Covid-19 has awakened the world to the grim reality of its lack of preparedness in healthcare, more acutely felt in poor and overpopulated countries like India.
An important objective of the lockdown in India was to prepare the healthcare system for the Covid outbreak. However, because of the supply chain getting battered, manufacturing operations stalling, elective surgeries getting postponed, pathology labs closing and hospitals running at a fraction of their capacity, the healthcare industry is urgently looking for remedies.
In an exclusive webinar organised by The Blue Circle on ‘Is the Healthcare Industry Catching the Coronavirus?’, prominent voices from healthcare –Pavan Choudary, MD, Vygon India, Dr. Harsh Mahajan, Founder & Chief Radiologist, Mahajan Imaging, Gautam Khanna, CEO, Hinduja Hospital, Navneet Bali, Director( Northern Region), Narayana Health, Tony Parmar, MD & CEO, Albert David, and Sunil Thakur, MD, Quadria Healthcare Private Equity, discuss the impact of Covid-19 on the healthcare industry and the way forward.
Current state of healthcare in India
Speaking on the state of Indian healthcare in the face of Covid-19, Pavan said that all the sub-sectors of healthcare have been impacted. Logistics has taken a hit and the demand curves have dropped.
Hospitals, already suffering from comorbidities such as price control, fall of medical tourism and a dip in elective surgeries have, since covid-19, taken a financial beating. Staff morale is down with several nurses and doctors (treating covid-19 patients) not allowed entry in their homes by their landlords and colony associations.
Gautam said that in the last few weeks, hospitals have had to focus on developing new infrastructure – isolation beds, isolation wards, new protocols, screening, triage, procurement, construction, ensuring employee presence in times of quarantine, and ensuring patients’ and employees’ mental and physical health.
He also informed that as we are heading towards the medium-term horizon, the issue is more about financial sustainability. “There was a study by FICCI and EY that said that hospitals are losing about 7.5 thousand crores a month. Some will close, some will sustain.”
Nurses and Doctors in a dilemma
Pavan brought to light the prominence of nurses after 1918, as they served the patients more courageously than doctors during the Spanish flu did. The relative power of nurses and the enrolment in nursing grew. The heroic role played by nurses fuelled the woman suffrage movement further. Women who were considered too delicate for the toxic vapours of political life bore the toxic favours of the real epidemic better and proved the robustness of their candidature.
Navneet shared that different governments, different doctors and hospitals respond differently. Giving the example of the three hospitals he heads, he said the behavioural pattern is completely different in each of them. One is a cancer hospital, wherein nurses and healthcare workers have a great sense of empathy towards patients, while another hospital in Katra, a small town in Jammu, has health workers who are afraid to contract the infection.
Pharma industry in a lurch
Speaking on how the pharma industry works, Tony said that it is a serial process industry – from procuring raw material, to packaging and manufacturing, down to depots and chemists. Even a single bottleneck affects the entire chain. “The last two months have been difficult as pharma has suffered several such roadblocks.”
IVD and imaging industry hit severely
Shedding light on the state of the IVD and imaging industry, Harsh said that workload and daily collections are down by 90 percent, while fixed costs remain the same.
Differentiating between pathology labs, and radiology & imaging, he explained, “For imaging, a patient has to physically visit the radiology center whereas in pathology, you can go to his home. However other than for covid-19, practically no other tests are taking place and unless there is an emergency,fearing infection no one wants to go to a radiology laboratory. Things are bad for both the sectors.”
He also said there will be a behavioural shift in people, “ People will be very cautious, and even in the second quarter pre-Covid normalization is not expected.”
Recovery of healthcare
Sunil said a new order will emerge that will harness this behavioural change in society that will be driven by access. He explained, “There will be a huge behavioural change of not being physically present, since things can be done online. More emphasis will be laid on resource management, models offering convenience, catering to business continuity plans, patient therapy continuity programs, and wellness models. This new order will attract significant attention from investors.”
Echoing this, Pavan said that the behavioural change which covid-19 would bring will impact the socio economic grain of the market. Companies which can tap into the change by adopting their products and services will succeed.
He further added that chaos is also a ladder in the world of business. New tribes would ascend on this ladder. Earlier it was doctor entrepreneurs who rose, now it could be nurses or medical technologists who might climb to entrepreneurial success.
He recalled how in medieval times in the UK, surgeons were looked down upon as they came from a class of barbers, and were not allowed to use the honorific ‘doctor’ before their names. With time, they organized, put together a full body of knowledge and today, they are even more powerful and respectable than physicians. So much so that they refuse to use the honorific doctor before their names in the UK as it would categorise them as ‘ordinary’ doctors (physicians).
Make in India Push
Tony said that Covid-19 has also raised red flags about API dependence on China, which is to the tune of 70 percent. “While the current government has already initiated change and is trying to incentivise more API production in India, it will take a good 3-5 years to come to a stage of significant self reliance in APIs.”
Adding to this Sunil said that it is not just about getting the benefit of a sustainable model. Several companies are moving their API from China; it is time for India to not just cater to the Indian market but also globally.
Harsh added that this is a unique opportunity to grab the spill overs from China and become a manufacturing hub, especially with the emergence of new technologies like AI, Blockchain and Big Data.
The way forward
While it may take time for the sector to recover, Gautam urged people to be truthful to save themselves, hospitals and other patients. There have been patients not sharing their travel history and going for surgeries and infecting doctors with Covid-19.
Pavan wistfully hoped for such a change in the moral climate of the society.
Navneet said that there is a paradigm shift between human life and economy. The relative worth of economic aggrandizement verses human life has gone down. This will also change society’s priorities at least in the short run and give an opportunity to healthcare players to change their models.
Sunil, in his concluding statement, said that healthcare will occupy the maximum mind share of the government. “It is time for healthcare experts to come together and provide the right direction.”