Forbes - Leadership

A Pandemic Silver Lining: Building Better Health Care Infrastructure And Advancing Health Equity

The COVID-19 pandemic laid bare the persistent and deep-rooted challenges of ensuring equitable health outcomes for all. As a global society we were forced to face the fact that, even in the 21st century, communities around the world still lack basic medical care as a result of underfunding in public health infrastructure. It challenged us all – public and private sector alike – to re-think the status quo and rebuild and reinvest in more equitable and affordable health care infrastructure.

As a son of India whose mother and family members contracted the virus despite precautions, I saw first-hand the many factors that left India and its people vulnerable to the latest COVID-19 wave. Under-investment over decades in the country’s primary health care infrastructure was among the most prominent. And, as is often the case when a crisis strikes in geographies set up like this, those at the lower end of the economic spectrum bear the brunt of the impact.

In India, even as support poured in from across the international community, much-needed medical support and supplies were going to the larger cities first, while those in more rural communities – where the majority of Indians live – continued to struggle.

A recent initiative piloted by Deloitte in collaboration with the Government of Haryana state in India offers a potential remedy to under-investment in public health infrastructure – and a silver lining to the pandemic.

Together with Dr. Srinath Reddy at the Public Health Foundation of India and Dr. Dhruva Chaudhry of the Post-Graduate Institute of Medical Sciences, we developed a uniquely Indian approach that leveraged local resources to deliver support and home care to those in the Karnal district with mild to moderate COVID – thereby freeing up local hospitals to care for the most critically ill patients.

The project encompassed five key integrated interventions:

  1. A remote command center for managing scarce resources including hospital beds, oxygen supply, ambulances, medical professionals, and monitoring at-home patients
  2. Virtual health capabilities and local engagement including a COVID-19 hotline, a team of 200 medical students mobilized to provide tele-health services, and rural midwife networks to connect people in rural communities to local health care infrastructure
  3. Three-tiers of medical infrastructure to serve patients including local isolation wards, field hospitals equipped with oxygen concentrators, and advanced medical centers with ICU facilities for critical patients
  4. An awareness and education campaign on health care protocols to support in-home care
  5. A COVID-19 response playbook for replication statewide

After the initial outbreak of the virus ebbed, Deloitte worked with the local government to launch an awareness campaign in the state’s rural areas where understanding of COVID prevention and treatment remained very low.

Between May 24 (the date of the project’s launch) and June 8, Karnal experienced an abrupt and significant reduction in deaths. Per the district administration’s figures, the number of deaths prevented via medical intervention increased by 50%.

During this time, 200 medical students consulted with more than 7,000 patients isolated at home, making roughly 41,000 telemedicine calls. The occupancy at the field hospitals (which provided oxygen to moderately ill patients) reached 50%, diverting those patients from traditional hospitals where they would have contributed to strain on the system.

Through the program’s three-tiered approach to triaging cases, approximately 90-94% patients were treated in the comfort of their own home. Over the program’s first two weeks, the death rate dropped from 10 per day during week one to six per day during week two. 

Through this enhanced health care infrastructure and refined model of public health engagement and collaboration, as well as the ongoing public education program targeted at underserved rural areas, health officials believe that 90% of future COVID patients will have the resources to convalesce from the virus at home.

My hope is that the work we are doing now in India will provide a roadmap to help other governments customize resources on the ground and align support with the specific needs in their local communities. And that this, in turn, will lay the foundation for a better, stronger, more equitable primary health care infrastructure around the world. With the Delta and now Lambda variants growing, no one is safe until we are all safe.

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