a ‘decentralised fight is the key’, even while he is clearly in control and works with a core team of dedicated people that is accessible and quick to respond.
At a time when retired generals are asking for the army to fight the virus, it is interesting that Iqbal Chahal, a marathoner, and engineer, who comes from a defence services background, has worked through ‘war rooms’ to control the virus.
On taking charge, visiting hospitals and COVID hotspots like Dharavi, Mr Chahal worked on three strategies: 1) eliminate the panic; 2) decentralise war rooms to cut response time; 3) build adequate infrastructure.
One of Mr Chahal’s first decisions was to abolish the central control room and order each of the COVID testing laboratories not to share test results directly with patients. They had to be shared with the BMC only.
BMC invited doctors and medical support staff specifically to handle the war rooms (especially fresh graduates from medical colleges and nursing schools across the state), provided them with a hefty stipend (Rs50,000 per month) and hotel accommodation at walking distance within the ward. It could hire over 900 doctors as well as 600 nursing students to accompany the ambulances in each ward.
Future Ready: Apart from setting up multiple facilities and reviving those what were shut down after the first COVID wave, the BMC is preparing for a possible third COVID wave around July on a war footing. Mr Chahal says he has 5,500 beds including nearly 3,000 oxygen beds vacant and available today. These include nearly 2,000 ICU beds with oxygen and ventilators. Four more jumbo centres are being set up which will further enhance patient capacity by 2,000 beds including 200 ICU beds.
Personal Post: For me the most important part of the model, on learning of my positive tests, BMC helplines, assured me that I can take care of myself at home, since I could easily self isolate. My doctor friends then advised me what to do.. and the treatment lines was more or less similar, and the advise to care givers, what to look for at what levels was more or less consistent. It was easy to distinguish between the scary fake news and good advise, as one could check with all the FAqs in WHO, CDC, and official websites. The usual caveats from traditional medicine, like ayurveda including doing pranayama, imbibing Khadha, salt water gargles, saying clearly that one should follow doctor prescribed treatment, clearly helped along with proning.
This brings me to my earlier post: http://emeets.lnwr.in/index.php/community-based-services The CBR process emphasises that care givers are the immediate family, neighbourhood groups and all these do it out of love, at no cost to the exchequer. It is prudent for the government to spend on resources to educate and provide support services, perhaps even monetary compensation to such care givers. Systematising such support on the lines of the Civil Defence Model will go a long way in, preparing this army of care-givers the tools they need for similar situations. The CBR model has proven successful in the case of disability support. There is no reason why it cannot be adapted for health emergencies like this one. This alongwith the AAP maholla Clinic should be a good model to follow in future.
For earlier documentation and Conversations on COVID, see http://emeets.lnwr.in/index.php/covid