Only eleven among India’s 28 states meet the WHO recommendation of 1:1000 doctor to population ratio, while none in the public healthcare sector manage to make the cut.

Is the Indian healthcare system equipped to handle the COVID-19 crisis? A good measure of our preparedness against the coronavirus is the proportion of doctors to the 1.35 billion population. The World Health Organization (WHO) recommends a standard ratio of 1:1000 (doctor to population ratio). Data shows that only eleven among India’s 28 states meet the WHO recommendation, while none in the public healthcare sector manage to make the cut.

While India has a booming private medical sector, the public healthcare system operates at a dismal ratio of 0.08 doctors for 1000 people. The states with the highest shortfall of doctors – Uttar Pradesh, Chhattisgarh, Odisha, and Madhya Pradesh – house a huge share of India’s rural population of more than 0.8 billion.

While Delhi has the highest number of doctors working in the public healthcare sector in India, Goa has the highest number of registered doctors, with a doctor to population ratio of almost 2: 1000. Incidentally, Goa is the first Indian state to become free of COVID-19, with no active cases.

Given that the Primary Healthcare Centres (PHCs) are the basic structural and functional unit of the public health services, it is important to ensure that India starts by addressing the shortage of doctors in that area. As per the 2018 government data, 10 Indian states face a shortage of doctors at the PHC level. Bafflingly, in most Indian states, the government has sanctioned more than the required number of doctors and in many states, the PHCs have more doctors than needed!

The need of the hour is to address this demand-supply mismatch in healthcare infrastructure. It is essential to realise that these numbers are the best-case scenarios when our doctors are available at their full potential. Many hospitals are already having doctors work in shifts to decrease the risk of infection. Yet, there are reports every day of doctors contracting the virus and having to quarantine themselves.

Unless all states meet at least the basic healthcare requirements – in terms of the number of doctors, personal protective equipment (PPEs), etc – the country cannot possibly tackle the pandemic. Right now, our best strategy is containment and stringent testing to ensure that the fragile healthcare system is not overburdened.

As global healthcare struggles to cope with COVID-19, India has a long way to go before it can win the battle. We have witnessed this before with the Swine Flu outbreak in 2009. Unless the country invests in more doctors and better public health infrastructure, we’ll continue to relive the consequences of such outbreaks – perhaps, more fatal and more challenging in the future.