• Dr. BL Shankar

The State of Karnataka has for many decades been a pioneer in imparting quality medical education. There are about 60 Medical Colleges among which, 17 are Government Medical Colleges. Karnataka was also the first state to open up medical education for private institutions, which gave it an edge in terms of medical facilities and infrastructure. Every year, approximately 9345 medical seats are available for admissions. There are 414 Government Hospitals and 10 Government Super-Specialty Hospitals. There are 118727 doctors registered in Karnataka and the State has the 3rd highest number of doctors in the country.

Any lay man looking at these statistics will get the impression that Karnataka is well-equipped to face any challenges in terms of pandemics, epidemics, outbreaks of disease or any other large scale medical emergency. Unfortunately, the COVID-19 Pandemic has proven that Karnataka’s preparedness is grossly inadequate and the whole medical system has crumbled and collapsed.

Karnataka has attained the dubious distinction of being number one in India as far as the number of Covid-19 active cases (As on May 13, 2021). The following statistics speaks for itself. Number of confirmed cases – 20,88,488 Number of active cases – 5,93, 078 Number of cases recovered – 14,74,678 Number of deaths – 20,712 The most tragic and devastating incidents have been of patients dying in hospitals for the want of oxygen. The fact-finding committee was recently appointed by the Karnataka High Court, consisting of 2 Retired High Court Judges, to investigate the Chamarajanagar District Hospital Oxygen Death Case. The Committee in its report has stated that the 37 patients who died overnight in the Hospital, died due to the lack of oxygen and have clearly said that it was due to the negligence of the District and State Administration. This is not only contrary to the Government stance which claimed that only 3 deaths occurred due to the non-supply of oxygenbut is a clear indictment of the Government’s negligence and mismanagement of the Covid-19 Crisis. Horrifyingly enough, since that incident, more instances of deaths for want of oxygen have been reported from different parts of Karnataka.

People have died on streets, in hospital corridors and on the way to hospitals as they could not find a hospital bed on time in spite of their best efforts. This struggle for beds, ICU’s, Ventilators and even life-saving medicines, which have a lucrative black market, shows the appalling state of affairs in Karnataka.

On close examination as to the causes of this tragedy, one would have to consider the following reasons: The government’s response to the advice of the expert Committee was too little and too late. In spite of timely warnings of the second wave, the state government didn’t bother to increase the supply of oxygen, expand the number of oxygen beds or invest in more ventilators. Capacity building was merely jargon.

The Triage or 3T (Test, Track and Treat) principle was thrown out of the window. Testing numbers are falling, tracking or contact tracing is hardly existent and since the first two T’s have failed miserably, the situation of the third ‘T’ i.e. ‘Treatment’ is no better. The government is unable to ensure adequate health facilities for the three T’s to be successful. At the onset of the second wave, as the number of cases shot up by the 1000s in Bengaluru and other districts, the Government panicked and took some hasty decisions which further complicated the crisis.

The Chief Minister himself was affected for a second time and was to be hospitalized, which speaks volumes of the extent of spread of the virus.

In spite of having a medical graduate as Health & Family Welfare Minister, they were not able to foresee the gravity of the pandemic and prepare for it adequately.

There is total mistrust among ministerial colleagues and strangely 5 ministers were entrusted with the responsibility of dealing with the crisis; one each for procuring oxygen, arranging hospital beds, coordinating with private hospitals, war room in-charge and procuring vaccines and surprisingly, one minister for finding public places for cremating the bodies of dead covid patients.

This has created more confusion than coordination and even now there is shortage of oxygen connected beds, ventilators and Remdesivir injections.

Private Hospitals are exploiting the situation and in spite of government’s directions, they are not fully cooperating and charging exorbitant fees, which is making it unaffordable and putting poor people at the mercy of God.
The vaccination programme is in total shambles and utter confusion is prevailing everywhere. Senior Citizens, physically challenged people and people with co-morbidities are made to run from pillar-to-post wasting their precious time and spending hard-earned money to get vaccinated. But large number of people are being turned away for non-availability of vaccines.

Vaccinating 18+ people was started by Chief Minister with much fanfare on May 01 but, was to be abandoned within a week for non-availability of vaccines.

The scenario may be the same or even worse in many other states, but this should not have been the situation in Karnataka; a state which was a pioneer and role model to other states in medical and technical education.

The reasons in short for the sorry state of affairs are; indecisive and ineffective leadership, lack of coordination among ministers, lack of timely decisions, ignoring scientific advice given by the Expert Committee, frequent shifting of decision making bureaucrats, allowing religious functions with thousands of people participating in it right from January onwards, conducting local body elections and by-elections to the assembly and parliament and lastly; the reluctance to impose area-wise and total lockdown. We can surely say that the magnitude of active cases and the suffering of the people in Karnataka is wholly government made.

The situation looks bleak and with the growing number of cases, especially in rural areas which barely had cases in the first wave, there is little positivity to look forward to. Severe underreporting in such areas has hidden the actual extent of spread but the situation is worse than what was imagined. The only solution lies in the Government setting aside its internal skirmishes, political one-upmanship and vested interest, and working in a focused and targeted manner to fight this Pandemic.

The writer is former Chairman of Karnataka Legislative Council