I dare to make a bold statement that COVID-19 pandemic is the most clamorous, most catastrophic and the most defining aeon of our lifetime. I am sure that most of us must have never witnessed anything else till date which has happened with such speed – from the end of December 2019, when the first cases in China were reported, to the start of May 2020, when an approximate of one-third of the world’s population is locked inside their homes.
This crisis surely is one of its kind and has no precedent to it – there are no rulebooks, no standards that tell governments what to do; how to shut down economies; when to re-open; and a how to exit strategy. We cannot deny the fact that this virus is a cross-species transmission (CST), also called interspecies transmission – it has jumped from its animal host to humans; it is pernicious as it seems to find new ways to hide itself; and now that we can be asymptomatic and yet be a carrier of infection is really deadly and devastating.
But what we should really be thinking about amidst this lockdown, where we all are trying to adapt to the “new normal”, is that, what are the challenges that our healthcare system is facing today; what are some of the most important innovations our healthcare industry needs to battle against this pandemic.
To address this situation, we as InnovatioCuris Foundation of Healthcare & Excellence (ICFHE) decided to bring some industry experts on a single platform to understand from them, what our healthcare system’s need of the hour is. As the world is being digitally delivered, we organised a first of its kind virtual ICInnovatorCLUB meeting on Saturday 2nd May.
Welcoming all the experts on board was Dr V K Singh, MD of InnovatioCuris (IC), quickly walked us through the idea behind this virtual platform and how IC is trying to do its bit in the fight against this pandemic. Dr Hem Chandra Pandey who is the vice chancellor of Uttarakhand Medical Education University marked the opening of the session and shared his views on how before this pandemic the public health issues were mostly being addressed by the government hospitals, but in this scenario, the government and private hospitals have come together to face and deal with this situation and the public health activities are being jointly carried out by both.
Dr Hem Chandra also shared that how immense is the role of the private hospitals in the state of Uttrakhand that is driving the healthcare services in collaboration with its research institutes and government hospitals.
Highlighting the issues of diagnostic challenges was with us the COO of Oncquest Laboratories, Dr Ravi Gaur. On a lighter note and to make us understand the depth of this distressful situation, Dr Gaur said “the smallest, tiniest strand of RNA (virus) has brought the species humankind to its knees. But we humans have pulled through the crisis earlier, and will pull through this.” In the past, humans have faced two major infectious diseases, TB and HIV which infect every possible organ and now, we are struggling with COVID-19, again a disease which is infectious and is infecting every possible organ in the human body. As a result, the industry is facing a lot of challenges in the diagnosis and understanding of disease progression .Identification of the COVID-19 positive patients and the technology being used to do this diagnosis is mostly RT-PCR in India and not rapid testing. The serology and antibody assay using CLIA, ELISA and rapid cards will play a role in surveillance and understanding epidemiology.
Some of the biggest challenges in testing/diagnosing the current situation are:
- Identification of suspected cases and faster diagnosis
- Continuous revision of testing strategies
- Augmenting the testing capacity Limited
- Availability of infrastructure (like Biosafety 2-3 standards etc)
- Limited NABL accredited diagnostic labs – Need to fast track accreditation
- Limited Skilled workforce
- Safety of manpower
- Limited resources like PPEs – innovators stepped up and helped with some innovative models and was made available with the help of government interventions, but costs are high
- Type of sample collection nasopharyngeal / oropharyngeal /buccal)
When to collect samples – time of sample collection (affects the accuracy of the diagnosis)
- Storage and transportation of the samples ( spl Viral transport media required and cold chain needs to be maintained )
- Availability of ICMR approved testing kits
- Logistic and supply chain disruption
- Scared Manpower and need for strong motivation and assurance
- Health being a state subject there is some disconnect and a lack of alignment on goals between the centre and the states. quality validation
- Catering to India’s 1.3 billion population is a huge task and calls for a smoother operational mechanism for the success of this collaborative approach.
- State governments need to step up measures and ensure a hurdle-free procedure and a safe environment for the medical and testing workforce.
Appreciating the level of surveillance that countries like India are able to achieve at this time, Dr Gaur also highlighted the importance and appreciated the support & alertness being extended by the government towards the capacity building and the steps being taken to overcome many of these challenges ,but a lot needs to be done still and we have ensure that the testing is available to the last man out there on the post and at an affordable cost. Dr Gaur added that COVID 19 Virus has exposed the fragility and frailty of the human race. What matters today is speed and accuracy of the test report .The key to success is to deliver the report in 4-6 hours. There is a strong need to have a near patient and rapid but very accurate test. As Covid19, has become pandemic, there is an urgent need to invest more in developing state -of -art-laboratories equipped with latest technologies and qualified skilled force. Indian Government has done a very commendable work but to foster development a strong collaboration between government managed labs and private labs is the need of the hour. Both public and private entities have their limitations, but a combined effort can and will definitely make a huge difference.
According to Dr Nagendra Swamy who is the Principal Coordinator of Federation of Healthcare Associations, Karnataka; there are approximately 16,00,000 beds in India out of which 8,00,000 are with the public health sector including government hospitals, armed forces etc. Another 8,00,000 are with organised private sector where the corporate hospitals have 62,000 published beds only and 1,00,000 beds available with large and tertiary care hospitals and moving to private medical colleges we have around 2,00,000 beds in this segment. The balance 4,00,000 beds in private healthcare that is virtually handling the common class and serving as the backbone of the Indian healthcare. While explaining how the small and medium sized hospitals are overlooked because of lack of branding and structure of positioning, he also threw the light on the role of such hospitals during the pandemic situations like the one we are in now.
As the bigger corporations are available only in metropolitan or tier I or tier II cities, but when the pandemic happens it happens everywhere and is not restricted to these major cities.We can’t defy the importance of the role these small and medium sized hospitals are playing to tackle the current situation as they are available in the nook and corners of the country.
Complementing the efforts and guidelines rolled out by MOHFW and ICMR to segregate the hospitals into COVID and non-COVID hospitals so that all the other healthcare facilities are also available to the patients without any risks of cross contamination with coronavirus.
Dr Swamy also shared his concern about the financial and disease burden challenges that such hospitals are facing today, and highlighted how these small and mid sized hospitals are tirelessly helping to fight this difficult situation by serving people with non-covid health issues keeping in mind the safety of all.
Pouring her heart out and further highlighting the challenges being faced by any mid sized hospitals today was Ms Upasana Arora who is the Director of Yashoda Hospital, Kaushambi and also holds the chair of Services Export Promotion Council (SEPC). Calling out to the industry experts, Ms Arora said that the need of the hour post this pandemic is to take into consideration the amendments in the policies in regard to the conduct of any hospital. She also emphasised on how all the safety measures like wearing masks, PPE etc should be considered as a universal precaution.
Moving ahead on the path of analysing the challenges that the healthcare industry is facing, Dr S K Gupta, Director of Cardiology & Medicine, JWM Global Hospital & Research Centre India, talked about one of the most important and least talked aspects to this dreadful situation that is trauma and anxiety that the health workers and people are facing today.
Putting it together, Dr Gupta told that there are three dimensional aspects to one’s well being, that is Spirit, Body and Mind.
Whether we talk about insomnia, strange dreams, or even too much sleep, all are types of sleep disturbances that are a part of our body’s response to trauma and anxiety.
“Heal thy self” and “self-awareness” are the key to good health that we all need to take care of. Mindfulness and relaxation techniques are proven to improve mood and sleep quality by enhancing the control over the body’s focus and arousal system as well as in managing anxiety and concerns.
Stress, in such a situation is quite normal and can be healthy (as it motivates one to take necessary actions), but too much sustained stress is not. High and unregulated levels of stress can have various negative consequences on the brain, immunity and also on the vascular system of the body, leading to blood sugar imbalances, high blood pressure, impaired immunity and inflammatory responses – the very precise opposite of what we need to fight the potential impact from this COVID-19 exposure.
Good sleep, healthy diet, good sleep and meditation are important practices to be taken into consideration. Three dimensional healthy lifestyle can do wonders and everyone should try to follow it, irrespective of one being at home, in a hospital or anywhere else.
Another interesting picture of challenges being faced by the private hospitals was painted by Dr Param Hans Mishra who is the current Group CEO of Kailash hospital.
It is really sad that we all are struggling with such a paradoxical setting today, where doctors who are the front line protectors/fighters have their own protection at the highest risks, the healthcare staff who are saving millions of lives and families have their own lives and families in the most vulnerable zone. And to top all this, is the shortage of resources and finances to serve these healthcare workers, organisations and ecosystems. It is a real challenge for the private sector as the reduction in the number of non-covid treatments/surgeries (due to fear of catching cross infection) leads to reduction in cash flow and high number of covid treatments demands more and more per patient inputs (financial as well as human resource).
Trying to find solutions to some of the above challenges, ICFHE under the umbrella of Ministry of Human Resource & Development (MHRD) organised two virtual national level hackathons (Fight Corona IDEAthon and MHRD Mega Online Challenge – SAMADHAN) in the months of March and April to call upon the young innovators.
Fight Corona IDEAthon was organised from March 27-29, 2020 by ICFHE under the aegis of the Ministry of Human Resource Development Innovation Cell, All India Council for Technical Education (AICTE) and FORGE Accelerator. It was a national level 48 hour virtual/online ideation hackathon that extended to 72 hours due to overwhelming response, to discover ideas from thousands of innovators, researchers, scientists, and educators from across India. More than 5400 teams and 300 mentors joined hands as a true community during these uncertain and challenging times to discover solutions that can help the nation rise as one in the fight against COVID-19.
There were nine IDEAthon winners, three in each track of Students, Educators & Researchers and Professionals & Startups. The winners were awarded the cash prizes and also incubation grants upto 40 lakhs. There were also nine motivational cash prizes (three in each category) given out to motivate some of the best ideas from around the country.
Standing tall on a highly impactful Fight Corona IDEAthon, the Ministry of Human Resources & Development, in collaboration with AICTE and InnovatioCuris Foundation of Healthcare & Excellence (ICFHE), again hosted a nation-wide mega online challenge SAMADHAN under two tracks- Track 1: Ideate-Simulate-Win and Track 2: Validate-Pitch-Deploy. Under the SAMADHAN challenge there were three categories namely: student innovators, researchers & educators and startups to share their ideas to solve the challenges posed by COVID-19 pandemic. The SAMADHAN challenge was a 14 days long hackathon from 14th to 25th April 2020, which saw more than 3200 teams participate from all over India.
From these hackathons, our healthcare ecosystem has got some bright solutions catering to some of the challenges posed by this pandemic.
Through an interactive discussion, Tarak Nagarajan from Abhaytech, Muthu Vangaliappan from Katomaran Technologies and Business Solutions and Dr Sachin Sharma from AI for good joined us and shared their personal experiences and promising solutions that they have developed to fight against this crisis.
Working on promising solutions like:
- disposable/ reusable lung and heart monitors that can be worn at home and only require a smartphone which will help to reduce the burden for hospital based monitoring and the bottleneck of available hospital beds.As most of the deaths are occurring due to comorbidity.The AI Algorithm developed by Abhayatech can act as a temporary doctor and constantly help in monitoring the patients and help ease the burden on doctors.
- autonomous mobile UV-C robot. It’s a AI enabled robot that can be used to sanitize hospitals, offices, campuses etc. It could be useful in hospital settings where the room has to be sanitized after each and every patient like MRI room or CT scan room etc.
- early detection of COVID-19 using CT scan images and machine learning techniques.
We hope that our Indian healthcare ecosystem will soon be able to implement such innovative solutions to cater some of the challenges mentioned by the experts and also that there will be more and more young innovators out there who are eager to help the community in this time of crisis.
Trying to fast forward this implementation process, ICFHE has taken a step towards creating a Hospital Innovation Screening Committee (HSIC) to get the innovations evaluated and tested on ground to expedite the validation process. So that any innovator who wishes to get their innovations evaluated by the thought leaders of the industry can get a platform.
As it’s said, every crisis is an opportunity in disguise. So let’s try to grab this opportunity and stand together to fight against this and any such pandemic in future.
Authored by Parthvee Jain, Editor, InnovatioCuris