COVID-19 and the Public Health System in Bihar

The global pandemic of COVID-19 which has forced the world into a virtual lockdown registered its first case from Bihar on 22 March 2020. A 38-year-old man, who had a history of travelling, passed away at the All India Institute of Medical Sciences in Patna due to kidney failure. Later he was tested positive for coronavirus. On 23 March, it was reported that most of the junior resident doctors working in the Nalanda Medical College and Hospital, Patna—the designated hospital by the Bihar government as the state’s primary hospital to treat cases of COVID-19—were exhibiting some symptoms due to exposure to a coronavirus positive patient. Instead of following a home quarantine for 15 days as advised, in the absence of any tests and response from the state government, all resident doctors continued to treat the patients for the next several days (Ray 2020). With no protocol regarding prevention and control of COVID-19, until the first death was reported, the mismanagement of the state administration forced Bihar into the stage of local transmission at the very beginning. The density of testing centres per population in Bihar is the worst in the entire country with only one centre, Rajendra Memorial Research Institute of Medical Sciences, in Patna to test its over 110 million population.

To deal with such a situation, what a state needs is not just expertise to identify the origin, spread, projected course and the methods to contain the virus spread, but also a strong health infrastructure with medical facilities and well-trained medical professionals at all levels—at the sub-centres and primary health centres (PHCs), and the rural and urban level. Also needed are adequate facilities for early detection, investigation, basic labs to conduct tests, and regular plans to conduct community health education to prepare the masses against an evolving pandemic. However, the condition of the public health system in Bihar is dismal.