Oxygen supply, hospital beds and guidance manuals are among measures India states are boosting in preparations for a possible third wave of COVID-19.

The Indian government is taking steps to ensure there is no more crisis of medical oxygen in the country like in the second wave. One such step includes "Project O2 for India", a National Consortium for Oxygen enabling the national level supply of critical raw materials, setting up small oxygen plants, manufacturing compressors, concentrators and ventilators.

India's daily cases dropped to 58,419 cases, on Sunday, the first time below the 60,000 level after 81 days of a hike, according to the federal health ministry.

In Uttar Pradesh, India's most populous state with 240 million people, the state government has begun intensive surveillance in the rural areas, equipping the health centers with all necessary medical facilities, increasing the COVID beds and medical staff and setting up oxygen plants in every hospital. Each bed will have oxygen and other necessary medical facilities, the government has announced. A total of 97,000 medical teams are already visiting door-to-door to screen the people.    

UP's Additional Chief Secretary Navneet Sehgel said a total of 427 oxygen plants are being set up across the state to ensure a continuous supply of oxygen in hospitals. 

A UP minister and government spokesperson Siddharth Nath Singh said 100-bed paediatric intensive care units are being set up in each of the state's 75 districts to tackle the third wave. "The state government has already allocated over $950 million under various health projects to improve health infrastructure," the minister said. The state government has also appointed a committee of medical experts to advise the government.

UP health secretary Amit Mohan said the government was preparing special medicine kits for children with syrups and chewable tablets and these are being sent to the warehouses in the districts to be distributed during the third wave.  

In Bihar state, the government has initiated a variety of measures to contain the potential third wave, including strengthening the health infrastructure and covering as much of the population as possible under its vaccination drive. Among these efforts, Bihar is trying to increase the total number of beds to 40,000 in government hospitals and provide oxygen supplies for every bed, and is also in the process of recruiting 30,000 more doctors, nurses and other paramedical staff to attend to patients.

"We are setting up cryogenic oxygen tanks at all hospitals to ensure availability of oxygen round the clock, installing oxygen generation plants in all 10 government medical colleges and hospitals and also arranging for pressure swing adsorption generators. Also, we are connecting every bed with an oxygen pipeline," Bihar Health Minister Mangal Pandey said, adding that they are going on a war footing.

The health minister said the government is growing more concerned about the safety of children, for which they are making all arrangements. "We are setting up special wards for children with necessary facilities such as ICU, ventilators and beds in all hospitals and have already placed orders for purchasing all essential equipment and medicines," the minister said.

Moreover, bi-level positive air pressure machines for children are being installed at all pediatric and neonatal intensive care units as well as special newborn care units. Special mother and child hospitals are also being set up in 20 of the state's 38 districts.

Other states across the country are also bolstering pandemic defenses. Jharkhand, with 31.9 million people, is the first state in India to formally prepare a manual of operation guidelines with the help of 14 clinical experts and health department officials to deal with the possible third wave.

"We have the first detailed document prepared by any state in India based on suggestions by eminent doctors and health experts," said Doctor Shantanu Agrahari, Empowered Committee chairman and Jharkhand's nodal officer for COVID-19 management. He said the document would be used for conventional preventive and treatment strategies to increase immunity against COVID-19. Several other Indian states such as Maharashtra, Madhya Pradesh and Rajasthan are also working on similar strategies.   

Most of the Indian states are focusing on giving protective covers to the children although the Indian government says there is no data to show children will be seriously infected in the subsequent COVID-19 waves.

"It's a piece of misinformation that subsequent waves of COVID-19 pandemic are going to cause severe illness in children. There is no data – either from India or globally— to show that children will be seriously infected in subsequent waves," said the director All India Institute of Medical Sciences, New Delhi, Doctor Randeep Guleria said. 

The Indian government is also working on the plan to quickly ramp up health infrastructure by constructing 50 100-bedded modular hospitals across the country in the next 90 days. These hospitals will be built adjacent to the existing hospital buildings.  

Rural India receives care for multi-level health infrastructure. The government now plans to transform 150,000 sub-health centers and primary health centers into well-equipped health and wellness centers, according to a report from the Ministry of Health and Family Welfare.

The writer is a freelance journalist for China Daily.