“Karnataka has relatively good health infrastructure with highest number of medical colleges in India”

“As of July15, 2,66,10,097 vaccine doses have been administered in Karnataka. Initially, due to a lot of rumour-mongering, there was vaccine hesitancy. But now, I don’t see much of hesitancy on the whole. We used the print media, TV and hoardings to promote vaccination drives. But, more importantly, reassurance from religious leaders, celebrities, and local district administrations that interact with people on a daily basis, helped in convincing people, even in rural areas. Hopefully, we’ll be able to get the entire population vaccinated in a very short span of time,” said Dr. P. Harsha, IPS, Commissioner, DIPR, Government of Karnataka and Nodal Officer, Mission ICU Bengaluru, in an interview with Uday India.

What was the situation at the time when you were appointed as nodal officer?

In the first week of May, Bengaluru had about 10,937 beds reserved for Covid-19 patients out of which about 559 beds were ICU beds and about 478 beds were ICU beds with ventilator. So, when the city was still at least 2 weeks away from the peak, more than 95% of the beds were occupied.The city was facing shortageof ICU beds, ventilators, and shortage of oxygen supply was another common concern faced by most of the hospitals.

What is your actual role and what are the objectives of your mission?

On April 30, I was appointed as Nodal Officer for setting up of 500 ICU beds on a fast track mode in each of the BBMP Zones. The mission had three main objectives. First, to immediately assess the requirement of critical care infrastructure, which will broadly include Oxygenated beds, HDU, ICUs. Second, to visualize a feasible operational plan and an implementation structure to create the infrastructure as assessed by experts and relevant departments of the Government tackling the COVID 19 crisis and third, to put up an elaborate action plan with implementation framework delineating clarity on roles and responsibilities of various departments of Government and functionaries involved, for consideration of the Government and coordinate the efforts on ground.

How did you hit the ground running?

My first step was to take all stakeholders into confidence.The entire government machinery was working on war-footing to combat the pandemic. Karnataka has relatively good health infrastructure with highest number of medical colleges in India. Apart from the government hospitals and teaching hospitals attached to government medical colleges we have private hospitals and private medical colleges. There are about 14 medical colleges in Bengaluru. I held extensive consultation with Medical Colleges, Various Experts handling COVID 19 crisis on ground with the Hon’ble Chief Minister of Karnataka, Joint Expert Committee (Technical Advisory Committee and Clinical Experts Committee), healthcare professionals of United Kingdom and did Site visit for assessment of infrastructure.

How did you go on with execution?

The Indian Institute of Architects, Karnataka Chapter came forward to conduct the baseline assessment for the facilities identified for bed Augmentation. They agreed to carry out these services pro-bono. A team of senior architects along with experts in the field of hospital design are assisting in conducting surveys at the hospital, and preparing the proposal, including cost estimations for the same.

The Confederation of Indian Industry has been acting as a conduit to channelize CSR funding from Corporates into healthcare facilities. They have conducted baseline assessment through their healthcare partners Columbia Asia Hospitals to aid Corporates in feasibility assessment.

How did the corporates in the state step up to help during the pandemic?

Karnataka’s bold step has set manybenchmarks in public, private cooperation. I am confident that the targets given to me as the nodal officer would be achieved as per the fixed timeline. I am keen that moreindustry leaders and brands should show their solidarity and support in enhancing the healthinfrastructure in the State.

So far they have played a major role. When I was appointed as a nodal officer in April 2020, there were two challenges: Where to find resources, and how to fill the gap. When I looked at government resources, we had a lot of constraints of floating tenders; it would have taken a lot of time. That’s when corporates stepped in.

My team reached out to all possible corporate groups; many were very enthusiastic and reached out to us. I put together a team to assess government infrastructure and roped in the Indian Institute of Architects for pro-bono assessments of existing infrastructure. We pulled in a bunch of experts from health care infrastructure to identify gaps there. We went out to corporates and listed two things: Infrastructure challenges and human resource challenges. The corporates helped with critical care beds, oxygen concentrators, oxygen supply, and so on. Some of them took on the cost of vaccinating roadside vendors, Metro Rail workers, the poor and needy. With their help, we are handling the situation in a much more prepared way, and our critical infrastructure has been beefed up.

Where the human resource gap in government hospitals was concerned, it was very difficult to find solutions because recruitments don’t happen overnight. This is where the Azim Premji Foundation helped and is funding the HR teams for around 10 hospitals in Bengaluru. Doctors for You and LabourNet helped with expert teams and charged some basic costs. I think this is the first example in the country where infrastructure and human resource gaps were filled. This translated into better care for patients and faster delivery of services.

How is the Karnataka government gearing up for a likely third wave of the pandemic?

The commitment of the Chief Minister to provide a robust health infrastructure in the State is evident from the extensive preparation in anticipation ofa third wave.The State continues to ramp up healthinfrastructure to ensure preparedness for any future Covid waves. It has specifically worked closely with the private sector to strengthenthe existing health infrastructure in the State

We’ve taken stock of all the Neonatal Intensive Care Units (NICUs) and have done a thorough audit of what can be upgraded in the government infrastructure. For example, there is Indira Gandhi Children’s Hospital, and efforts are underway to upgrade the number of critical care beds there. We’ve ensured that oxygen infrastructure is up to the mark and we are not taken by surprise. Recently, one of our corporate sponsors, Lowe’s India, committed to donate an on-site generator that supplies 500 litres of oxygen per minute. With such initiatives, a lot of critical gaps in the infrastructure are being addressed. But the major challenge is finding the sufficient number of paediatricians and neonatologists. A lot of training has been planned for those who are practicing general medicine on how to treat paediatric age groups if there is a third wave, which will most likely affect children

How many people have been vaccinated in Karnataka? Have you seen any vaccine hesitancy?

As of July15, 2,66,10,097 vaccine doses have been administered in Karnataka. Initially, due to a lot of rumour-mongering, there was vaccine hesitancy. But now, I don’t see much of hesitancy on the whole. We used the print media, TV and hoardings to promote vaccination drives. But, more importantly, reassurance from religious leaders, celebrities, and local district administrations that interact with people on a daily basis, helped in convincing people, even in rural areas. Hopefully, we’ll be able to get the entire population vaccinated in a very short span of time.

What are your learnings from the first and second wave of the pandemic?

The learnings are huge. Number one: Despite whatever we have done so far, the health infrastructure in the country needs to add numbers in a consistent way, and it should not be a knee-jerk reaction. Pandemics, which come in waves, put severe stress on the health infrastructure. So we have to increase this infrastructure manifold, and in a regular manner. Number two: Human resources. We need to do audits of every state, every district and every town about how many professionals are required. And correspondingly, we should be proactive about giving them proper pay packages, adequate protection, and so on. Number three: Awareness levels. A majority of people died because they didn’t know the seriousness of the condition and where they should go for treatment; they didn’t know that they should keep monitoring their oxygen saturation level, rather than going to 20 hospitals.

We have to majorly increase our health infrastructure, plug in the human resource challenges, and educate the population.

You have been a one-man army in this whole effort. How satisfied are you with the mission?

Bengaluru is a city with vibrant civil society and enormous spirit of volunteerism. Bengaluru, the Silicon Valley of India is home to several MNCs of global repute. I am glad that we received overwhelming response from corporates. I must thank CM BS Yediyurappa’s inspiring leadership and guidance for this. Our aim is to set up at least 500 critical care beds in each of the eight zones in the BBMP. Although the cases have reduced and the second wave seems to be retreating, we will keep this channel open and continue our efforts to increase preparedness for future.