Omicron: Is India better prepared in 2022 for a third COVID-19 wave?

Rapid spread of the new COVID-19 variant, Omicron seems to be putting India’s healthcare infrastructure to litmus test once again. While India’s total tally of Omicron has already breached 1700 cases, the daily coronavirus count has swelled to over 33,750 cases per day, the highest in last three months.  

 

India was caught unprepared in May 2021 when the country started recording over 4.5 lakhs cases a day. The second wave of COVID-19 stretched capacity of the healthcare system to its limits with perilous shortages of hospital beds, oxygen concentrators, life-saving drugs and medical supplies. While urban India strived to counter the onslaught of the pandemic, the already inadequate healthcare system in rural India stood simply incapable to handle the swelling number of COVID-19 patients.    

 

Soon after, the government came under strict scrutiny for the inadequate healthcare infrastructure, it started ramping up its medical oxygen availability. Now, when Omicron is apparently pushing India into a third wave of the pandemic, as on December 23, the government has installed 3,236 pressure swing adsorption (PSA) plants in the country from various sources with a total commissioned oxygen capacity of 3783 MT. Moreover, 114,000 oxygen concentrators are being provided to states under PM CARES and COVID-19 Emergency Response & Health System Preparedness Package-II, or ECRP-II. ECRP-II funds have been sanctioned to the states for installation of 958 liquid medical oxygen storage tanks and medical gas pipeline systems in 1374 hospitals. 

 

For management of COVID-19 patients, isolation facilities are needed. As a matter of fact, the government has increased isolation beds. Pan-India, the isolation bed capacity and ICU bed capacity -- which was 10,180 and 2,168 before the first lockdown as on March 23 2020 -- was enhanced and is currently at 18,03,266 isolation beds and 1,24,598 ICU beds as on August 3 2021).  As lack of oxygen claimed several lives, India has attempted to significantly step-up oxygen availability across states.  

 

Despite efforts in last many years and nominal hikes in the expenditure on budget, India’s health statistics remains deplorable. According to the government data, India has 1.4 beds per 1,000 people, 1 doctor per 1,445 people, and 1.7 nurses per 1,000 people.  

 

In case, the infection spreads in the hinterland, the statistics do not paint a very good picture. According to the rural health infrastructure statistics released by the union health ministry this year, as on March 31, 2020, there is shortfall of 6.8 per cent of allopathic doctors at primary health centres (PHC) out of the total requirement at all India level. Overall, there is a shortfall of 76.1 per cent specialists at the community health centres (CHCs) as compared to the requirement for existing CHCs. 

Public health experts still believe that the preparedness of India is better this time with vaccinations, natural immunity and with healthcare infrastructure being strengthened. 

“Levels of preparedness in India are much higher this time. Unlike Delta, Omicron variant has been identified and flagged quickly thanks to improved genetic surveillance. Preliminary studies suggest lower infection severity of Omicron variant, possibly resulting in lower hospitalisation rates. Early response in the form of restrictions could keep the surge at manageable levels,” said Dr Bishnu Panigrahi, Group Head, Medical Strategy and Operations, Fortis Healthcare. 

“Installation of oxygen plants at hospitals will offset demand-supply mismatch and can make hospitals self-sustaining. There is also a widespread coverage of vaccines with more than 90 per cent partially vaccinated and over 60 per cent fully vaccinated eligible population in India. Vaccination has also started for 15-18 age group on January 3, 2022,” he added. 

 

According to the World Health Organization (WHO), consistent evidence shows that the Omicron variant has a growth advantage over the Delta variant with a doubling time of 2-3 days and a rapid increase in the incidence of cases is seen in a number of countries, including those where the variant has become dominant, such as the United Kingdom and the United States of America. While the cases are rising rapidly in India, public health experts though believe that severity of the disease may be lesser. 

 

“Initial available evidence about the Omicron variant suggests that it causes milder disease though it is highly infectious, leading experts to hope that number of affected people with severe disease would be less, and also that this wave would have a rapid rise of numbers, but an equally rapid decline. However, even if the wave is massive, the infrastructure and plans are in place to tackle it with minimum loss of life,” said Dr Harsh Mahajan, President, NATHEALTH, healthcare federation of India. 

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