As the State rides the third wave of COVID-19 and the focus shifts to how normal life can be resumed, the crippling impact the pandemic has left on the State’s health system is more stark than ever.
Two years of fighting SARS-CoV-2 has been catastrophic not just for the State’s health system, which expended all its energy on futile exercises to tie down the virus and lay claim to exceptionalism, but also the healthcare workers, most of whom are exhausted and suffering burnout.
The stigma surrounding COVID, anxiety over personal safety and that of families back home, physical rigours of operating donning a suffocating PPE kit and helplessness of having to watch people die every day were humbling and distressing, said doctors.
In some ways, COVID exposed the health system’s vulnerabilities even when it empowered the system in some ways.
“The COVID-19 succeeded in perking up a lethargic health system, got it up and running. All of us jumped headlong in the fight and stood with the political administration to fight the new scourge. The department, which used to function from 10 a.m. till 5 p.m.., learnt to work round-the-clock and for the first time, there was a sense of ownership among the health staff. But we failed to reckon that there is no B team and that we have to sustain a long innings. Today, all of us are exhausted, overburdened and have no fight left in us,” a senior Health official said.
But even so, the entire burden of the system during the pandemic was borne by some 30% of the department personnel, who are struggling to keep their head above water, while for many others, COVID has been a long two year vacation, he said.
“There is no performance assessment in the department. There are many who are still working from home without even a computer, while many others, who were roped into various teams and working groups at the beginning of the pandemic, continue to work round-the-clock even after two years. They have no personal time, no work-life balance and sadly, they are the ones who are called upon to give more and more. They have been offered no incentives or even a certificate of appreciation and are totally demoralised,” a senior doctor in the department said.
These past two years, the system has been fighting COVID to the exclusion of all else and the impact it has had on all routine activities of public health as well as other vertical programmes such as non-communicable diseases (NCDs) control or cancer care is something which is still being uncovered. Treatment continuity as well as prognosis was affected in the case of all NCDs, including cancer.
At the field level too, activities such as supervision, evaluation, reviews and follow-up have been suffering. Better utilisation of human resources in the system, pooling and redeployment of staff from various wings could have helped minimise the fatigue that has affected the system now.
“The COVID management was confused with COVID data management and this obsession with generating reels of spreadsheets and charts, still takes up a lot of energy, time and human resources which could have been diverted to deficient areas. The saddest part of the last two years was how the Health department surrendered all leadership to political administration,” a senior Health official said
Some of the gains during the pandemic include the strengthening of the data management system such as LDMS portal, which many hope can be upscaled for the monitoring and surveillance of all infectious diseases in the long term; the strengthening of the telemedicine system, e-Sanjeevani and major infrastructural upgradation that happened (hospital beds, ICU/ventilators, oxygen plants), in the name of COVID preparation.
Going forward, as one resigns oneself to living with COVID and tackling it alongside other infectious diseases, motivating a tired work force to find the enthusiasm to get all the public health programmes back in order is going to be a tall task, many acknowledge.
