Dharavi holds hope for other cities: Dr Sudarshan

Manipal Hospitals chairman Dr H Sudarshan Ballal, who is also a member of Karnataka's expert committee on Covid-19, says the healthcare sector is in a crisis as non-covid patients are fearing to visit hospitals. Time has come to re-evaluate the coronavirus, he tells ET’s KR Balasubramanyam and Akshatha M. Edited excerpts: How do you see the virus playing out?Covid-19 numbers are swelling exponentially. But what we also see is in densely populated cities like Delhi and Mumbai, and especially Dharavi slum, probably with the highest density of population in the world, the infection has sort of plateaued. That means there is hope for other cities.How do you view the trends in Bengaluru?I am hopeful Bengaluru will see its peak soon in the next one or two months, and we will see the numbers plateauing or coming down. We have to bear with this virus for two more months by changing our lifestyle and learning to live with it, and not panic about it. It is difficult to predict, but maybe 60,000 cases a month for the next one or two months. Maybe about 1.5 lakh cases a month in Karnataka, going by the current trend. Most people think September and October is the time when numbers will start coming down. Hopefully by the end of this year or early next year, we will have the vaccine. In the near future, covid will be like any other virus. So, how do we correct the course?There are two issues we have to look at: One is dealing with the virus, and two, taking care of people with non-covid illness. By paying a lot of attention, we have taken Covid centrestage, but many other diseases causing mortality have been ignored. To give some perspective, as a country with a population of 1.4 billion people, India has had about 35,000 covid deaths in seven months. Out of the 10.5 million die in India every year, 60% die due to non-communicable diseases like diabetes, hypertension, obesity etc; 40% of them die of communicable diseases like Sars, H1N1, Malaria, TB etc. But every hospital in the country is focussing only on corona. This is interfering with the care of people suffering from other diseases.This is the only time in history during a pandemic hospital footfalls have come down as only people with corona are visiting us. Others are fearful.. Corona deserves importance, but we should not go overboard and completely ignore others who are probably dying because of lack of care. Hospital beds are a precious resource, and all corona patients are getting admitted. In my opinion, 60%-80% of patients don't deserve to be in hospitals. Vulnerable people are suffering due to corona…It is time we started to look at reverse-isolation. Protect normal but vulnerable people from infection. Largest number of mortality is in the vulnerable group. Till such time a vaccine is available, we should see they are not exposed to coronavirus. I have never seen this kind of stigmatisation since my student days. As if one is doomed with corona. No one even wants to talk to them. That is the reason why people don't want to declare their covid status. We should end this instant stigmatisation and fear psychosis. As a healthcare veteran, how do you view lockdowns? When it first came, it was a new virus, extremely infectious, and all states took drastic steps to slow down its spread. I have not seen in my career of 50 years such massive lockdowns, testing and restrictions which were probably necessary in the early part of the epidemic. However, in the long run, lockdowns are not an answer. People lose jobs and earning capacity.Our economy will collapse if we don't open up in a phased manner with precautions even as we treat the people who are sick. Lockdowns have caused a lot of economic hardship; our healthcare industry is struggling, children are not getting education. Vaccination is very important for children to prevent the spread of infectious disease. If children don't get vaccinated that will be another major problem. But parents don't want to take their children even for vaccination fearing infection. Time has come for us to reevaluate corona. It is not as dangerous as far as mortality is concerned. Patients should feel hospital is a safe for them to visit if they are sick. Non-communicable diseases could have serious long term consequences. The message is Covid is an important disease but not at the cost of other diseases. Too much attention to Corona may distract you from non-Covid diseases. Now the entire healthcare resources of our country are spent on Covid. There is nothing else happening. Such focus was good initially, but not anymore.What is the proportion of covid patients at Manipal Hospitals? At Manipal Hospitals, 50-60% of beds are occupied by Covid patients and non-Covid patients are treated in the remaining 40% beds. The footfall to hospitals (non-Covid patients) has drastically reduced. We are telling people with illness to get treated and not to wait for Covid to go away. Sections of private hospitals are turning away covid patients… The government should improve the bed management system. It is quite tragic that patients are running from pillar to post. There should be a real time dashboard and efficient triaging and directing patients to hospitals where beds are available. Often, a patient may require ICU beds, but hospitals may have beds, but not in ICU. My submission to the government is to manage the beds better, while building the infrastructure. There has to be a coordinated effort between private hospitals that should share real time occupancy and availability of beds and the same is to be reflected on the dashboard. Which state has handled Covid situation better?Karnataka handled it better in the first three months. Kerala has done reasonably well. Despite the surge in cases, Kerala continues to be a good model in managing Covid. All governments are learning quickly. Delhi and Mumbai were in shambles, but now they all seem to be on the right path. But the biggest success story I feel is, if Covid has not spread like a wildfire and caused huge mortality in Mumbai’s Dharavi, there is hope for everyone. But we do not know what factors contributed to the containment of infection in Dharavi. But there are a lot of things that are beyond someone’s control. It is a very difficult disease to predict.