For months since the pandemic spread its tenta-cles to Goa in mid-March, the State governmenthas been faltering. Protocols and SOPs keptchanging constantly and worse still communi-cation and official messaging left all and sundryconfused and short on confidence in the State’sresponse. In July, the dreaded virus ravaged Goaand one week into August there aren’t any signsit has been tamed but wisdom seems to havefinally dawned and the medical frontlines havefinally been left under the charge of men andwomen whose job it is -- doctors. THE GOANanalyses the belated change of strategy in thefight against COVID.ASHWINI KAMATThe State’s lone dedicated Covidfacility has recently come underheavy flak due to mounting com-plaints from patients and their kinabout the lack of round-the-clockattention to patients with comorbiditiesmaking them vulnerable to complica-tions resulting from the Coronavirus.That comorbid conditions puts a Covidpatient at a much higher health risk is afact that has been since the very onset ofthe pandemic. This is what prompted theGoa government to launch a state-widesurvey back in mid-April with the aimof identifying persons with health con-ditions under the titles of Severe AcuteRespiratory Illnesses (SARI) and Influen-za-Like Illnesses (ILI). SARI and ILI are justtwo of two categories from among thebroad spectrum of health issues whichhave resulted in over 70 Covid-relateddeaths in Goa till date.Despite being fully aware of these as-pects, the Health Department had failedto devolve standardized testing andtreatment protocols at every Covid facilityso far. Coupled with this, the criminalmismanagement of the Covid Hospitaland Covid Care Centers has only con-tributed to spread sheer panic amongGoans with even the slightest healthcondition. Health Minister Vishwajit Ranewent on record that comorbidities cannotbe an excuse for increasing Covid-relatedfatalities but only after being rapped onthe knuckles by Goa Governor Satya PalMalik.But earlier this week, the HealthDepartment changed tact and ordereda complete overhaul of the state’s solededicated Covid Hospital at Margao withDean of Goa Medical College and Hospi-tal Dr Shivanand Bandekar in-charge ofsteering the treatment protocols at theCovid Hospital.Instead of rushing Covid patients tothe GMC to manage complications aris-ing from comorbidities, superspecialityconsultants and experts from the GMCwill now travel on call to Margao to treatthe patients. The hope is that this willprevent fatalities resulting from delayedconsultation with experts from cardiol-ogy, oncology, neurology, nephrology,neurosurgery and urology departments.Committees have been set up to overseemanpower deployment, treatment proto-col at the Covid Hospital as well as to en-sure better functioning of the operationtheatre at the hospital.However, a lot more needs to be done.Dr Oscar Rebello, a member of theTreatment Protocol Committee, informedthat one of the first and foremost sugges-tions made by the committee to the GMCDean and the Health Department wasfor immediate and urgent enhancing ofmanpower at the Covid Hospital.It is not a secret anymore that the Cov-id Hospital is facing grave staffing issues.The facility is highly understaffed and thedeployment of attendants, nurses, clean-ing staff, paramedical staff as well as thetrained medical staff is long overdue. Thesmall teams posted on duty at the CovidHospital are utterly exhausted and arebegging for rotation schedules.“We suggested that they pull outthe staff members posted on non-es-sential services such as the ancillarydepartments of GMC, which can easilycontinue to function on skeletal staff. Thedepartment needs to follow a protocol ofwork schedules for these healthcare andfrontline workers. This will help in liftingoff the burden of administrative dutiesand data entry work from the active med-ical teams posted at the Covid Hospital,”Dr Rebello stated.It is neither possible nor advisable tocontinue running the dedicated Covidfacility in such a state where two nurseslook after 60 patients, a fact that hasbeen confirmed by the kin of a patientadmitted at the hospital.The order further asked for the numberof senior residents to be increased underthe department of medicine, anesthesiaand pulmonary medicine by five resi-dents each.The biomedical waste, food supply,laundry services and housekeeping willnow be outsourced to agencies such asEco Clean and Scoop Oxygen etc whichpresently cater to GMC.Several private medical practitionershave pointed out time and again that anunderstaffed and ill-equipped Covid facil-ity puts not only the Covid patients at riskbut also risks the life and well being of themedical workers posted on duty there.Agreeing with this, Dr Rebello said,“Manpower should be deployed imme-diately and in required numbers at theGMC, Covid Hospital and all other Covidmanagement facilities set up by the gov-ernment. This cannot wait. The existingnumbers are frighteningly inadequate.The Dean and the government had bothagreed to deploy the manpower require-ment.”The Health Department had alsobeen advised by the to procure someequipment such as the high flow nasaloxygen therapy units which are of crucialimportance in stabilizing the critically illCovid patients.The delay in procurement of emergen-cy equipment along with the lethargyis plugging other gaping holes in thestate’s Covid management strategy haveput the life of every Covid patient in thestate at risk. Yet, no one is being heldaccountable and zero-transparency ap-pears to be the only Covid protocol being followed in Goa.