COVID-19’s triage challenge

This time-tested, effective strategy could help tackle COVID-19 but poses unique challenges in India

Sanjay Nagral
April 27, 2021, The Hindu

The second COVID-19 wave has hit India with great ferocity. It’s déjà vu and more. Family, friends and colleagues are infected, hospitals are flooded with patients, there is a shortage of beds, and ambulances are screaming through the streets. There are curfews and lockdowns, and death is in the air. But there is something different about this wave. Apart from the difference in the disease pattern (infectivity is higher and younger people are being affected), a larger proportion of the elite has been infected. In Mumbai, high-rises have been more affected than slums. The elite have been rudely exposed to the dysfunctionality of our healthcare system which the poor have endured for years. The secure world of the privileged has been exposed. Imbalance between demand and supply of healthcare facilities is not peculiar to India. But there is something in our social DNA that could be making it worse.

A time-tested, effective strategy to face the challenge of a sudden large load on the healthcare system is the concept of ‘triage’. This means that when there are a large number of people needing urgent care and there are limited resources, the victims are divided into multiple categories based on severity of disease. The most severe are treated first as any delay will cost lives. The rest are treated later as per their level of severity. This idea was first introduced by Napoleon’s military surgeons to treat battlefield injuries and showed immediate impact. It is now standard practice in many countries when treating mass casualties.

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