such as organising a series of webinars and other allied activities ever since the outbreak of coronavirus. It has recently started a series of HEAL-Thy Samvaad to be held on every 1st & 3rd Thursday of the month. To know more about HEAL Foundation, visit: www.healfoundation.in and about its dedicated program on COVID-19 @ www.covidfighters.in.
About ICCIDD: Association for Indian Coalition for Control of Iodine Deficiency Disorders (ICCIDD) was established in 1997 to conduct research on the problems of Iodine deficiency disorders and other Micronutrients, Nutrition & Healthcare Delivery, Environment and Development in the community and suggest solutions
- May 18, 2020
Amid Lockdown 1st Patients’ Rights eConclave Raising Issue of “Non-Coved Essential Healthcare Servoces” held
A unique of its kind 1st eConclave around ‘Patients’ Rights’ was held amid the hue and cry of COVID-19 panic. It addressed almost all the issues of ‘Patients’ Rights.’ The umbrella topic was “Are Non-COVID Essential Healthcare Services Becoming Casualty due to COVID Panic” consisting several allied-topics intact with. The eConclave was organised by the ‘healthcare advocacy’ group- HEAL Foundation in association with Sewa Bharati– world’a largest ‘social services’ organisation, on 16th May 2020 from 04:00 to 06:00 PM.
The aim of the eConclave was to bring to discussion the underlying problems the Non-COVID patients have been facing due to COVID panic. It has been seen that during the COVID hullabaloo, the non-COVID patients are the greatest sufferers. Most of the patients suffering from fatal diseases like cancer, kidney patients on dialysis and diabetes are in trouble as the essential patients’ regular health services are not being provided to them due to the obstruction in regular healthcare delivery.
Addressing the eConclave Dr Swadeep Srivastava, Founder, HEAL Foundation said, “Ever since the outbreak of COVID-19, everybody was only talking about the COVID-19 and its infection. But there was no discussion around the day to day problems that the regular patients with fatalities have been facing due to the COVID panic. A deliberate discussion was very much required around the stigma created by COVID-19 and in the post COVID-19 scenario, where the healthcare professionals, as well as institutions, will be required to address the comprehensive patient care to avoid the crisis of COVID and non-COVID patients.” Dr Srivastava further said, “In only 60 days, with over 6 Webinars & Summits, we at HEAL have done about 20 hours of ‘health education’ discussions/ deliberations involving over 75 Experts, Medical KOLs & Women Leaders & Media & Public Health Experts, including the 1st Live eHealth Summit & the 1st Patients’ Right Conclave reaching out to above 3 lac people directl. We are committed to ‘spread right health awaress from home’ & make sure that our fellow citizens do not suffer due to lack of information or due to any ‘mis-information circulated on Social Media.”
The session saw over 500 participants who had a volley of questions with them asking with each panellist. Over 10 panellists from different sectors — medico, journalist, social worker, entrepreneur, health communicators and legal experts attended the eConclave with enthusiasm & zeal and deliberated their respective stances. They passed their constructive criticism and suggested probable solutions as to how to tackle the outgoing and the forthcoming situations.
Deliberating on the essence of amity amongst different sections of society, Dr Ram Kumar, Secretary-General, Sewa Bharati said, “The COVID-19 pandemic has given us an opportunity to come together to fight this adversity unitedly. We, as a society can bring a solution to any such problem. The spirit of mutual cooperation can only rescue the sufferers and pave the way to come out from the crisis. Sewa Bharati has been working ceaselessly to provide the essentials for the survival to the deprived. Since the outbreak of COVID-19 pandemic and the lockdown, we have managed to provide meals to lakhs of people who were on the brink of starvation.”
The other speakers deliberated on the respective topics assigned to them. Dr Dipak Shukla, CEO PSRI Hospital threw light on — ‘Post lockdown Healthcare Professionals and Institutions are required to address comprehensive & holistic patient care, beyond COVID-19’; Dr G S Grewal, President-Elect, Delhi Medical Association deliberated at length on — ‘Absence of Guidelines of GOI for standalone Clinics in Pvt Sector leading to uncertainty’; Dr Yogendra Malik, National Secretary, National Medical Organisation deliberated on — ‘Stigma created by COVID-19’ needs answers from all of us.’
Deliberating on the Pandemics and how these are handled worldwide, Dr Chandrakant S Pandav, former HoD, Deptt of Community Medicine, AIIMS said, “This is the 20th pandemic and not the first. The 1st occurred in 165 AD taking away the lives of almost 5 million people. So no need to worry, take precaution, follow the preventive measure of social distancing with physical space distancing compounded with social sensitivity and enjoy every moment. The COVID-19 in modern times has given the message that the entire world is a family. Follow the Ayurvedic way of life and ensure to make your immunity strong.”
The remaining speakers like Mr Sridharan Ramkrishnan, Consulting Editor, TV-9 deliberated on — ‘Media’s constructive responsibility’; Mr Sudhir Mishra, Medico-Legal Expert on — Patients’ Rights & Access of Healthcare been compromised, how to correct it? Mr Manoj K Das, Chief Editor, Mathrubhumi threw analytically light on — ‘Role of Language Media during COVID-19 Pandemic (examples from Kerala)’ and Mr R Shankar, President, HEAL Foundation took the overview of the entire session deliberating on — ‘Essential services of Non-COVID Patients need reinstatement in a proper planned way’.
Examining the topic — ‘Doctors and Patients both suffer of COVID-19 panic: What are the solution and the way ahead’, Dr Deepak Singla, Medical Director, Maharaja Agrasen Hospital, said, “We need to come out from the COVID-19 panic and move towards normalcy as the lockdown has put the lives of the regular patients such as kidney patients on dialysis and diabetes is in trouble. The regular vaccination of children is disturbed. The society and the government must work to bounce back to normalcy retaining the essential preventive measures intact.”
About HEAL Foundation: HEAL Foundation is a not-for-profit organisation, which has been working diligently under its flagship initiative COVIDFighters — dedicated to fighting COVID-19 Pandemic with its various awareness drive such as organising a series of webinars and other allied activities ever since the outbreak of coronavirus. You can know more about HEAL Foundation @ www.healfoundation.in & about it’s dedicated program on Covid 19 @ www.covidfighters.in .
About Sewa Bharti: Sewa Bharti, Delhi, part of Rashtriya Sewa Bharti- world’s largest social services organization, works among the economically weaker sections of Indian society, including tribal and indigenous communities, urban slum dwellers and resettlement colonies. You can know more about Sewa Bharti, Delhi @ www.sewabhartidelhi.org .
- May 13, 2020
The lockdown has also increased the faith and trust in ‘family doctors’ and general physicians whose first line of action is medical management, not surgeries!!
Covid 19 has recalibrated the earth, our lives, plans, and the way we think and act. Abnormal is the new normal – from people staying at home, working from home to eating at home while the offices ‘flew’ to the Cloud.
While there are many developments triggered by the virus that has foot-printed itself across the globe, one striking feature is that non-Covid patients have suddenly vanished during the lockdown period. Where have these patients gone to?
For all the people in the Healthcare sector or related sectors & even for ‘general analysts’, this topic has been intriguing and become a part of ‘Chinese Whisper’ that—Was the load of patients at Hospitals (the Govt. & the big ones) an ‘over capacitated’ situation which was created due to the ‘fear tactics mastered by the Medical Meditators (comprising mostly of Referring Drs themselves) OR is it just merely the ‘fear of Covid’ which stops all medical cases to land up & make a cue at Hospitals & at Drs OPDs!! This question will only get a complete appropriate answer once it is answered by itself, which is possibly in the next 2 months when the ‘Covid Fear’ is almost at the edge & these Hospitals & the OPDs are ‘back to normal’.
But facing the brunt are multi-specialty hospitals in the private sector and super-specialty corporate hospitals. Once a beehive of activities with patients coming in droves, the corridors of these hospitals are enveloped in an eerie stillness; the corridors used to echo with anxious footfalls, but today it is the silence that tip-toes through these polished disinfected walkways.
So, coming back, where have the patients gone during the lockdown? There are two reasons: one the obvious and the other mysterious.
The obvious ones are Four:
- The Covid 19 lockdown has seen a drastic dip in accidents and crime. Data from municipal records in central Mumbai comprising more than 10 million people, the number of deaths fell by about 21 percent in March compared with the same month of 2019.
And in the neighbouring state of Gujarat, overall deaths due to accidents or crime nose-dived to more than 60 percent in Ahmedabad.
In 2018, road accidents in India claimed more than 1.5 lakh lives. In 2020, which includes the coronavirus lockdown, there was a dip in such accidents by 15 percent.
Death on tracks has also dropped drastically as passenger services came to a screeching halt. In Mumbai alone, figures show that more than half a dozen people die every day on the rail network.
Reports also claimed that there were fewer victims of crime being brought in to hospitals.
- Air traffic grounded, patients who come from abroad for medical tourism have either postponed their trip or gone to other countries. In fact, Kerala sees the maximum number of medical tourists thronging Ayurvedic centres during Karkidagom month (July-August) when treatment and rejuvenation procedures are supposed to be very effective. This year, all the bookings have been cancelled.
- Mid-size hospitals are cautious and are insisting that patients who come in should be Covid free and prove the same. If a Covid patient enters the hospital, the entire set-up gets shut and doctors and paramedical staff have to undergo quarantine. This will be financially back-breaking.
- There could also be a case of non-reporting of non-Covid cases. For example, last year, over 8 lakh infants died due to malnutrition, infections, poor sanitation etc, according to a UN report. In 2020, so far no such cases have been reported from poor states because Covid has been taking the limelight, time, and media space.
Now the mysterious reasons.
Major multi-specialty and corporate hospitals have seen a sudden disappearance of patients with cardiac ailments. There has also been a major dip in heart attack cases.
Studies have shown that cardiac ailments are the biggest killers in India, claiming three million lives every year. Where have these patients gone during lockdown?
Dr. Ajit Mullesari Sankardas, Director of Cardiology at the Institute of Cardio-Vascular Diseases, Madras Medical Mission in Chennai, was quoted in the press as saying “We normally see 4-5 patients with symptoms of cardiac diseases a day. Now it is just 2 a day.”
The consortium of state government hospitals too has recorded a 40 percent decline in patients with complete blockage of a major heart vessel. This is technically known as ST-Elevation Myocardial Infarction (STEMI). In case of Non-ST Elevation Myocardial Infarction (NSTEMI), where the blockages are partial, there has been a whopping decline of 70 percent.
Kerala hospitals have recorded a 30-50% drop in patients with heart attacks. Prior to March 25, hospitals in the state with advanced cardiology units used to record around 10 to 15 heart attack cases every day. This has come down drastically.
Punjab and Gujarat reportedly recorded a dip in 30 percent in heart attack cases during the lockdown.
So, that begs the question: Where have these patients gone?
Cardiologists say that the decline in numbers may be due to reduced pollution levels, no traffic-induced stress, reduced physical activities or they may be keeping away due to fear of getting infected with Covid if they visit a hospital, especially since heart ailment is considered as a co-morbidity and these patients may easily get infected.
There could also be the issue of lack of transport. Patients from other states without frontline cardiac units may not be coming. For example, New Delhi and Gurugram used to cater to a large volume of patients from Uttar Pradesh, Bihar, and Bengal. But with the lockdown, they are unable to travel long distances. Moreover, with record unemployment, many may just not be able to lay their hands on money needed for healthcare.
This has driven many to local clinics. The lockdown has also increased the faith and trust in ‘family doctors’ and general physicians whose first line of action is medical management, not surgeries, if the symptoms are not alarming.
With emphasis on ‘natural living’ and shoring up the immunity levels, many patients have started opting for Ayurveda. ‘Going Green’ is the new mantra for health.
Some senior cardiologists held a webinar on the issue recently on the mystery of vanishing patients. Besides reduced stress and pollution, they highlighted the fact that people have improved their diet and junk food consumption has dropped; also they are eating and sleeping on time. People are also taking their medicines regularly now.
Dr. A George Koshy, a cardiologist at Thiruvananthapuram Medical College Hospital, who took part in the webinar was quoted in the press as saying: “Heart attacks are also triggered by infection, but now overall infections have come down and as a result, people are taking lower amounts of antibiotics.”
This trend has also been recorded in the US, Italy, and other countries.
But there are other cardiologists who have taken a different stand. Coimbatore based Dr. Thomas Alexander, director of STEM India, an NGO that develops modules and protocols for management of heart attacks, says patients may be ignoring or managing the minor symptoms. Some may be going to smaller clinics.
“It is safe to treat patients with medicines than take them for a procedure if it is not essential,” he was quoted.
Following divergent views, the Cardiological Society of India is now planning a countrywide study by comparing data during the lockdown period with that for the same period last year.
This has triggered a debate in social media if major hospitals were wheeling every patient with minor symptoms for an angioplasty. Some have even accused some major hospitals of fixing a ‘target’ for angioplasty and using costly equipment if needed or not.
Unrealised costs of buying expensive medical equipment and servicing loans have left private hospitals in gasp for a desperate breath.
“With the current Covid-19 crisis, the private healthcare sector is faced with a twin predicament—while the sector is investing additional manpower, equipment, consumables, and other resources to ensure 100% preparedness for safety in the hospital(s)… eventual treatment of patients, when needed… is also experiencing a 90% drop in its revenue with sharp drops in out-patient footfalls, elective surgeries, and international patients,” said Dr. Naresh Trehan, chairman, CII Healthcare Council, and managing director, Medanta hospitals, was quoted in the media.
The ‘empty hospital corridor syndrome’ and dip in OPD walk-ins are expected to continue for at least 3-6 months. This could majorly impact cash flows as 80% of the sector’s costs are fixed. In India, 72% of hospitals and 60% of hospital beds are in the private health sector, the fourth-largest employer in the country.
Private hospitals have started scaling down their elective caseload while still maintaining a full workforce and stocking up on extra inventory. This is squeezing them financially.
The private sector has requested the government for a financial package in order to pay salaries and vendors. Some proposals on the table are that this package can be in the form of an emergency assistance loan for 10 years at 0% interest, tax waivers, clearing pending dues from government schemes like ESI, CGHS, etc.
But not everything is down and out. Lockdown period has seen a steep increase in lifestyle diseases like obesity, depression, anxiety, etc. These should become part of statistics to get a holistic picture of the Covid Lockdown Syndrome.
As said earlier, Covid has changed everything, including our hearts and heads.