During the nearly six months of the pandemic, there are more questions than answers about the virus. Nobody really knows how many Indians have been infected with the new Coronavirus and how many have died.
Perhaps we will not even know, because many people are without symptoms and the death registration system is not well in all the states of the country. No one can officially guess when we will be able to use the corona vaccine.
An issue amidst all this uncertainty, which concerns us, is the state of our infection control strategies. How effective are they? One question that bothers me a lot is the quality issue. We all know that in the beginning of the epidemic, like other countries, India also used to seek Personal Protective Equipment (PPE) from abroad.
Domestic PPE manufacturing began around February. Prime Minister Narendra Modi recently told us that India has now become the second-largest manufacturer of PPE. Within six months more than 1,200 companies are making PPE kits and more than three lakh N-95 masks are made every day. This is good news, but is the constant focus on quantity preventing us from focusing on quality?
This epidemic has given rise to cottage industries of PPE, hand sanitizer, mask etc. People with no connection to medical supplies took this as an opportunity and started making protective equipment. And now there is a flood of indigenous PPE kits. Many of them are not selling and their prices have come down.
Talking to people in this industry, it became clear that quality is a serious issue in the PPE market. There has been a flood of complaints about substandard PPE, sanitizers, gloves, etc., raising concerns about the impact on the country's public health responses to infection control strategies.
According to the United Nurses Association, as of June 30, more than a thousand nurses were infected in Delhi alone. The general secretary of the association said that things are improving and hospitals are making sure that their health workers are properly protected.
Most worrying is that once-in-use PPE kits are used multiple times. The World Health Organization permits multiple uses of PPE after intensive refinement only as a last resort when PPE is unavailable.
The root of all these problems is the lack of mandatory standards. The Central Drugs Standard Control Organization has not defined any classification of PPE kits for medical use, says Dr. Sanjeev Rehan, chairman of the Preventive Wear Manufacturers Association of India. Under the medical device regulations, it is not possible to understand the regulatory requirements applicable to the industry without classification.
After meetings between the industry and the government, things have started improving a bit. Rehan says that the National Standards Society of India Bureau of Indian Standards (BIS) was already working towards creating a standard for PPE, which would be in line with the global standard. A large number of PPE manufacturers fall in the small, micro and medium industries (MSME) sector. They need cooperation to upgrade their technology and infrastructure.
The MSME Ministry and the State Governments should support them so that they meet the global standards. This is not charitable work. PPE manufacturers wishing to exploit the global market need to meet global standards to be able to export successfully. And without the safety of our doctors and health workers, our infection control strategy will not work. We have our own security in their security only.