Underlying Conditions

India’s coronavirus crisis was decades in the making

23 March 2020
A woman pauses at Delhi’s government-run Safdarjung Hospital amid a growing outbreak of COVID-19. Private healthcare has boomed while public health facilities have been neglected for decades, leaving India ill-equipped to handle the COVID-19 pandemic.
Biplov Bhuyan / Hindustan Times / Getty Images
A woman pauses at Delhi’s government-run Safdarjung Hospital amid a growing outbreak of COVID-19. Private healthcare has boomed while public health facilities have been neglected for decades, leaving India ill-equipped to handle the COVID-19 pandemic.
Biplov Bhuyan / Hindustan Times / Getty Images

The global coronavirus crisis has been called many things: a pandemic, an unprecedented crisis, a re-run of sorts of the Spanish flu’s decimation of the human population just over a century ago. In India, from the eyes of anyone who studies public health, it is also a catastrophe that has been in the making for decades, perhaps since as far back as Independence. 

In weeks of reporting since India saw its first COVID-19 cases and deaths, I am yet to speak with an epidemiologist or infectious-disease expert who is surprised that the country is utterly unprepared for what awaits us—which, they all agree, is a surge of infections and resulting deaths. 

One assessment published in a medical journal in January reckoned that India had 2.3 ICU beds per 100,000 people. The medical system in Iran, for which the assessment put the figure at 4.6, is overwhelmed with COVID-19 cases. Experts in the United States, where the ratio of ICU beds was reckoned to be more than six times higher, are warning that it will soon run out of ICU beds too. India has less than one allopathic doctor per thousand people—the minimum recommended by the World Health Organisation. As of 2016, the Indian Medical Association was showing a shortage of tens of thousands of critical-care specialists. The dominant share of doctors and beds are in the private healthcare sector, which has enormous leeway to set its own prices and make its own rules—and to exploit both to put profits before patients. 

Vidya Krishnan is a writer and journalist. Her first book, Phantom Plague: The Untold Story of How Tuberculosis Shaped our History, will be published by PublicAffairs in 2021.

Keywords: COVID-19 Ministry of Health and Family Welfare public health
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