Journal of Global Resources
Volume 6 (01a)https://doi.org/10.46587/JGR.2020.v06si01.013

Special Issue June 2020
Page 91-95
ISSN: 2455-2445 (Online)

13
THE BURDEN OF COVID-19 ON HEALTHCARE RESOURCES IN INDIA
Swagata Mandal
Biostatistics and Demography, International Institute for Population Sciences, Mumbai, India
Email: swagata9011@gmail.com
Abstract: The COVID-19 pandemic has caused huge pressure on healthcare systems all over theworld. This prevailing infectious virus requires constant testing of cases, isolation of patients,
treatment and research on vaccination, medication, transmission and prevention. This study aims
to determine the burden the virus has made on the Indian healthcare systems. Testing andisolation of the cases is the mechanism being used to combat the pandemic so this study analyses
the tests performed, testing labs for COVID-19 and hospital beds in the state level. Based on theimportance of testing, the doubling time of the tests performed and the confirmed cases iscalculated. Graphical analysis is undertaken to study the public hospital beds, testing labs, positive
cases and tested cases state-wise. The results indicate that more tests need to be performed, andfor this to occur more testing labs should be set-up and sufficient isolation beds must be
constructed for the treatment of the patients.
Key words: COVID-19, Healthcare, Testing Labs, Tests, Health Care Resources
Introduction
The first case of COVID-19 occurred in Wuhan Seafood Market, China in December 2019. The
virus was named as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or novel
coronavirus (Guan 2020). The symptoms observed were similar to pneumonia (GAO 2020). The
initial symptoms reported were mainly fever, with a few cases of having difficulty in breathing, andchest radiographs showing invasive pneumonic infiltrates in both lungs (WHO 2020). After the first
identification, this virus began spreading rapidly and the spreading mechanism was unknown to thespecialists (Rothan 2020). It was then observed that there was a human-to-human transmission ofthis virus (Phelan 2020). On 30th January 2020, the World Health Organisation declared COVID-19
as Public Health Emergency of International Concern after it had spread across several countries
globally (Cascella 2020). On 11th March 2020, COVID-19 was declared as a pandemic by WHO.
India was not able to escape the spread of the virus. On 6th April 2020, the Union Health Ministry ofIndia declared that it was in between stage 2 and 3 of the pandemic. India went under nationwide
lockdown on 24th March 2020, and is proposed to remain till 3rd May 2020. To tackle the virus
outbreak, testing is an important step (Sanchez 2020). The healthcare workers are working day
and night to combat the disease and cure the patients. This study is dedicated to analysing thehealthcare resources in India.
Data Source
The data on daily testing of COVID-19 cases are obtained from the Indian Council of Medical
Research. ICMR updates their daily tests performed to detect the SARS-CoV-2 virus. The data is
on daily testing for our analysis is taken till 19th April 2020. The data on state-wise labs present for
testing novel coronavirus is also taken from the report released by ICMR on their website. Thisdata is taken till 20th April 2020. The data on total COVID-19 state-wise affected cases are takenfrom the Ministry of Health and Family Welfare (MOHFW) website. Since the number of cases is91

increasing every moment, we take the data updated on the website till 5:00 pm on 20th April 2020.
The number of daily cases is also taken from the MOHFW website. The data on public hospitalbeds present in each state of India is also taken from the MOHFW press release. The list of public
hospitals present was last updated in July 2018 by the ministry. Data on individual state testing is
obtained from the health departments of the respective state.
Confirmed Cases and Daily Testing of COVID-19
The first case of novel coronavirus infection was found in Kerala, India on 30 th January 2020. The
number of cases was constant for a long time and suddenly increased 2 nd March 2020 onwards.
There were only three cases in India on 2nd March 2020, but as on 20th April, the number of cases
went up to 18539 (Fig. 1). As of 12th April 2020, there were 9205 positive cases of COVID-19, andwe can see that the number has doubled in a short span of only eight days. Though it is alarming
to see the steep rise in the number of cases, it is equally important to identify these cases at theearliest so that proper treatment measures can be taken.
Figure 01: Confirmed Cases of COVID-19 in India (2nd March 2020 to 20th April 2020)

19-04-2020

17-04-2020

15-04-2020

13-04-2020

11-04-2020

09-04-2020

07-04-2020

05-04-2020

03-04-2020

01-04-2020

30-03-2020

28-03-2020

26-03-2020

24-03-2020

22-03-2020

20-03-2020

18-03-2020

16-03-2020

14-03-2020

12-03-2020

10-03-2020

08-03-2020

06-03-2020

04-03-2020

20000
18000
16000
14000
12000
10000
8000
6000
4000
2000
0
02-03-2020

CASES

DAILY COVID-19 CASES

DATE

Figure 02: Daily Testing of Samples for COVID-19 (17th March 2020 to 19th April 2020)

DAILY TESTING OF COVID-19
450000400000SAMPLES TESTED

350000300000250000200000150000100000
50000
0

DATE

92

The testing of samples is very important to recognize the hidden cases of COVID-19. As of
19 April 2020, there were 401,586 samples tested to find the novel coronavirus (Fig. 2). The
number of samples tested on 12th April 2020 was 195,748 and the number of samples tested has
doubled only in seven days. We can see that the government of India has increased the number of
testing to find out the undetected novel coronavirus cases. It is also observed from Fig.1 and Fig.2
that the number of confirmed cases has increased at the same rate as the number of tests
performed. Thus, it becomes important to perform more tests to identify the cases faster andprovide proper treatment to them.
thState-wise Healthcare
The novel coronavirus infection has affected each state of India in different ways. Some states
could not escape the consequences of the infectious virus while others are low in the charts. Fig 3
displays the fifteen states that have positive novel coronavirus infections greater than two hundred
as on 20th April 2020. Maharashtra is leading the charts with 4,203 cases. Maharashtra had morecases than Delhi and Gujarat combined. It is important to perform sufficient test to detect the
COVID-19 cases.
Figure 03: States most affected by COVID-19 (as on 20th April 2020)

STATES

COVID-19 CONFIRM CASES
Maharashtra
Delhi
Gujarat
Madhya Pradesh
Rajasthan
Tamil Nadu
Uttar Pradesh
Telengana
Andhra Pradesh
KeralaKarnatakaJammu and KashmirWest Bengal
HaryanaPunjab

4203
2003
1851
1485
1478
1477
1176
873
722
402
395
350
339
233
219
0

500

1000

1500

2000

2500

3000

3500

4000

4500

CASES

To facilitate abundant testing in each state of India, there must be a well-equipped lab
facility to enable quality testing. Fig 4 contains the functioning testing centres in each state which
are certified by the Indian Council of Medical Research. There are a total of 290 labs for testing
COVID-19 all over India. We find that Maharashtra has the maximum number of testing labs inIndia with twenty-two government labs and twenty private labs. Tamil Nadu ranks second in thenumber of testing labs followed by Telangana. Also, there are about twenty-two states and union
territories where the number of testing labs is less than ten. The government must take measures
to increase the testing centres so that we can get the number of patients infected by the virus at
the earliest. Table 1 presents the number of COVID-19 tests performed in the states as per theavailable information from the respective health departments as of 10th April 2020. We find that the
maximum number of tests is performed in Maharashtra. The state of Rajasthan has performed
fairly better in conducting COVID-19 tests despite a lower number of testing labs. The union
territory Delhi must conduct more tests and construct more labs for testing since the number of93

confirmed cases is very high. We also observe that the number of positive cases tested in Tamil
Nadu is higher than the comparing states. Odisha accounts for the lowest positive turnout of thetested cases. Testing of the cases is necessary and a greater number of labs and tests will ensure
better identification of the cases. After the testing process, there must be an adequate number ofbeds available to accommodate the patients for treatment.
Figure 04: COVID-19 Testing Labs in States and UTs (20th April 2020)

45
40
35
30
25
20
15
10
5
0

Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli and…
Delhi
Goa
GujaratHaryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
KeralaLadakhMadhya Pradesh
Maharashtra
Manipur
Meghalaya
MizoramOdishaPuducherry
PunjabRajasthan
SikkimTamil Nadu
Telangana
TripuraUttar Pradesh
Uttarakhand
West Bengal

NUMBER OF LABS

COVID-19 TESTING LABS

Government Laboratory

Private Laboratory

Collection Site

STATE

If we consider Table 1, which gives us the number of public beds available across India asof July 2018, there are a total of 739,024 public beds are available in India. Tamil Nadu tops thecharts with 72,616 public beds available. Maharashtra ranks second with 68,998 public beds.
Comparing with the total number of cases in the states, we can be assured that we have a fairly
large number of existing public beds alone so that the patients can be well accommodated. The
government authorities of the Centre and States have also taken steps to dedicate many schools
and other public institutions for COVID-19 care.
Table 01: Covid-19 Tests Performed in States/UT
STATE/UT
1
2
3
4
5
6
7
8
9
10
11
12
13

Maharashtra
RajasthanKeralaDelhi
Tamil Nadu
Karnataka
Gujarat
Madhya Pradesh
Andhra Pradesh
PunjabOdishaJammu and Kashmir
Chandigarh

Total tested
Samples
30000
22324
13339
11061
8410
7975
7718
7049
6374
3461
3249
2961
223

94

Percentage ofNegative Cases
96.22
92.60
92.47
87.35
81.31
96.21
93.77
68.66
94.02
85.87
98.52
93.01
89.24

Percentage of
Positive Cases
3.78
2.33
2.73
8.16
10.83
2.60
4.90
6.40
5.98
4.36
1.48
6.99
8.52

Figure 5: State-wise Public Hospital Beds

Tamil Nadu
Maharashtra
Andhra Pradesh
Uttar Pradesh
Karnataka
RajasthanWest Bengal
GujaratKeralaMadhya Pradesh
Delhi
Assam
Bihar
TelanganaOdishaChhattisgarh
HaryanaPunjabJammu & Kashmir
Himachal Pradesh
Jharkhand
Uttarakhand
TripuraMeghalaya
Puducherry
Chandigarh
Goa
Manipur
Arunachal Pradesh
Mizoram
NagalandAndaman & Nicobar…
SikkimDadra & Nagar Haveli
Daman & Diu
Lakshadweep

NUMBER OF BEDS (in thousands)

PUBLIC HOSPITAL BEDS
80
70
60
50
40
30
20
10
0

STATE/UT

Conclusion
The number of confirmed cases in India has crossed seventeen thousand as of 21st April 2020.
The testing for COVID-19 cases is also increasing. The government should construct more testinglabs and employ more professionals to speed up the process. ICMR has imported rapid testing kits
to perform faster testing of individuals. From the hospital beds, we see that India already has
sufficient public beds. The beds for COVID-19 patients must be isolated from other patients so that
infection transmission is prevented. The patients with any possible symptoms or possible exposure
are put under quarantine till the test results are known. So, the government must makearrangements for such special quarantine centres in bulks as soon as possible. India is currently
under lockdown till 3rd May 2020, but the lockdown must be extended to a sufficient duration if thecases of COVID-19 are not in control.
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