June 2021 • DALLAS MEDICAL JOURNAL 13
facturers, but it has struggled to inoculate
its citizens. Barely 3% of the India’s 1.4
billion people have been fully vaccinated,
the lowest rate among the 10 countries
with the most COVID-19 cases, leaving
India and its ill-equipped health care system
vulnerable to a potential third wave,
experts say.
The Serum Institute of India, which is
supplying the AstraZeneca vaccine, and
local firm Bharat Biotech which is providing
Covaxin, have both said they are ramping
up production but the supply remains way
short of the millions of doses India needs.
Russian vaccine has also recently been
approved.
Hurting Healers: Deadly Toll
on Physicians
According to the Indian Medical Association
(IMA), 50 doctors died in one day during
one particular week in May, and overall,
1,000 Indian physicians have succumb to
death with COVID-19 in this pandemic. The
list was accumulated by the IMA, the media,
and other medical agencies, according
to IMA President Dr. Anup Nigam. Even a
couple of physicians I know, from the U.S.,
who visited India last month (after being
fully vaccinated three months back) to take
care of a family member, succumbed to
COVID-19. Part of the explanation behind
the devastating death toll is that frontline
physicians are exposed to a constant barrage
of highly infectious patients carrying
a high viral load. Personal protective equipment
was also running low, and there is a
low vaccination rate.
Communities Coming
Together
Various Indian physicians organizations
in the U.S., like AAPI (American Physicians
of Indian origins) have been working
tirelessly to support Indian physicians,
hospitals, and patients. It has donated
thousands of oxygen concentrators, a few
hundred ventilators, and high-flow oxygen
equipment to various parts of India. AAPI
has also started a free telehealth program
helping patients in India so many of
them do not need to go to overstretched
hospitals and physicians, and expertise is
available at home. It also added a consulting
program to physicians in India.
Many organizations in North Texas also
contributed and sent supplies to India;
they include Dallas County Medical Society,
India Association of North Texas, and India-
U.S. Chambers of Commerce.
Improving Situation
Recently, it has been suggested that the
second wave may have already reached its
peak after daily cases reached a record
high of over 414,000 on May 7. On Tuesday,
May 25, India posted 196,427 new
coronavirus cases over the last 24 hours,
its lowest daily rise in infections since April
14, and less than half the 414,188 peak
reported on May 7. The test positivity rate
has come down from about 19.45% to
about 10%.
From many sources in India, I hear that
the cases in major cities like Mumbai and
Delhi, which were astronomically high three
weeks ago, has gone down by nearly 50%.
But there is spread into smaller towns and
rural areas. Dr. Alex Thomas, president of
the Association of the Healthcare of India,
said in mid-May 2021 that the infection
is now spreading from the western part
of India to the east, as well as from major
cities to rural areas. The worry is the lack
of facilities and shortage of the health
care workers, more so in the rural areas,
and these communities cannot handle
the surge. Further, testing for COVID-19
is rarely done in the small town and rural
areas, and the apparent low number of
cases can be misleading. India may not be
out of woods yet.
In conclusion, India needs to take up the
mammoth task to vaccinate its citizens
on a war footing basis to get towards herd
immunity. This is possible if India not only
ramps up its vaccine production, but can
also import the vaccine from international
sources. Apart from this, India needs to
improve upon implementation of life saving
preventive measures, deliver more medical
supplies, including oxygen, and open more
hospital beds where needed to curb this
deadly virus. These measure can help India
achieve success quickly and be better
prepared should there be any third wave.
Anil Tibrewal, MD, is board certified
in general surgery and a fellow of the
American College of Surgeons and Fellow
of Royal College of Surgeons of England,
Edinburgh and Glasgow. He practices at
Methodist Health System, Dallas, and specializes
in open, laparoscopic and robotic
abdominal surgery, including gallbladder,
hernia, gastrointestinal, colorectal, thyroid
and parathyroid, and breast surgery. DMJ
Photo courtesy of Dr. Anil Tibrewal
A COVID-19 patient is being transferred to
the new ICU at Christian Medical College
Vellore, in Tamil Nadu, India.