Ayurvedic Surgery: who should be concerned?


         A strange situation has cropped up after the claim of Ayurvedic doctors doing surgeries has got the CCIM approval. Serious doubts has been raised by Allopathic medical organizations about the consequent safety issues.

       There would always be claims or counter claims about who should be allowed to do surgeries.  But there has to be a neutral and competent authority to decide, rather than claiming the competence.  After all it is question about safety issues of millions of  people.

      Who should really decide about it?

     NABH  has raised concerns about the issue.

    Although it has limitations and can be applicable only to a fraction of hospitals, but still a larger network of hospitals or clinics are not covered by NABH.

      In such situation, who should be worried about the safety? Strangely the stakeholders, who would be affected most are silent on the issue: the patients.

      If patients  have nothing to protest and they feel safe or do not anticipate any danger, why allopathic doctors should make a noise about it? They would be seen as a Jealous cat.

     Use Ayush docs for clinical work and you could lose ACCREDITATION: NABH TO HOSPITALS

         The National Accreditation Board for Hospitals and Healthcare providers (NABH) has warned allopathic hospitals accredited with it that they could face withdrawal of accreditation if they were found employing Ayush doctors for performing clinical duties in ICUs and other patient care areas in place of MBBS resident medical officers (RMOs) and emergency doctors. A “cautionary notice” the board issued on Thursday said, “This is a blatant violation of NABH standards for healthcare accreditation and very much against patient safety norms and compromise quality of modern medicine clinical care outcomes.” TOI had, in October, reported on the use of Ayush doctors in ICUs for night duty being a fairly common practice in many private hospitals, particularly in Maharashtra and Gujarat. Thursday’s notice stated that the NABH has taken a serious note of the matter and reiterated that deploying of Ayush doctors in allopathic hospitals for writing independent orders and clinical work without the supervision of allopathic doctors is not permitted. In case the allopathic hospitals are employing such doctors to work as clinical assistants, under applicable state laws, they should not be involved in direct patient care and should strictly follow job responsibilities as defined by hospital management, it added.  Ayush doctors working in allopathic hospitals will not be considered by the NABH as RMOs during the process of assessment and for the purpose of grant of accreditation, stated the notice, adding that any violation may invite adverse decision by NABH, including withdrawal of accreditation. However, even as the NABH has been carrying out surprise inspections in hospitals in this matter, it is yet to have a definite list of states that allow Ayush doctors to be employed in allopathic hospitals to either prescribe a pre-defined set of allopathic medicines or to do clinical procedures after completing a bridge course. NABH officials clarified that the board’s legal team was in the process of determining the status of the law in different states.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Challenges of Covid Vaccination-2021


If 2020 was consumed by Covid Virus ,  the next year 2021 will be  for Covid vaccination.

All over the world, billions of people are going to get vaccine.

Corona vaccination is one of the most anticipated events in every country. in coming weeks, multiple vaccines   are likely to get regulatory approval. 

    However, while making a good vaccine was the difficult part, earning  trust of public in vaccine is going to be another one. Especially the hurried development at Pandemic speed  and lack of awareness about safety issues will be areas of concern.

  The adverse events, which are unexpected medial problems that occur with drug treatments, are unavoidable part of any treatment, including vaccine science.

    The system need to be in place to identify  the causal relationship between vaccine agent and  the adverse event.  The objective criteria have to be in place to identify and treat, as the population to be vaccinated is also very large.

 The main hurdles equally challenging will be sourcing, distributing and giving the actual vaccination doses.

The preparation for mammoth exercise will also be a herculean task. It may take months to get ready to supply and build the chains and preparation for this need to begin now.

A systematic approach needs to be ready, so that the process of vaccination gets on smoothly and quickly, as soon as the doses are available. For example, the need for transport vehicles and the storage facilities for billions of doses at distant places will be one of challenges.

It will take mammoth number of healthcare workers, who will vaccinate people at different towns and cities.  

This exercise, if not done in a well-planned manner, could result in chaos.   The failure to set up a system will not only result in suboptimal vaccination but also non uniform supplies. Maintaining the cold chain will be crucial for effectiveness.

 People should get it based on needs rather than black marketing or money power.   The issues which look insignificant like the financial complexity among various stake holders or customer clearances need to be settled first, as they may become significant hurdles for smooth distribution.

    Most important would be to safeguard citizen’s faith in vaccine and clinical trials. As for the future science to develop, would   require people’s co-operation, faith and participation.

     Government regulators and Vaccine makers need to recognize the utmost importance of the communication about the true results of trials and effective communication with the public.  The misinformation and distrust should not  undermine the good work of medical science and advancements.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Authorities mum on Adverse Event at Covid Vaccine Trial


Safety data of Covid Vaccine- need disclosure

   There are two important aspect of a successful vaccine,

1. Efficacy  for the prevention

2. Safety

       Given that the Covid vaccine is needed urgently and will be developed within a years’ time, some doubts about the safety aspect are natural. But safety can be assured, if the data about side effects is made public.

   All  the  companies  in a bid to rush their  vaccine into the market, are eager to  create an hype. But a caution need to be exercised against such hyping, especially when long term safety data is not available.

  Even the sparse details of the severe side effect,  that leak into the public domain, may be just tip of the iceberg, as far as long term safety data of a vaccine is concerned.

   All the side effects, mild or severe, need to be made known  and  in public domain, rather than exposed later after the use.

More than a month and a half after an adverse event occurred in a clinical trial in India of the AstraZeneca vaccine, the Central Drug Standard Control Organisation (CDSCO), the regulator for vaccine trials, has not issued any statement on the occurrence. It also did not respond to queries about whether it has completed its investigation to determine if the trial participant’s illness was related to the vaccine. Serum Institute, which is partnering the pharma MNC and Oxford University for producing the vaccine in India, has also refused to comment. This is in sharp contrast to AstraZeneca and Oxford University going public when one of the trial participants in the vaccine trial in the UK fell ill and halting the trial till an independent safety monitoring board and UK’s regulatory authority gave safety clearance. Information about the occurrence of the serious adverse event (SAE) during the vaccine trial in India came from the family of the trial participant, which has sent the company and the regulators a legal notice. Serum Institute merely stated that it would issue an official statement next week. AstraZeneca had issued a statement within days of the trial participant in UK falling ill and halted the trials across the world in the UK, Brazil and South Africa. The trial was resumed within a week after the independent safety review committee and national regulators gave clearance. The Indian Council of Medical Research is a co-sponsor of the trial along with Serum Institute.

According to the ICMR, it is for the DCGI to take a call on whether or not to halt the trial. The DCGI heads the CDSCO.

The 40-year-old trial participant, a business consultant with an MBA from New Zealand who says he took part in the trial deeming it his duty to help such an important venture, was administered the vaccine at SRMC on October 1. Eleven days later, he woke up with a severe headache, and progressively lost his memory, showed behaviour changes, became disoriented and was unable to talk or recognise his family members, according to the legal notice. As soon as he fell ill he was admitted to the ICU in SRMC.

“Though the legal notice we have served talks of a compensation of Rs 5 crore, our focus is not on monetary compensation. It was sent just last week, more than a month after the occurrence when we saw that none of the authorities was making the adverse event public. They ought to have warned other participants so that they could watch out for similar symptoms. We want to know why the occurrence of the adverse event has been kept under wraps and why the trial was not halted like it was done in the UK. Is an Indian life of less value than that of an UK citizen?” asked a close family friend who has been helping the family cope with the illness.

WHO says more data needed on AstraZeneca dose

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Penal Servitude for Doctors, Nurses- Administrators Delight


                         Life for health care professionals like  doctors and nurses is hard in present era, right from getting into medical college, passing the exams, gaining experience, work under new imposed legal environment, with  over-regulation and under the moral burden of over-expectations of society. The benefit of these difficult situation is reaped to the maximum by administrators and overpowering medical industry.

            Despite working amid of a national emergency in Covid-times, the meagre salaries of hundreds of doctor and nurses are not paid for months in Hindu Rao Hospital, Delhi

         Ironically where doctors are punished for small genuine mistakes or even poor prognosis during  medical treatment, the blunders of health  administrators are taken as trivial issues.  More ruthlessness, cunningness or cruelty towards health care workers is possibly becoming an appreciated quality of health administrators.  Why no punishment for the administrators for such blunders?

     Consequently, with no support from society, to whom they serve, doctor and nurses gradually are pushed to a penal servitude. If this is regarded as normal in present era, anyone would wonder, what does slavery constitute?

   No salaries  for doctors for four months

The doctors alleged negligence and apathy on part of the government and said that they were unable to run their basic errands and accomplish their daily routine due to non-payment of salaries.

  Irked over non-payment of salaries for over four months in a row, doctors at Delhi’s Hindu Rao Hospital announced that beginning Saturday, October 10, they would stop attending to patients including those suffering from Covid-19. Hindu Rao Hospital, the largest municipal hospital in Delhi with 900 beds, is currently a dedicated Covid-19 facility.The doctors alleged negligence and apathy on part of the government and said that they were unable to run their basic errands and accomplish their daily routine due to being unpaid for months.Abhimanyu Sardana, President of the Resident Doctors’ Association (RDA) of the hospital, said that several letters and reminders had been sent to Delhi Chief Minister Arvind Kejriwal regarding the issue faced by the doctors, who are frontline warriors at the Covid-19 dedicated facility. “Don’t ignore the basic needs and rights of doctors,” wrote the RDA-Hindu Rao.

            Be it any circumstances like working without any facilities, poor infrastructure, non-availability of drugs, inhuman duties hours over 48-72 hours or poor pay, the administrators would say, “you are a doctor, it is your moral responsibility.”  Armchair preachers and administrators will always remind them of moral duties, but easily forget their own.

   25 factors- why health care is expensive

   REEL Heroes Vs Real Heroes

   21 occupational risks to doctors and nurses

   Covid paradox: salary cut for doctors other paid at home

advantages disadvantages of being a doctor

Covid effect: Reasons for costly oxygen


 

Oxygen has been a essential lifesaving therapy for covid patients. As large numbers require oxygen for prolonged periods because of post covid lung damage, the requirement has increased manifold. So it is in short supply and there is no dearth of people want to monetize the need. There are multiple reasons of shortage.

 The Indian express explains

   The delay in transportation of oxygen to dealers, conversion into cylinders and supply to hospitals can get long if even a tiny link in the supply chain falters.  

As Covid-19 sweeps across the country, urban and rural areas alike face an unprecedented spike in oxygen use. Around 3-5 per cent (over 50,000) of active Covid-19 cases in India have lung tissues damaged enough by the virus to require external oxygen support.

Since March, medical oxygen demand has grown from 750-800 to over 2,500 metric tonnes, and now, hospitals are struggling.

The supply 

In an ideal scenario, it takes 3-5 days for oxygen to journey from a manufacturer to a patient’s bed. But delay in transportation to dealers, conversion into cylinders and supply to hospitals can take longer if even a tiny link in the supply chain falters.

India’s big oxygen manufacturers, such as Inox Air Products, Linde India, Goyal MG Gases, National oxygen, use cryogenic distillation technique to compress air, feed it into distillation columns and get liquid oxygen. It has 99.5 per cent purity. This process, an official from Inox said, can take two-and-half-days.

The liquid oxygen is filled into special cryogenic transport tankers that maintain -180 degree centigrade temperature to travel to smaller plants in hinterlands, where liquid oxygen is converted into gaseous form, fed into cylinders and transported to the final destination – hospitals.

India has the capacity to produce 6,900 metric ton of liquid oxygen daily, health secretary Rajesh Bhushan said in a media interaction. According to the All India Industrial Gases Manufacturers’ Association (AIIGMA), over 2,500 tonne is being directed towards hospitals, most consumed by coronavirus patients, and another 2,000-2,300 tonne is industrial requirement each day. So if India is not exhausting its capacity of 6,900 metric tonnes, why is oxygen suddenly a concern?

Logistics

Medical oxygen demand has grown threefold in six months. “The issue is not of supply, it is of transportation and storage,” says health secretary Dr Pradeep Vyas, Maharashtra, which produces one-fifth of India’s oxygen capacity.

As demand surges, logistics are falling short. India has roughly 1,200-1,500 tankers for transport. Before the pandemic, the tankers were enough, but now they are difficult to hire and cost more.

Inox is the biggest manufacturer of liquid oxygen in India, with capacity of 1,911 metric tonnes per day. It currently supplies 1,400 tonnes, and has 550 transport tanks and 600 drivers to supply to 800 hospitals across India. But this may soon fall short.

It can take 5-6 days, for instance, for oxygen to travel from Inox Pune plant to Osmanabad, where a dearth of oxygen has emerged. The Centre is now working to utilise nitrogen tankers to transport oxygen. In just Maharashtra, 10 more tankers have been roped in.

Then there is the problem of storing this huge quantity of oxygen, says Saket Tiku, president of AIIGMA. Most rural hospitals do not have oxygen tanks as the need never arose before. A critical Covid-19 patient can need 30-60 litres of oxygen in a minute. One cylinder can run out in 15 minutes to an hour, depending on oxygen directed to patients.

States are looking at alternatives, from buying extra dura and jumbo cylinders to installing oxygen tanks as buffer stock. Inox has got the contract to fix 64 jumbo tanks across Covid hospitals to store 4 lakh litres.

Several states have also begun construction of oxygen generation plants that convert air into oxygen, and provide 93.5 per cent purity. But this construction will take months. The AIIGMA states that across India, 500 oxygen plants are in the process of construction, of which two major ones will be in Pune (Maharashtra) and Modinagar (Gujarat).

The price rise

Oxygen is generally quite cheap, but suddenly it has become expensive. A cylinder that would earlier cost Rs 100-150 now costs Rs 500-700 for refilling. With this, hoarding has begun. Fearful of not getting a Covid bed in hospital, people are keeping oxygen cylinders at home.

Before the pandemic, it would cost Rs 1.5-2 to refill a cubic metre of oxygen. But the cost of logistics has risen, so now Delhi will find refilling costs Rs 10-15 per cubic metre, and Mumbai Rs 15 per cubic metre. The government has fixed the cost of refilling at Rs 17.49 per cubic metre.

Several private hospitals charge patients Rs 1,500-3,000 for oxygen per day. “Based on our analysis, oxygen cost cannot exceed Rs 300-400 per patient per day in a hospital,” said Dr Sudhakar Shinde, IAS officer in-charge of fixing price cap for hospitals.

The industrial sector is bearing the brunt too. Requirement for oxygen had dipped to 250 metric tonne per day in March after lockdown. As restrictions were lifted, industries restarted work. Now, the industrial requirement is at 2,00-2,500 metric tonne. But there is limited supply.

Madhya Pradesh relied on Maharashtra and Gujarat for oxygen – as supplies from these states reduced, it has turned to Chhattisgarh for supply. In some states like Maharashtra, only 20 per cent oxygen produced can be directed for industrial purposes, rest are reserved for medical use.

What government is doing

There is also the wastage of oxygen – mild cases who don’t need it are put on oxygen support, sometimes leakages are reported from oxygen pipelines. An expert committee under MoHFW has fixed oxygen supply to 40 litres in intensive care units and 15 litre per minute in normal ward per patient per minute.

It has advised to monitor patients on oxygen support daily, and only put those with oxygen saturation levels below 94 on oxygen support. As per the committee, 20 out of 100 patients turn symptomatic and three of them critical. This is the pool that may require oxygen.

In Numbers 

India’s per day oxygen production capacity: 6,900 metric tonne

Current requirement: Over 2,500 metric tonne

Oxygen Transport tankers: 1,200-1,500

Active Covid cases: 9.75 lakh

On oxygen: 5.8%

25 factors why medical treatment are expensive

90 doctors in Maharashtra resigned due to harassment by administration


      

     

      Unparalleled sacrifice by medical community during pandemic  has not  resulted in any enhancement of  respect or prestige to the medical  profession. It was not enough  to stop physical or verbal assaults, legal or financial  exploitation. It was not sufficient  to alter the course of oppression  by administrators or moral blackmail by society. Sadly it is getting more worse. Doctors and nurse have been reduced to sacrificial lambs, that are easily slayed, when administrators tend  to put  themselves on high moral  pedestals. 

Financial and legal complexities have been the major side effects of modern medicine, especially for doctors. They are facing  complex  environment,  which are beyond their control. Besides financial and legal complexities, moral dilemmas, facing verbal and physical assaults are creating  complex working conditions. But if doctors are not able to work, who will be the sufferer, does not need an Einstein brain  to guess. Criticized  by administrators despite their sacrifice, media insults are adding to their disillusionment and possibly  a withdrawal response.

90 doctors in Maharashtra  resigned  due to harassment by administration

Over 90 gazetted medical officers posted in Yavatmal district of Maharashtra have resigned today from their service allegedly due to consistent harassment by the administration and District Collector MD Singh. 

These doctors have been serving at the civil hospital, sub-district and rural hospitals and primary health centres in various capacities. 

In a letter written to the government today, Dr Rajesh Gaikwad and Dr Pramod Rakshamwar, both office bearers of the Maharashtra Association Of Government Medical Officers, says, “Despite marathon efforts by the doctors throughout the pandemic, administrative officers and DM is mistreating the doctors which has led to resentment among entire fraternity.”

     Such  incidents  are not only  painful to the medical fraternity but also expose the hypocritical  attitude of the administrators as well as  the insensitive approach of society towards health care workers, although everyone expects doctors and nurses to be sensitive towards everyone else. Such indifferent   attitude demoralizes and causes deep discouragement to the front line doctor and nurses, but sadly remains a routine business for administrators. The pain of being  treated like a dispensable disposables remains as  a deep hurt within.

Reel Heroes vs Real Heroes

25 factors, why medical treatments are expensive

Pros-cons of being a doctor

Potential Ray of Hope: Highly effective coronavirus antibodies


        Identification of highly effective antibodies, will not only provide a passive immunity, but can be helpful in developing vaccine as well. This discovery may be a potential ray of hope against Covid war.

Highly effective coronavirus antibodies discovered may lead to passive Covid-19 vaccine

     BERLIN: Scientists have identified highly effective antibodies against the novel coronavirus, which they say can lead to the development of a passive vaccination for Covid-19. Unlike in active vaccination, passive vaccination involves the administration of ready-made antibodies, which are degraded after some time. However, the effect of a passive vaccination is almost immediate, whereas with an active vaccination it has to build up first, the researchers said. The research, published in the journal Cell, also shows that some SARSCoV-2 antibodies bind to tissue samples from various organs, which could potentially trigger undesired side effects. The scientists at the German Center for Neurodegenerative Diseases (DZNE) and Charite – Universitatsmedizin Berlin isolated almost 600 different antibodies from the blood of individuals who had overcome Covid-19, the disease triggered by SARS-CoV2. By means of laboratory tests, they were able to narrow this number down to a few antibodies that were particularly effective at binding to the virus.  Highly effective coronavirus antibodies identified, may lead to passive Covid-19 vaccine The researchers then produced these antibodies artificially using cell cultures. The so-called neutralising antibodies bind to the virus, as crystallographic analysis reveals, and thus prevent the pathogen from entering cells and reproducing, they said. In addition, virus recognition by antibodies helps immune cells to eliminate the pathogen. Studies in hamsters — which, like humans, are susceptible to infection by SARS-CoV-2 — confirmed the high efficacy of the selected antibodies. “If the antibodies were given after an infection, the hamsters developed mild disease symptoms at most. If the antibodies were applied preventively — before infection — the animals did not get sick,” said Jakob Kreye, coordinator of the research project. The researchers noted that treating infectious diseases with antibodies has a long history. For Covid-19, this approach is also being investigated through the administration of plasma derived from the blood of recovered patients. With the plasma, antibodies of donors are transferred, they said. “Ideally, the most effective antibody is produced in a controlled manner on an industrial scale and in constant quality. This is the goal we are pursuing,” said Momsen Reincke, first author of the research. “Three of our antibodies are particularly promising for clinical development,” explained Harald Pruss, a research group leader at the DZNE and also a senior physician at Charite – Universitatsmedizin Berlin. “Using these antibodies, we have started to develop a passive vaccination against SARS-CoV-2,” Pruss said. In addition to the treatment of patients, preventive protection of healthy individuals who have had contact with infected persons is also a potential application, the researchers said. How long the protection lasts will have to be investigated in clinical studies, they said. “This is because, unlike in active vaccination, passive vaccination involves the administration of ready-made antibodies, which are degraded after some time,” Pruss said. In general, the protection provided by a passive vaccination is less persistent than that provided by an active vaccination, the researchers said. “It would be best if both options were available so that a flexible response could be made depending on the situation,” Pruss added.

Financial complexity of Modern medicine: 25000 hospitals near closure


Financial and legal complexities have been the major side effects of modern medicine, especially for doctors. They are facing  complex  environments,  which are beyond their control. Besides financial and legal complexities, moral dilemmas, facing verbal and physical assaults are creating  complex working conditions. But if doctors are not able to work, who will be the sufferer, does not need an Einstein brain  to guess. Criticized despite their sacrifice and treating the patients, media insults are adding to their disillusionment and possibly  a withdrawal response.

Rates for Covid hospitals: IMA doctors across Maharashtra threaten to stop work if demands not met in 7 days

Doctors with the Indian Medical Association across Maharashtra have threatened to stop work indefinitely if their demands are not met within the next seven days. On September 15, all IMA members who are hospital owners will submit copies of their hospital registrations to the IMA branch offices at various places. These branches will appeal to the state government that they are unable to manage the hospitals with the new rates. “We will urge the state to take charge of the private hospitals,” said IMA Maharashtra president Dr Avinash Bhondwe.

The IMA is protesting against the “unaffordable rates forced by the state government” for Covid hospitals and said it is increasingly difficult to meet the expenses to run the small and medium-sized private hospitals. It has demanded that the government should run all private hospitals.

Bhondwe said at least 25,000 mid-sector hospitals are on the verge of closure. “The government had accepted the proposal to increase the rates for the ICU and give concessions in biomedical waste disposal charges and electricity bills. The government had also agreed to cap the rates of PPE kits and masks for doctors and the rates of medical oxygen used by hospitals were also to be reduced as per the central government’s regulations. This was to be finalised in a proposed meeting with IMA before September 1,” Bhondwe said.

However, IMA officials said the state unilaterally came out with new rates on August 31 and the IMA decided to start their protest at a meeting on September 4. On September 9, all the 216 IMA branches paid a tribute to doctors in Maharashtra and burnt symbolic copies of medical council registrations

IMA Maharashtra convened a meeting of 14 different medical organisations of all the pathies, including Ayurveda, homeopathy, yunani and dentistry, all the disciplines of modern medicine and specialties on September 12. These organisations have supported the agitation and decided to form a joint action committee to work together.

25 factors- why medical treatment expensive: are doctors responsible

Advantage disadvantage of being a doctor

Expensive medical college Fee

Salary cut for doctors; other paid at home

Covid pandemic to infected plastic pandemic


Now, while we are fighting the COVID-19 pandemic, plastics use is increasing again. But, while the pandemic is just temporary, plastic pollution will be long lasting.  

For our current battle to fight the COVID-19 pandemic, we see a dramatically increasing demand for personal protective equipment (PPE) which comprises various plastic and rubber items. Moreover, there are many other fresh, clean plastic items widely used in medical applications for creating a sterile environment, such as pill casings, disposal syringes, catheter, and blood bags. These items are also made of synthetic polymers such as polyvinyl chloride (PVC) and PP, which are not biodegradable. Therefore, it would be not surprising to see that the COVID-19 pandemic is generating tons of medical waste.

dumping Covid-19 infected waste in public places

               The Biomedical Waste Management Rules, 2016, define biomedical waste as“any waste that is generated during the diagnosis, treatment or immunisation of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camps.” Therefore, broadly, any waste generated from treating patients comes under the ambit of biomedical waste.

As per available data, India produced approximately 600 tonnes of biomedical waste per day before the coronavirus first hit.

However, ever since Covid-19 showed up on our shores, the amount of biomedical waste produced in India has increased exponentially. This is mainly due to two factors:

  • Medical facilities themselves are producing far more biomedical waste as they battle the virus. As of August 30th, more than 4.14 crore tests to check for the virus had been conducted in India. Further, with over 36 lakh persons having tested positive for the virus, medical facilities have also been producing a lot more medical waste as they treat these patients. Therefore, all of the cotton swabs, samples, injections among other medical inputs necessary to test and treat these patients become highly contagious bio-medical waste that needs to be treated and disposed of with utmost caution.
  • Due to the infectious nature of the coronavirus itself and the strategy of home quarantining of asymptomatic COVID-19 Positive patients, adopted by the country, a major part of affected household waste has now become biomedical waste. The amount of waste that is hazardous is large due to the fact that India has some of the worst waste segregation numbers in the world. This forces infrastructure that is already burdened beyond capacity to handle mixed waste that it is not equipped to handle.


Treatment facilities and growth in biomedical waste

A factor that infinitely complicates India’s fight against Covid-19 is that as per available data, India, a country of more than 1.3 billion people, has only 198 Biomedical Waste Treatment Centres (BMWTCs) and 225 medical centres in the country with captive waste treatment facilities. Simple maths tells us that India’s infrastructure to process biomedical waste was already inadequate during pre-Covid times. However, post-Covid, India is truly staring at a disaster of alarming proportions if it does not rapidly increase its biomedical waste treatment capacity.

There have already been multiple instances of Covid-19 infected waste being dumped in public places including in Delhi and Vijayawada. In addition to this, due to the rapid and sustained increase in biomedical waste due to Covid-19, most BMWTCs are running out of capacity to handle the waste. For instance, the two BMWTCs in Delhi have a combined capacity of handling 74 tonnes of biomedical waste in a day.

However, a report submitted by the Environment Pollution (Prevention and Control) Authority to the Supreme Court of India showed that Delhi’s biomedical output had risen from 25 tonnes per day in May to 349 tonnes per day in July. Similarly, Covid-19 related waste in Mumbai rose from 12,200 kg per day in June to 24,889 kg per day in August, essentially doubling in three months. A similar situation has arisen in West Bengal as disposal facilities there too have reached maximum capacity.

Proper waste segregation and disposal is need of the hour. Disease burden may keep on rising, if proper steps are not followed.

Covid paradox: salary cut for doctors, others paid at home


What a paradox!!  Firstly the doctors were employed on contract basis at meagre salary, only for Covid. At a time when other employees of government getting salaries while sitting at home while doing nothing, these contractual doctors were  drowned in pool of Covid patients, risking their lives.

        Cruel heights of insensitivity and  as an epitome of poor governance,  salaries of these 900 doctors were subjected to  massive deductions. They had no choice, but to resign.

       Ironically, on one hand every one appears to rue about  non-availability of doctors, but on other hand they are given a shabby treatment. For example everyone wants to employ doctors on contractual basis and hence paying them poorly and clearly with an intention to “ use and throw policy”.

Salary cut, 900 Kerala Covid doctors resign
THIRUVANATHAPURAM: Nearly 870 doctors appointed to Covid first-line treatment centres (FLTCs) across Kerala have tendered their resignation over deductions in their salary. They were among the 1,080 MBBS graduates who passed out of government medical colleges this year and appointed on Covid duty on a temporary basis. While they were promised Rs 42,000 a month, what each finally gets is Rs 27,000. “From the amount, Rs 8,400 was deducted in the name of the government’s salary challenge, apart from TDS and professional tax. Now, we are getting only Rs 27,000,” said , state president of Kerala junior doctors association 2020-21. The association has fired letters to the chief minister and health minister seeking their urgent intervention.

being a doctor,a disadvantage

pros cons of medical profession

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