When 32-year-old Hrishaan Savlani got his COVID-19 test results last week, his fears that his fluctuating body temperatures and a mild cough were more than just a seasonal flu were confirmed. The Mumbai-based copywriter tested positive for coronavirus and was advised to isolate at home. Because his symptoms were considered mild, government doctors decided against having him admitted to a quarantine ward or hospital.
The problem though, was the lack of clarity on what he needed to do to treat himself at home.
“This was very confusing since the government doctors did not really brief me on what medication to follow,” he told VICE. He said his private doctor sent mixed signals as well.
“The private doctor I usually go to first prescribed hydroxychloroquine, and then decided against it because of the changing World Health Organization guidelines. I am glad the symptoms did not get worse but I wish we had some kind of standard protocol and information on best practices for home quarantine. Here, I just feel like I’ve been made to fend for myself.”
Private hospitals and doctors in India’s metropolises have found an opportunity amid the chaos: they are now offering home isolation “packages” for those with mild symptoms or for those who are asymptomatic and advised to self-care in accordance with the current government protocol.
Stepping in for a healthcare system that seems to be buckling under the weight of escalating coronavirus cases in the country, these private players offer remote monitoring for those who sign up. For a fee, their services can include sending a medical kit (usually comprising a thermometer and a pulse oximeter that monitors the oxygen levels, both of which can be bought at most drugstores), basic immune-boosting medicines (available at most stores too), video consultations with doctors, daily monitoring of vitals, and in some cases, counselling and wellness advice sessions.
Still others offer advanced versions of a basic package, that include additional services like home visits by a nurse and a coronavirus test. While Medanta, a hospital in Gurgaon in the National Capital Region of India, offers a basic package that costs Rs 4,900 ($65), their complete care package costs Rs 21,900 ($290), a hefty price in India.
Some private doctors have packages with eye-popping prices too. Dr Dhrumil Panchal, a private physician with a clinic in Mumbai, offers a package for Rs 30,000 ($400).
“The costs go towards not just the medical kits, tele-consultations and nurse visits, but also to provide a safe place to stay and food for our staff, instead of having them risk living with their families,” said Panchal, who claims to have worked with around 100 patients so far.
These private doctors say that they are having to step up due to the lack of government resources to address the pandemic.
“As a country, we have limited healthcare resources,” said Dr Vikas Oswal, a private sector chest physician who also works in state-run hospitals and is in charge of two coronavirus isolation wards in Mumbai. “Even though we have converted so many places into quarantine centres including stadiums and trains, we are now facing a shortage of nursing staff and healthcare workers. To reduce their burden so that we can prioritise the available hospital beds and resources for only those who really need it, these services have come up.”
The situation is most dire in the populous cities of Mumbai and Delhi, which are reporting an alarming shortage of hospital beds. The government itself warned that the country's healthcare could soon buckle under the pandemic.
Delhi deputy chief minister Manish Sisodia predicted that until the end of July, the capital city will need 80,000 beds. Currently, there are just over 8,500 dedicated COVID-19 beds available. "For Delhi this is a big problem, if cases continue to rise," Sisodia said.
In Mumbai too, critically ill people continue to fight for beds in hospitals, sometimes dying as they wait for ambulances and hospital care.
But Oswal, who himself has been offering home quarantine guidance over the phone for two months for a small fee, is critical of how some private players might be jumping in to fill the gaps in the healthcare system. “I know I go against my fraternity when I say so but it’s not fair to charge enormous amounts for such fancy-sounding packages, like most private players are doing,” he said. “It’s just not the right thing to do.”
In some regions, the government is at least able to subsidise such services. Those told to self-isolate can avail of similar services offered by the private hospitals, with the expenses borne by the state governments. The tie-up between home healthcare company Portea and the Government of Delhi is one such example.
“Currently there are 1,500 patients who are being diagnosed in Delhi daily, out of which nearly 1,000 are identified as able to isolate at home,” said Meena Ganesh, managing director and CEO of Portea. Since May 4, the company claims to have guided 8,000 Delhi residents through their home isolations.
“The teleconsultations happen through doctors provided by the government but we coordinate the whole process because we are strong from a technology perspective. This collaborative way of figuring how to keep more people out of hospitals while also ensuring great care is changing the way the pandemic is being dealt with in the country.”
Whenever symptoms escalate and in cases where hospital treatments might be necessary, Portea notifies the appropriate government agency for action on the ground.
But while states like Delhi and even Chennai have such tie-ups, most state governments do not provide such technology-enabled solutions and might not have the budgets to support them.
Over the weekend, India overtook both Italy and Spain to register the fifth highest number of coronavirus cases in the world, with over 275,000 registered cases as of writing. The country sees almost 10,000 new cases a day, with around 7,745 deaths to date.
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