Fever, flu and family physicians during COVID 19 pandemic 2020 in India

Fevers - undifferentiated, often unacknowledged, is one of the largest morbidity afflicting in primary care settings and the overall healthcare ecosystem in India. FEVER is probably also the largest public health entity in terms of DALY - (Disability Adjusted Life Years) impacting the working population both in urban as well as rural areas; however, it remains unaddressed by public health programs, which are largely organized through vertical disease-focused national programs. The family physicians see a high volume of undifferentiated fevers throughout the year with seasonal and regional variations in India. Family doctors are not formally linked with the public health programs as India continues to march on selective primary care. Family physicians and medical officers are the most vulnerable for exposure to undifferentiated patient load. The first two health workers who died of COVID 19 in India (Indore) were practicing family physicians. Two mohalla clinic doctors tested positive in Delhi and two other general practitioners have been found to be infected in Mumbai. The media discussions have been on increasing capacity for critical care and the number of ventilators etc., It is also important for the governments to urgently review the functionality of PHCs, CHCs and district hospitals, and create a framework of partnership with standalone family physicians and general practitioners as well as nursing home, small hospitals to play a constructive role in managing the epidemic.