Anant Bhan Profile picture
18 Apr, 14 tweets, 3 min read
Many of us who have been health activists have been crying hoarse for years about the need to strengthen our health system, focus on public health
Last summer brought policy and public focus to this dire need. One thought lessons were learnt.
Clearly not.
There is INCREDIBLE stress on the health system right now in many parts of the country. Health professionals over worked, burning out, turning positive with families in droves. And sometimes cannot find beds for themselves or their family in the hospitals they are working in.
I have never seen this kind of a situation before. Lots of people reaching out for help. To provide care, advice, help patients and those in medical need is what health providers are trained for. It is what this is unique about health as a profession.
Imagine not being able to help because there is no capacity, no bed, because there are multiple claimants for that one bed all with medical need. Where the only way a bed might be available is a patient discharge or sadly, a patient death
Ambulances lined up outside hospitals waiting to be able to transfer the patient to the facility, and at times to ferry out those who could not make it.
Where morgues in some hospitals are in a state which one only expects in a disaster setting
Bodies lined up
Where every phone call with friends, colleagues and family revolves around the pandemic impact. On the people who make up the data we see represented on the TV screens.
The 'cases', the 'deaths'.
Individuals, not a statistic.
And what is going to be hidden from view for a while is the impact on non Covid care. Which had not yet recovered from last year's extended focus on COVID-19
When entire referral hospitals become Covid care only, where does it leave those patients.
As one drives in the city, the only shops often open are medical stores. Often in close proximity to each other. And yet, there are many waiting their turn to buy medicines.
Medicines which sometimes are in short supply. So people beg and plead and wait resigned for stocks
Thr uncertainty of how long this current upswing in cases will go on for.
On what more than a year in confinement means for our young and the elderly.
On whether if a loved one does fall sick and is hospitalized, there will be an opportunity to see them, to tell them how loved and valued they are. To be able to say a proper goodbye if one were to loose them.
This is now personal for many of us, the privileged in this country. Hardly any of you would have been untouched
Investment in, nurturing, strengthening social sectors like health, education is not a choice. It is a requirement. Short term steps will not cut it.
So do not buy excuses, do not settle for a system with faults. Think about how even the well off among you had to run around in this time of crisis for access to care.
Remember that is how it is often even in non pandemic times for those who might be less resourced than you.
Is that the country you wish for your self, your children, your family, your communities, your nation.
The reform has to be us. Please, please demand and ensure that we build a learning, resilient health system

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More from @AnantBhan

14 Jan
THE VACCINE DILEMMA
The government has announced an intent to go ahead with vaccination as of 16th Jan 2021 with both Covishield and Covaxin. There is going to be no choice. You will only be able to receive one of the two, whatever is allotted to you by the govt.
While you have an option of opt-out, it will put potential vaccinees in a tough situation. You have to decide for yourselves based on publicly available (or the lack fo it) information-- on safety, immunogenicity, and efficacy on both vaccines.
If you are allotted Covishield, you will follow the current protocol as described and practiced in the dry runs. Image
Read 42 tweets
12 Jan
With regards to #COVISHIELD which will be rolled out on 16th onward, the CDSCO SEC approval requires the recipient to be given a factsheet prior to the vaccination. Has this been prepared--has anyone seen it?
Was it distributed in the dry-runs? Available widely?#COVID19 #vaccine Image
So both these documents are indeed available (factsheet for recipient and the leaflet for the medical provider). Thanks to @Dr_Aqsa_Shaikh for pointing that these are available on the SIIL Website. Hope the factsheet will be available at all vaccine sites. Sharing here for info ImageImage
Read 5 tweets
8 Jan
The #COVID19 pandemic shows the need for building capacity within the country for critically evaluating ethical issues in health research
We @SangathIndia #Bhopal hub are delighted to have been funded by @thakurfdn to to create an online/digital course on health research ethics
The project is called DRISHTi (Developing capacity in health Research ethics Training) and the digital course will be targeted at health professionals as well as general public. The course is proposed to be 8-10 weeks long, completely digital in format and in the English language
The course has the potential to be a key contributor in developing capacity within India to conduct and evaluate health research from an ethics perspective.
Read 6 tweets
7 Jan
The ICMR DG and some other experts have argued that phase 1 and phase 2 data is enough for restricted emergency use approvals, and that phase 3 efficacy data is not necessarily required.
Dr T Jacob John also makes an argument in this regard, though also clarifying that there might have been some early safety data from those vaccinated in the phase 3 which is ongoing as well
BUT if we were going to base a regulatory decision on just phase1 and phase2 data, why did we have to wait till 02nd Jan 2021. That data was available a few weeks earlier, and in fact was considered in the 09th December CDSCO SEC meeting. Why not take the decision then itself?
Read 4 tweets
5 Jan
Have been in touch with Rachna for the last few weeks as we discussed issues with one of the #Bhopal #clinicaltrials site for #Covaxin. Lots of issues with trial conduct as documented in her thread below.
Issues with informed consent, care of trial participants, recruitment.
This issue needs to be highlighted more as it shows us what poor oversight could mean, especially because we are now talking about expanded use of vaccines "in clinical trials mode" (not that I am sure anyone really knows what that means)
Now this is probably just an issue with an inexperienced trial site and investigators who were eager to be part of a prestigious study, but faltered on some aspects of trial conduct. But imagine this happening at scale-- how are we going to ensure protection of the vaccinees?
Read 9 tweets

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