18:42 GMT17 June 2021
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    A surge in COVID-19 cases and a lack of adequate resources have left Indians in dismay. After metro cities, infections are now spreading to rural areas, where two-thirds of India's population lives and where access to testing and medical care is limited.

    According to the Indian Medical Association (IMA), a voluntary organisation of Indian medical professionals, over 400 doctors have lost their lives in the line of duty battling the ongoing COVID-19 crisis. To make things worse, the menace of black fungus, or Mucormycosis, has posed an additional challenge for the medical community in the country.

    On Thursday, India's Ministry of Health asked all states and union territories to declare Mucormycosis, also known as black fungus, an epidemic. 

    The IMA as well as several healthcare experts have warned against the possibility of a third COVID-19 wave in the country. The experts have stressed that getting vaccinated and following the COVID protocols strictly is the only shield in the fight against the coronavirus pandemic.

    Sputnik reached out to Dr J.A. Jayalal, currently a professor of surgery at Kanniyakumari Medical College and head of UNESCO Bioethics in India, to discuss a range of issues.

    Sputnik: In the ongoing wave, the number of deaths among doctors is increasing. Bihar has the highest number of deaths of doctors due to COVID-19. What is the possible cause?

    Dr Jayalal: The medical fraternity always has more chances of getting infected because we are exposed to more people. Also, the density of viral infection is high because of working in an environment where there is a lot of positive cases.

    Secondly, the working hours are extremely long right now and doctors cannot take care of their own safety measures. Wearing PPE kits for long periods, exhaustion, as well as dehydration, are also making matters worse. When war is happening, soldiers should be taken care of properly. The doctors need consistent care and protection to fight.

    The government is also helping but still, it's a long way to go. The most important thing is the government needs to augment the manpower. So many doctors are waiting for their NEET PG exams to be conducted. If this happens soon, more PG doctors will come. There is a need to create adequate posts.

    Sputnik: What are the major flaws in the Indian government's strategy to fight the coronavirus pandemic? What exactly went wrong?

    Dr Jayalal: Basically, it was unpreparedness and lack of foresight. Another thing is the vast population of our country and the unequal distribution of our healthcare system. But you cannot blame anybody. Initially, all the oxygen used to be prepared in the industries. There are a lot of logistics hurdles.

    Bodies of suspected Covid-19 victims are seen in shallow graves buried in the sand near a cremation ground on the banks of Ganges River in Prayagraj, India, Saturday, May 15, 2021
    © AP Photo / Rajesh Kumar Singh
    Bodies of suspected Covid-19 victims are seen in shallow graves buried in the sand near a cremation ground on the banks of Ganges River in Prayagraj, India, Saturday, May 15, 2021

    The government should realise that the disease is spreading from the metros to the rural areas and more care should be taken to see that necessary infrastructure, oxygen, Remdesivir, and beds are reaching there. The focus should be more on rural areas. But the ultimate goal should be vaccination. Vaccinating everyone eligible should be the priority.

    Sputnik: The current crisis is having a devastating impact on doctors and healthcare staff. How are doctors in rural parts of the country handling the situation?

    Dr Jayalal: Oxygen is the major issue in the rural parts of the country. The main issue is that patients who are coming to the hospitals are already in a bad state. This is not like the first wave. 70-80 percent of the people coming to the hospital are in a bad state. There is an acute shortage of manpower in the rural region.

    Sputnik: The menace of black fungus is rising. Do you think a delay in taking this matter seriously may worsen the situation?

    Dr Jayalal: We are at a stage where we are getting more and more black fungus cases. Now, almost all the districts have cases of Mucormycosis. The government needs to anticipate this and make sure of the availability of the drugs to treat black fungus. The main problem we are facing is that the essential drugs like Amphotericin B are not available. Unfortunately, there are no Indian producers for these drugs. The protocol for the management of this infection should be announced as well.

    An Indian doctor checks a man who recovered from COVID-19 and now infected with black fungus at the Mucormycosis ward of a government hospital in Hyderabad, India, Thursday, May 20, 2021
    © AP Photo / Mahesh Kumar A
    An Indian doctor checks a man who recovered from COVID-19 and now infected with black fungus at the Mucormycosis ward of a government hospital in Hyderabad, India, Thursday, May 20, 2021

    Sputnik: People are falling prey to quackery methods to cure COVID-19 and other ailments. There are several reports of death due to this too. How should this be handled?

    Dr Jayalal: This can be handled only by the government. We are not against any system, but it's the responsibility of the Health Ministry to periodically announce what is good and what is not good. What we do in modern medicine is followed under necessary guidelines and research. The government needs to ensure that people are aware.

    Sputnik: The IMA and health experts are constantly warning against the possibility of a third wave. Do you think India is ready for it?

    Dr Jayalal: Yes, we need to prepare ourselves to face the challenge. The only option in front of us is vaccination and COVID appropriate behaviour. Now at least we have filled in the required infrastructure and by the time a possible third wave comes, I think, we will be self-sufficient with oxygen and essential drugs. But we need to maintain the focus on vaccination and ensure everyone gets it. At least for the next 3-4 months, there should not be any political or religious rally, and then we can face the challenge more confidently.

    Sputnik: Cases of assaults on doctors and healthcare staff are also rising. What measures should be taken to control this?

    Dr Jayalal: It is natural for the people to have that feeling of anger when they are coming with hope, and there is no oxygen or bed, and their loved ones are dying. But it is the responsibility of all the stakeholders, including the government, to ensure the protection of the doctors and other medical staff. This can be done in two ways: declaring all the hospitals as a protected zone and implementation of strict law in the hospitals as well as COVID centres. Also, miscreants should be punished stringently so that they can set an example for others.

    Sputnik: When can we expect this COVID situation to get better?

    Dr Jayalal: I am expecting August-September will be a fruitful period for us. Within 2-3 months this storm will definitely be over. By August-September, we will be relatively free. But yes, this will only be possible if we follow all the COVID-appropriate behaviour for a year. 2022 will be a pleasant year for us.


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