Why India can’t afford a free run of the Corona virus

Fresh from the cheer and celebration of PM announced Janta Curfew, the fresh numbers of Corona affected in India has hit all of us like a bombshell: 467 as of Tuesday 23rd March 2020, a jump of 71 fresh cases over the previous day. Concerns and consternation aside, Indians are conjuring if India is hurtling towards a healthcare apocalypse!

To objectively explore the situation and see bad can be how bad, I started with the assumption that for the time say the Covid-19 (novel Coronavirus) outbreak in India has spiked to the same proportions as in other countries where it has exceeded normal limits. To model that scenario, I needed to estimate total number of infected people and what proportion of such infected people are serious.

For my study I took data of the following countries where the Special or Intensive Care patients admitted due to Covid 19 has reached the three figures mark viz., China, Italy, USA, Spain, France, Switzerland, Netherlands, Belgium, Sweden (Iran also considered for its total number of cases).

Table 1.0

Data from Worldometer and Wikipedia as on 23^rd March 2020 (Data for Serious Cases of Iran not available)

Need of the hour was to get a semblance of what percentage of India’s population can at worst be affected by Covid 19 based on data of countries which are worst hit. To this extent, I worked out the weighted average percentage of total population likely to be affected and the same comes to approximately 0.0129%

Now, to gauge the approximate percentage of Serious / ICU cases as a percentage of those affected by the virus, I calculated the weighted average of serious cases to total percentage of infected population and the same comes to approximately 4.29% (a bit on conservation side due to non-availability of Special Cases data from Iran). So we can approximate the percentage of serious cases to total infected as 5% say.

Now, from Worldometer data, we know that India’s population is 1.380 billion as on March 21^st 2020.

If 0.0129% of India’s population is liable to be affected by Covid-19 in the worst case scenario case, that comes to 1,78,020. Latter is the number of likely affected persons in India assuming Covid 19 has run out of control. But the estimate is even higher than China’s figures, where the disease originated. To this extent, if we extrapolate the number of infected cases based only on China’s figures and estimate pro-rata infected comparing populations for China and India, we may still have approximately 78,000 cases of the disease. Here, the tacit assumption is we shall be able to replicate the response as good as China’s if things go really out of control and be effectively able to crackdown on the disease. However, if the assumption is relaxed, the figures may be even double or more.

Assuming 5% of the affected population are serious cases, that comes to 3,901 say 4,000 (with assumption on control). And figures of approximately 8000-9000, if the assumptions are relaxed.

Now, all these 4,000 likely serious cases will require ICU care with ventilator beds.

Plus an additional 15% or 12,000 shall need to breathe in highly concentrated oxygen for at least 3-6 weeks from beginning of the disease to recovery

So, a total of anywhere between 16,000 patients shall require ICU care with ventilator beds (with assumption on control). And a figure close to 40,000 patients if assumptions of control are relaxed.

India currently has 70,000 ICU with ventilator facility both government and private hospitals combined. However, these 70,000 ICU beds cater to nearly five million patients requiring ICU admissions per year and is already stressed.

So, to put it straight : India is not prepared to meet the requirement of ICU ventilator beds if Covid-19 spirals out of control.

Now, lets come to the cost and time for producing these additional ventilator beds.

A reasonably good ventilator ICU bed can cost anywhere from 5 lakhs to 10 lakhs Indian Rupees in India and may go upwards to 35 lakhs per bed if imported.

Considering the conservative 5 lakhs per bed, it shall require a minimum provision of 800-1800 crores Indian Rupees and considering 35 lakhs per bed, a provision of nearly 5,600 -12600 crores depending on the levels of control.

Indian’s total healthcare budget as of 2020 is 69,000 crores Indian Rupees. So we are looking at a minimum investment of anywhere between 1.2 – 2.2 % up to 8.2 – 15.4 % of our total healthcare budget only on Ventillator beds.

As per data from the US, these beds can take upto 8 months for production. Even if its expedited, may still take anywhere between 2 / 3 /4 months for production and delivery.

So, even if we have a budget, we cant take into use those many beds on immediate basis if exigency arises.

In conclusion, we can say, India can’t ill afford a community wide spread of the disease since it can completely overwhelm the capacity of India’s existing healthcare system in terms of ICU care (ventilator beds).

Cutting down to the basics, complete lockdown (suppression technique) as opposed to partial measures (mitigation technique) is recommended to contain Covid 19.

At an individual citizen level, Indians need to practice and also motivate others to implement “social distancing”.

India now needs the cooperation, empathy and blessing of every citizen along with bold decisions from the Government to contain and control this pandemic from having a free run in India.

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