This story is from August 10, 2020

MBBS bureaucrats give shot in arm to Covid strategy

In India, medical professionals working in state administrations have been at the forefront of shaping the early response to the Covid-19 epidemic. In Kerala and Jharkhand, they head bureaucracy; in other states, they manage crucial committees which oversee field management. Some who are in the police were even deployed to explain containment measures to restive crowds.
MBBS bureaucrats play major role in giving shot in arm to Covid strategy
LAB ON WHEELS: A mobile Covid testing facility in Hyderabad (PTI photo)
NEW DELHI: India has come in for praise for slowing down the SARS CoV-2 outbreak, but one factor that’s gone relatively unnoticed is the role of medical professionals working in state administrations who shaped early response to the epidemic.
From ramping up testing facilities and bed capacity to revising contact tracing norms, they’ve been credited with initiatives that led to a turnaround.

In Kerala and Jharkhand, they head bureaucracy; in other states, they manage crucial committees which oversee field management. Some who are in the police, were even deployed to explain containment measures to restive crowds. As Tamil Nadu chief secretary K Shanmugam says, officers with a medical training “have an advantage” in handling the situation.
Maharashtra: The state’s best known Covid recovery story was helmed by Pankaj Ashiya, an IAS officer of the 2016 batch. As special officer in the powerloom township of Malegaon, he was able to effect a high rate of recovery. Increased screening and a sizeable contact tracing ratio in densely populated areas was the strategy he adopted in consultation with community leaders. Ashiya is now posted in another hot spot, the Bhiwandi-Nizampur belt adjoining Mumbai, where cases in July have declined below the tally for June. Maharashtra has 29 medical professionals in the service. Eight were roped in fight the pandemic, some as municipal commissioners and district collectors, others in planning. Public health secretary Pradeep Vyas drew up a policy for Covid care centers, testing labs and capping treatment cost in private hospitals. Prashant Narnaware was asked to monitor admission to private hospitals. Others like Vijay Rathod and M R Dayanidhi were made municipal commissioners in urban centres around Mumbai where cases are widespread.
Uttar Pradesh: In UP, there are seven doctors in administration. Vipin Jain who joined three years back, was posted in Ballia, a high incidence area. Jain’s interventions helped keep Ballia’s mortality rate at 1%. In mid-April, before focus turned to extensive testing, the town had already trained four technicians who were being sent out in ambulances to collect samples. “We initially started with random sampling but soon shifted to targeting sampling. This included not just migrant workers but also those in the high mortality bracket,” he said. At least four other district magistrates in UP are doctors by training. A sixth is chief development officer in Mathura. Rajneesh Dubey, seventh, is additional chief secretary of medical education.

Kerala: When Poonthura, a coastal village in the capital, was made a containment zone, residents were not ready to accept restrictions. They were out on the streets protesting and even prevented a team from collecting samples for testing. IPS officer Dr Divya V Gopinath was then deputed to reach out and explain the steps taken. “More than the police, I am a doctor. So please listen to me,” was how the deputy commissioner addressed the crowd. Now she heads law and order for the entire coastal belt in Thiruvananthapuram.
Among IAS officers too, there are several with a medical degree in senior posts.
Bihar: There are at least five medical professionals-turned-IAS officers posted in districts. Three are district magistrates. Madhubani DM Nilesh Ramchandra Deore, said medical expertise helped him to prepare in advance. “It also helped me to make subordinates understand that this pandemic will take time and that we must all must gear up for several months,” he said. Kishanganj DM Aditya Prakash said he was able to understand the transmission cycle and worked with his team to break it into identifying high and low risk groups.
Tamil Nadu: Nearly 20 IAS officers here are doctors by training; at least half were roped in for epidemic management. K Gopal and B Chandra Mohan, members of an apex monitoring panel, analyse data and suggest interventions such as setting up fever clinics and expanding testing capacity. Others are posted in field support teams and control rooms tasked with procurement of medical gear and monitoring health infra. Notably, Arun Thamburaj, in charge of Thiru-Vi-Ka Nagar, a suburb in Chennai with the highest cases, was able to staunch the spread. “Being a doctor, you can quickly rationalise health-related issues, instead of following instructions blindly,” said Thamburaj, who was in the IPS before he quit to join IAS.
West Bengal: Purulia which borders Jharkhand was a green zone until an influx of migrant labour put it on Bengal’s Covid map. What may have led to a rapid spread, considering the district’s limited healthcare resources, was preempted by a doctor-turned IAS officer. Akanksha Bhaskar, additional district magistrate, began routine visits to healthcare centres and hospitals, troubleshooting in every way possible. Bhaskar, a graduate from RG Kar Medical College in Kolkata, was able to boost treatment and preventive measures and even repurpose a hospital to handle infectious diseases. Before her, all Covid positive patients in Purulia were sent to neighbouring Bankura. Purulia has not reported a single Covid death.
Gujarat: When death rates climbed to nearly 7%in Ahmedabad in early May, Dr Manish Kumar, a 2013 batch IAS officer, was despatched as officer on special duty. He was asked to visit private hospitals and audit critical care units. “That contributed to bring down death rates drastically,” says a senior official. Kumar also flagged shortage of beds and raised availability by requisitioning more private hospitals. Because of the audits, 3 hospitals were derecognised and fined as inquiries revealed that their death rates were higher compared to others. For a man who admittedly battled depression in his formative years, 36-year-old Kumar is now a role model for Gujarat’s youth.
Jharkhand: The man supervising overall management of the healthcare sector in Jharkhand is himself a medical professional. Principal secretary, health, Dr Nitin Madan Kulkarni prioritised the setting up of six state-run laboratories for tests across Jharkhand.
Punjab: Amritsar police chief Dr Sukhchain Singh Gill is member of a doctors’ panel which monitors the situation. He also heads a probe on allegations against a private diagnostic lab for allegedly colluding to declare healthy people as coronavirus positive. According to Gill, a medical background puts him in a better position to understand tracing of cases.
Madhya Pradesh: There are 16 IAS officers in MP who have a medical degree. Two — Pankaj Jain and Fating Rahul Haridas — are collectors of Vidisha and Seoni. Jain worked with AIIMS in Delhi before becoming a bureaucrat. “Being a doctor helps in better communication,” Jain said.
Andhra Pradesh: Dr KS Jawahar Reddy, special chief secretary, is the face of Covid management. He frames guidelines on hospital care, tracing, testing, treatment. Then there’s additional chief secretary to CM, Dr PV Ramesh, in containment planning. The state has implemented a surveillance system, apart from five rounds of doorto-door surveys, to locate vulnerable groups. Another doc-turnedbureaucrat Dr Mallikarjuna Reddy, is CEO of Dr YSR Aarogyasri Health Care Trust, which offers free treatment for Covid-19 at corporate hospitals.
(With inputs from Neha Lalchandani, Debashish Karmakar, Julie Mariappan, Gaurav Pandey, Ranjan Dasgupta)
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