key: cord-0874298-9fq0004l
authors: Davey, Kevin; Blanchard, Janice; Douglass, Katherine; Verma, Ankur; Jaiswal, Sanjay; Sheikh, Wasil; Halder, Meghna; Palta, Kamal; Jena, Narendra N.; Poovathumparambil, Venugopalan; Nomani, Sajid; Gidwani, Shweta
title: Emergency medicine in India: Time for more than applause
date: 2021-03-25
journal: Acad Emerg Med
DOI: 10.1111/acem.14244
sha: b367704939c69e2d99c80d0c7c53bbde6a123f84
doc_id: 874298
cord_uid: 9fq0004l

As the COVID-19 pandemic continues to rage across the United States and Europe, attention has been diverted from the toll the virus is taking in India. India is currently home to the second largest COVID-19 outbreak in the world, with more than 10 million confirmed cases and over 150,000 confirmed deaths1 .

As the COVID-19 pandemic continues to rage across the United States and Europe, attention has been diverted from the toll the virus is taking in India. India is currently home to the second largest COVID-19 outbreak in the world, with more than 10 million confirmed cases and over 150,000 confirmed deaths. 1 Although officially reported numbers are down from a peak over the summer, many experts believe that the true number of coronavirus cases in India is much higher than reported. 2 Throughout the pandemic there has a great deal of focus on the role that emergency medicine (EM) providers have played in the fight against COVID-19, dutifully standing on the frontlines to provide compassionate care for patients while exposing themselves to a deadly virus. The frontline providers in India have shared in this sacrifice: more than 660 doctors in India have died while caring for patients with COVID-19. 3 Despite their sacrifices, many of these doctors are denied formal recognition as trained EM physicians by the Indian government. While news media has been flush with heroic tributes to frontline providers, India's emergency physicians need more than appreciation. In a demoralizing fight against an invisible enemy, what many of these doctors truly need is recognition--recognition by India's government as validated, sanctioned, wholly competent, and legal practitioners. Even before the pandemic, the need for emergency care in India was immense. Injury is the second most common cause of death in India after age 5, second only to ischemic heart disease. 9 It is estimated that in 2016, a total of 415 people died each day in India due to road traffic injuries. 10 While the arrival of several promising COIVD-19 vaccines gives reason for hope, quantities are limited and much of the existing supply has already been purchased by wealthier countries. This, combined with the emergence of more contagious and potentially more deadly variants, suggests that the state of the pandemic in India will likely worsen. Increasing EM training pathways in India must be a national priority. As precariously positioned and underresourced as the Indian emergency medical system may be at present, it would no doubt collapse entirely without the tireless work of these unrecognized doctors. In the early days of the pandemic, people across India cheered for health care workers as they remained away from their homes and families to stand guard and care for patients on the frontlines. The time is now to formally recognize their contribution with more than a just round of applause. Katherine Douglass https://orcid.org/0000-0003-4730-571X

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