Health workers collect swab samples from people for COVID -19 tests, in New Delhi, Thursday, April 23, 2020. Photo: PTI/Ravi Choudhary
New Delhi: Over a quarter of the country’s 736 districts have no epidemiologists at the district level and 11 states have no epidemiologists at the state level as well, according to a report in IndiaSpend.
Per a letter from the Ministry of Health and Family Welfare, Prime Minister Narendra Modi has asked all states’ chief ministers to immediately hire epidemiologists or healthcare specialists trained in dealing with infectious diseases.
The move prompts the question as to why the government didn’t take these measures earlier.
Union health secretary Preeti Sudan sent the letter directing chief ministers to hire epidemiologists on April 7, 2020, when India had recorded 124 deaths from COVID-19. The letter singled out 216 districts and 11 states across the country that had epidemiologists’ positions vacant, including Andhra Pradesh, Telangana, West Bengal, Haryana, Chhattisgarh and Assam.
Sudan’s letter also said that hiring must be undertaken on a “war footing” since epidemiologists were a “critical element in the effective management of pandemics like COVID-19”.
If there have indeed been vacant positions for epidemiologists, etc., it’s unclear why they were not filled earlier considering India has been home to the tuberculosis and HIV/AIDS epidemics for at least a decade.
The Integrated Disease Surveillance Programme (IDSP), run by the National Centre for Disease Control, has been conspicuously absent from the fight against COVID-19 thus far, IndiaSpend reported. The IDSP’s network of epidemiologists is meant to pick up on spikes in disease in the areas of their work.
“Lockdown, testing and treatment is all very important but if cases are not picked up by epidemiologists in surveillance in the first place, it will affect the entire process,” Sujeet Kumar Singh, director of IDSP, told IndiaSpend. “So IDSP’s surveillance is an important link.”
The novel coronavirus, which causes COVID-19, is a respiratory virus and its testing criteria have been expanded to include severe acute respiratory illness (SARI) and influenza-like illness (ILI), thus increasing IDSP’s role in the ongoing crisis.
“Since the symptoms look similar, it is essential that patients with respiratory illness are tested for COVID-19, whether or not they have had travel history to hot spots,” T. Sundararaman, former dean at the Tata Institute of Social Sciences’ department of health systems studies, told IndiaSpend.
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Curiously, the IDSP stopped publishing weekly numbers for seasonal influenza (H1N1) in India from February 2, 2020, three days after the country reported its first case of the novel coronavirus.
Both H1N1 data and COVID-19 data are crucial to understand the spread of the novel coronavirus. Indeed, the IDSP’s last report records India’s first three COVID-19 cases in Kerala along with 18 deaths due to H1N1.
“All the information is there. … Maybe it has not been uploaded because everyone is very busy right now,” Singh, IDSP’s director, said.
After receiving the letter from the Centre, several state governments have issued also circulars calling for epidemiologists to apply for jobs.
Speaking to IndiaSpend, the director of the National Health Mission said that hiring for such positions will be challenging because most outstation candidates will not be able to travel, thanks to the lockdown.
Other healthcare workers have also pointed out that the contracts are unlikely to attract many takers since the state governments have only offered short-term employment at low salaries, and the window for applications closes in a few days.
Shrikant Kalaskar, who has worked with the Union government to train staff in disease surveillance and outbreak investigation, told IndiaSpend, “These jobs are offering very low remuneration but asking for people with postgraduate degrees in medicine to apply. Why would someone risk their life in this pandemic situation, for such short term jobs, with such low pay?”
Telangana, for example, has reported over a thousand cases of the coronavirus. It has 33 districts and 30 sanctioned positions for district-level epidemiologists, but of which only six have been filled. The state has been offering a remuneration of Rs 50,000 per month and now aims to hire people on an outsourcing basis for four months only.
The Government of Karnataka, on the other hand is hiring one state epidemiologist on a temporary basis at a remuneration of Rs 33,600 per month, and the Government of Assam has also invited applications from those with degrees in Ayurveda and homeopathy.
(For both the states, there appears to be no way to apply via the governments’ websites even though the circulars direct applicants to apply online.)
The New Indian Express reported that the Bruhat Bengaluru Mahanagara Palike had advertised for four epidemiologists on contract under the National Health Mission for the low salary of Rs 25,000 per month. The required qualifications included an MBBS with a postgraduate degree or diploma in preventive or community medicine, public health or epidemiology – or for medical graduates with six months’ experience and/or a master’s degree in public health or epidemiology.
Additionally, Himachal Pradesh has said it will hire one epidemiologist at a remuneration of Rs 40,000 per month plus a one-year contract, while Chhattisgarh is offering to pay Rs 60,500 for state epidemiologists and only Rs 35,000 at the district level.