COVID in India: Six Areas Ripe for Investment
Read Time: 5 Minutes
India, according to the World Health Organization, had a reported 9.9 million positive COVID-19 cases as of mid-December. This was versus 72 million infected people in the whole world. But for every COVID-positive person detected in India, there are possibly five to eight people who have not been tested. So it’s possible there are about 40 million to 70 million people with COVID infections in India. The number of deaths as of right now is recorded at 144,000.
Of those infected, about 80% have no symptoms or some mild ones and do not require medical attention or hospitalization. The remaining 20% requires some form of hospitalization, of which 5% require the ICU. There are 1,000 public hospital beds per million, with another 500 per million from the private sector. The number of people who require hospitalization is about 25,000. That is a shortfall of two and a half times, which will likely continue for a while.
The transmission rate in India as of this writing is such that for every case of COVID, 1.4 to 1.5 new cases are estimated to occur. Two additional factors have come in November and December. The Durga celebrations and Diwali are soon, and lots of people are congregating. That’s a major threat for a second wave — Delhi is already experiencing the third wave. Winter is also coming, bringing freezing temperatures in the north, making infections more likely. The season also brings seasonal flu.
In that sense, there is no letting down in the pandemic. We have been hearing optimistic notes, but those are not standing up with the trends that we see.
India has 3,600 healthcare workers per million, compared with 45,000 per million in the United States. The per-million healthcare population being the lowest in the world, India’s workers will be challenged further than they were with other illnesses such as AIDS, TB, and malaria.
With all this, the COVID epidemic in India will open up opportunities for public-private partnerships, venture capitalists, and others. Here are six areas that are ripe for opportunity:
1. Laboratory testing
There are three national networks of labs: Metropolis, Dr Lal PathLabs, and Thyrocare. Then there are more than 10 regional labs. They do most of the testing with home collections, and that has become much easier for senior citizens and others. During this pandemic, they have increased the testing cost by 30%. But there is no shortage in getting these tests done. The diagnostic test industry is crowded, but there are opportunities for innovations and further efficiency.
2. Generic medicines
There are no online medicine delivery systems in India. The government is opening up generic medicine outlets, 200,000 outlet stores across the country, where medicines will be available at 10% of the branded cost. There could be a niche for online ordering and delivery of medicines.
3. Digital doctor consultations
The recently formed Indian medical commission authorizes doctors to be able to consult and provide prescriptions to patients online so they don’t have to examine every patient like was done before. That has happened in a large way in the United States as well. But telemedicine is in short supply. The platforms required to do an efficient teleservice are few. They are not professionally managed like Uber. Investors can look at having clinical services as well as consultations done online or even by visiting doctors, going back to the old-time family practice.
4. Multispecialty clinics
A whole COVID episode lasts about four weeks, at the end of which the person looks apparently healthy and is able to go back to work. But some people suffer from an indefinite period of chronic illnesses as a result of COVID. These could include mental illnesses, neurological problems, and worsening diabetes and hypertension. These individuals need multispecialty clinics, including care from a neurologist, diabetologist, gastroenterologist, and musculoskeletal and hypertension specialist. These people cannot go to a multispecialty hospital and sit in five, six different outpatient departments every other day and get consultations. Private online clinics, where people can go and have multiple consultations, could be the solution.
5. Oxygen generators
Most Indian hospitals do not have oxygen plants. The government has decided that it is unable to cope with getting the oxygen in cylinders because that makes it very expensive to treat COVID. When COVID will last for an unspecified period, hospitals will need oxygen plants and a piping system across all wards and operation theaters. State governments are willing to outsource these investments to private companies. It’s just like a lot of private labs running in government hospitals.
6. Health devices
Venture capitalists and others have the capacity to invest in health devices, like ones that look at risk measurement of blood pressure. For COVID, for example, there’s the oximeter that tells users oxygen saturation in their blood. These days, every family in major cities has an oximeter at home. It costs about 2,000 to 3,000 rupees. That is something that gives the first indication of COVID. The second one is to go through a CT scan, which is only at imaging centers. A simpler solution is using an ultrasound, which could be done on a smartphone. Innovative solutions could be a boon for people everywhere.
The pandemic is too big for any single government or institution to handle, so investors and entrepreneurs will be needed to fight COVID-19.
About Subhash Hira
Dr. Subhash Hira specializes in infectious diseases, dermatology/STI, and public health. He has had a distinguished 35-year career during which he has held senior positions including director of the National STI/HIV Control Program of the Zambian Ministry of Health and Lecturer at the University of Zambia; Associate Professor at the Uniformed Services University of the Health Sciences, Bethesda (USA); Professor at the University of Texas-Houston (USA); Technical Advisor to NACO (Ministry of Health, Government of India); and Director, ARCON (1993-2003). For most of his career he has been involved with HIV/AIDS, tuberculosis, and other infectious diseases and has several firsts to his credit. Currently, he is a health expert on the Vision India Committee, designing the future of the health sector in India under the aegis of Niti Aayog, New Delhi.
This healthcare industry article is adapted from the November 4, 2020, GLG teleconference “Diagnosis of the Indian Healthcare System.” If you would like access to this teleconference or would like to speak with Indian healthcare industry expert Subhash Hira, or any of our more than 700,000 industry experts, contact us.
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