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New Delhi, May 30: The COVID-19 pandemic has left the Indian private healthcare sector in acute financial distress, a new survey said on Friday adding that the healthcare facilities in the country have witnessed at least 80 per cent fall in average revenue.

Post the lockdown from March 24, Indian hospitals have seen a large impact, especially among small and medium-sized hospitals, which are now facing existential challenges.

The survey by healthcare industry body NATHEALTH was conducted in 251 healthcare facilities across nine states and 69 cities to assess the impact of COVID-19 on the domestic healthcare industry.

The findings showed that 90 per cent of the surveyed healthcare facilities are facing financial challenges with 21 per cent facilities facing an existential threat.

"There is a need for a stimulus package to revive the Indian healthcare industry which will be crucial to provide much-needed relief to the healthcare sector which is the frontline defence in this fight against COVID-19," said Dr Sudarshan Ballal, President NATHEALTH.

According to the survey, hospitals in tier 1 and tier 2 cities are experiencing a 78 per cent reduction in OPD footfalls, and a drop of 79 per cent in in-patient admissions.

The study found that 90 per cent of organisations require some form of financial assistance.

The findings indicated that even after the lockdown lift, the situation will remain difficult for the hospitals and nursing homes as patients will hesitate from visiting hospitals.

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

New Delhi, 17: Tensions on the Indo-China border have spiked to the highest since 1962 after over 20 troops, including an Indian commanding officer, were killed in the face-off in Galwan valley that has seen a six-week long standoff underway with the Peoples Liberation Army.

The Army said that the soldiers – including the Commanding Officer of 16 Bihar regiment in charge of the area – died while a `de-escalation process’ was underway. Sources said that this death toll could rise up as some soldiers are currently not accounted for after PLA troops attacked with spiked sticks and stones in the Galwan valley.

Chinese side also has casualties but the number is still not known. The Indian death toll is perhaps the worst single day loss in decades and has come at a time when thousands of troops are forward deployed in Eastern Ladakh.

ET was the first to report on May 12 about a massive troop build up in the Galwan valley, which is an old flashpoint that had seen action in the 1962 war as well.

There have been reports of casualties on the Chinese side in the clash but numbers are currently not available. Worryingly, information from the ground suggests that several Indian soldiers, including four officers, are missing and could have been taken captive by a vastly larger Chinese force. Their status is still not known.

“During the de-escalation process underway in the Galwan Valley, a violent face-off took place yesterday night with casualties. The loss of lives on the Indian side includes an officer and two soldiers. Senior military officials of the two sides are currently meeting at the venue to defuse the situation,” an Indian Army statement reads.

The Ministry of External Affairs said that the clash occurred when the Chinese side violated the LAC. “On the late-evening and night of 15th June, 2020 a violent face-off happened as a result of an attempt by the Chinese side to unilaterally change the status quo there. Both sides suffered casualties that could have been avoided had the agreement at the higher level been scrupulously followed by the Chinese side,” a statement reads.

The loss of the Commanding Officer is especially devastating and he had been directly involved in de-escalation talks with the Chinese side, including one hours before the clash took place. Sources said that the talks on Monday morning had led to an agreement for Chinese forces to withdraw from Indian territory as part of the disengagement.

According to one version, the CO had gone to the standoff point with a party of 50 men to check if the Chinese had retreated as promised. As the Indian side proceeded to demolish and burn illegal Chinese structures on its side of the LAC, including an observation post constructed on the South bank of the river, a fresh stand off took place as a large force of Chinese troops returned back.

Sources said that a Chinese force in excess of 250 quickly assembled near Patrol Point 14 and were physically stopped by Indian soldiers from entering Indian territory. Soldiers from both sides did not use firearms but the Chinese soldiers carried spiked sticks to attack.

Given the terrain of the region, a part of the standoff and clash took place in the middle of the Galwan river that is currently flowing at full spate, leading to high casualties as injured soldiers got swept away. Indian soldiers have to cross the Galwan river at atleast five points to reach PP 14, which marks the LAC.

Chinese media reports on Tuesday quoted the spokesperson from its Western Theatre Command as laying claim over the Galwan valley region and blaming the Indian side for the clash. Reports quoted Col Zhang Shuili as saying that India has violated the consensus made during Army commander level talks.

As reported, Galwan river area has a painful history with China, with Peoples Liberation Army (PLA) soldiers surrounding a freshly set up Indian Army post in July 1962, in what would be one of the early triggers to the Sino-Indian war. At an Army post that was overrun at Galwan, 33 Indian soldiers were killed and several dozen taken captive in 1962.

In the past, the Doklam crisis in 2017 saw tensions building up along the Pangong Tso lake as well with soldiers engaging in a fight with sticks and stones. However, the Eastern Ladakh standoff is of a much more serious nature, with over 6000 Chinese troops lined up with tanks and artillery, faced off with a larger Indian forces. Troop build up has also been reported across the borders in Himachal Pradesh, Uttarakhand, Sikkim and Arunachal.