India is fighting warfare to combat the second wave of the COVID-19 pandemic. The healthcare system in India is very close to a difficult or dangerous situation, with many hospitals unable to handle the persistent arrival of patients at the same time also running short of beds, oxygen cylinders and other essentials, and now the dearth of vaccine as well. If there had been enough beds, oxygen supplies, ventilator and other essential resources, if healthcare system had been better prepared for the second wave, many lives could have been saved. It's not a second wave - it's a tsunami that is happening.

The healthcare professionals in India includes largely eight categories, namely: doctors (allopathic, alternative medicine); nursing and midwifery professionals; public health professionals (medical, non-medical); pharmacists; dentists; paramedical workers (allied health professionals); grass-root workers (frontline workers); and support staff.

As we are preparing to equip ourselves with more ICU beds, ventilators, oxygen supply etc., the direction in which we also need to focus is the shortage of skilled personnel i.e, doctors, nurses and other paramedical staff. To get the human resources to run the new infrastructure is the bigger challenge. We cannot create human resources overnight. This shortage of healthcare professionals is severely affecting the response to COVID -19.

According to World Health Organisation (WHO), India was suffering from the shortage of healthcare professionals even before the pandemic, The nurse to patient ratio for India is only 1:483, i.e. 2.1 nurses per 1000 population.  This workers statistic indicates that the country is in a “critical shortage of healthcare providers” category. India faces the problem of acute shortages and unbalanced dispersals of skilled healthcare workers as have many other low- and middle-income countries. Not only is there a shortage of health professionals, but these workers are also determined in urban areas, sending-off rural areas with a lack of quality care.

India needs to resolve this life threatening challenge with a prominent approach. Strategies like appointment of private sector health workers and associated health professionals when necessary or needed in emergency care after obligatory training can be beneficial. Health workers more than 60 years of age and those having co-morbidities must be kept away from hospital premises, due to their higher vulnerability to infection. They could be involved in tele-consultation, coordination, and administrative tasks from home or away from the covid care unit in the hospital. Hiring of retired doctors and other staff can also be done to take care of administrative work.

Government and private hospitals are finding it problematic to employee new and additional healthcare workers to care for Covid-19, may be due to reduction in salaries, late payments and also fear of infection are deterring qualified professionals from applying for vacancies. Hence these issues should also be addressed and should to be provided with incentives and word of appreciation to motivate them.

Nurses who have finished their training but are yet to take their final exams. These trained nurses should be deployed to work in COVID ICUs, Similarly, the young medical student waiting for exam should also serve in COVID care units. While relinquishing these nurses and doctors the focus should be on government hospitals in urban as well as rural areas.

Doctors and nurses should work in shifts and take proper rest so that there are less chances of getting infected and level of mental and physical fatigue can also decline

More emphasis should be given on short term courses related to paramedical field and allied areas as well and promoting them broadly, so that there should have more skilled and qualified professionals assisting the doctors in intensive care units.