India and COVID – 19 Pandemic - Standing at Crossroad!!!!!

COVID-19 recovery rate and its association with development

Objectives:

The recovery rate is important to determine a country’s development towards controlling coronavirus. It is a function of myriad factors – death rate, cases requiring hospitalization, quality of care, and discharge policies, among others. India’s recovery rate is growing steadily from an earlier low of 10% to 11%. It is imperative to understand the determinants of recovery rate in a country to enable improvements in the same.

Material and Methods:

COVID-19 data have been compiled from several sources, including the Ministry of Health and Family Welfare, National Disaster Management Authority, and Indian Council of Medical Research and demographic and health data from Census of India, 2011, National Health Profile, 2019, and were used. The study uses linear regression to understand the relationship between recovery rate and development indicators in India.

Results:

Our analysis emphasizes the beneficial impacts of the health system and better economy on the recovery rate. Investment in health, urban stay, non-slum and non-poor population, and effective governance is instrumental in improving recovery rate.

Conclusion:

Scaling up health facilities and medical infrastructure, slum decongestion, focus on economically weaker sections, capacity building of health workers and ameliorating long-term investments in health, health research, and better quality of living are also essential to address recovery of COVID-19.

Community care for COVID-19 in the constraint resources is the need of the hour to provide health facility to the last man of the queue

In COVID era, the developing countries like India are facing big problems and fail to provide health care to needy patients. The main reason for this failure is limited health resources and overpopulated states. Considering these, it is need of the hour to establish community care for COVID-19 in every district. The trained health worker will be instrumental in categorizing COVID-positive patients in three different zones that are green, yellow, or red on the basis of mild, moderate, or severe clinical symptoms, respectively. All such patients may be treated under the guidance of doctors of the telemedicine department of the tertiary center with close monitoring under CCTV camera and other telemedicine software. The only limitation of this model is that we need to shift sick patients (red) to higher center. The estimated cost is approximately 2,29,000 only to establish one center.

Use of cluster analysis to monitor novel coronavirus-19 infections in Maharashtra, India

Objectives:

A novel coronavirus disease (COVID-19) has been continuously spreading in almost all the districts of the state Maharashtra in India. As a part of the healthcare management development, it is very important to monitor districts affected due to novel coronavirus (COVID-19). The main objective of this study was to identify and classify affected districts into real clusters on the basis of observations of similarities within a cluster and dissimilarities among different clusters so that government policies, decisions, medical facilities (ventilators, testing kits, masks, treatment etc.), etc. could be improved for reducing the number of infected and deceased persons and hence cured cased could be increased.

Material and Methods:

In the study, we focused on COVID-19 affected districts of the state Maharashtra of India. We applied agglomerative hierarchical cluster analysis, one of data mining techniques to fulfill the objective. Elbow method was used for obtaining an optimum number of clusters for further analysis. The study of variations among various clusters for each of the variables was performed using box plots.

Results:

Results obtained from the Elbow method suggested three optimum numbers of clusters for each of the variables. For confirmed and cured cases, cluster I corresponded to the districts BI, GO, ND, PA, SI, WS, JN, CH, OS, HI, NB, JG, RT, LA, KO, AM, ST, BU, DH, AK, YTL, SN, AH, SO, AU, RG, NG, NS and PL. Cluster II corresponded to the districts TH and PU and cluster III corresponded to the district MC. For the death cases, cluster I corresponded to the districts BI, GO, ND, PA, SI, WS, JN, CH, OS, HI, NB, JG, RT, LA, KO, AM, ST, BU, DH, AK, YTL, SN, AH, SO, AU, RG, NG, NS, PL and TH. Cluster II corresponded to the district PU and cluster III corresponded to the district MC.

Conclusions:

The study showed that the district MC under cluster III was affected severely with COVID-19 which had high number of confirmed cases. A good percentage of cured cases were found in some of the districts under cluster I where six districts (GO, SI, CH, OS, SN) had 100% success rate to cure patients. It was observed that the districts TH, PU and MC under clusters II and III had severe conditions which need optimization of medical facilities and monitoring techniques like screening, closedown, curfews, lockdown, evacuations, legal actions, etc.

The pathway to comfort: Role of palliative care for serious COVID-19 illness

The novel coronavirus disease (COVID-19) pandemic has led to significant distress among people of all age groups. Patients with advanced age and severe life-limiting illnesses are at increased risk of death from COVID-19. Not all patients presenting with severe illness will be eligible for aggressive intensive treatment. In limited resource setting, patients may be triaged for supportive care only. This subset of patients should be promptly identified and receive appropriate palliative care with adequate symptom control strategies and psychosocial support. Breathlessness, delirium, pain, and noisy breathing are main symptoms among these patients which can add to the suffering at end-of-life. The COVID-19 pandemic also contributes to the psychological distress due to stigma of the illness, uncertainty of the illness course, fear of death and dying in isolation, and anticipatory grief in families. Empathetic communication and holistic psychosocial support are important in providing good palliative care in COVID-19 patients and their families.