Avoid complacency, be ready for third wave

The Covid-19 second wave has caused an unprecedented health, economic and societal impact in our living memory. It has also exposed the weaknesses in our health system and in our ability to mount an effective response to a public health emergency of this magnitude.

While many countries of Europe and the United States had already experienced the pandemic in various waves, sadly we did not learn from these countries and tended to celebrate victory prematurely, much before the battle was actually won. As a result, the country was caught off guard and unprepared to respond adequately when the second wave suddenly hit us and many lives were lost and families tragically devastated by the rampaging virus.

Now, there is already a talk of the third wave while we are still grappling with bringing the second wave under full control. The latest trends, however, bring hope as the number of new cases and deaths show a steady, though slow, decline.

As we begin the process of unlocking, there should not be any room for laxity in the practices of Covid-appropriate behaviour and urgently getting vaccinated. The process of unlocking should occur in a systematic and graded manner. Social, religious and election gatherings, including melas and marriages, must continue to be restricted. By preventing such superspreader events, we can hope to break the chain of transmission and end the pandemic sooner than later.

There should not be any hurry to dismantle the physical infrastructure, such as makeshift hospitals created during the second wave. Instead, we should use the lull period to continuously ramp up the surge capacity in terms of hospital beds, oxygen supply, PPE kits and life-saving medicines.

Even as the threat of the third wave is real, what is also clear is that its severity or potential impact will entirely depend on what we as a nation and its citizens do now. Do we use the opportunity to learn from the previous waves and strictly adhere to Covid-preventive measures as advocated by the government? Will the governments at the Central and state levels appropriately strengthen the health capacity in terms of health workforce, essential supplies, such as hospital beds and oxygen supply, and vigorously pursue the system of test, track and isolate cases?

Or, do we decide to go the way we did before the second wave, and take it as it comes, to our own peril? So, what are the lessons that we can use now?

First, that the situation is highly dynamic and, therefore, complacency by the government as well as the people at large must be avoided at all costs. As we have to live with this virus for the foreseeable future, it becomes necessary that we continue to practice preventive measures, such as wearing of masks consistently and correctly, and swiftly getting the vaccine to all eligible people, especially those most vulnerable to severe disease.

These measures, along with physical distancing and frequent washing of hands with soap that do not cost much, can save us from illness and our loved ones from untold mental and psychological trauma that accompany the Covid-19 infection.

Prevention remains the bedrock of our response to Covid. In this regard, the government’s responsibility is to devise and implement a comprehensive and evidence-based communication strategy designed at individual behavioural change; and ramp up vaccination production and distribution on a war footing.

Experience shows that behavioural change is possible only through inter-personal communication imparted by someone belonging to the community or one trusted by the community. The social media being a double-edged sword, measures are required to ensure it is used in a positive manner and particularly to counter disinformation.

In addition, we need to continuously monitor the behaviour of the virus to detect new mutations through the gene-sequencing surveillance system. The current network of 10 labs under the Indian SARS-CoV-2 Genomics Consortium (INSACOG), established to ramp up the process of sequencing across the country, should be expanded by enrolling other labs so as to cover enough samples required for this purpose.

One of the key elements of preparedness is our ability to anticipate. Like it is said, ‘prepare for the worst and hope for the best’. Over-preparation is certainly better than under-preparation.

The epidemiological and gene-sequencing data as credible tools for our preparedness should be disseminated widely and made available to all — to the Central, state and local health staff, scientific community as well as civil society and interested individuals — for use in enhancing their own preparedness. States and districts should have the freedom to not only collect and collate but also analyse data for public health action. Surveillance, after all, simply means ‘information for action’.

Keeping a close eye on the evolving epidemiological situation by analysing real-time surveillance data and positivity rates can provide early warning signals. For example, regarding the occurrence of focal outbreaks, they need to be investigated promptly and managed with appropriate containment measures in order to prevent further spread of the disease beyond the local area.

The Covid-19 pandemic has made one thing amply clear: that health needs to be accorded a top priority by the government and all individuals. This means the strengthening of the country’s health system by enhancing the human resources, finances, the health information system and the governance system.

Since big cities largely bore the brunt in the first two waves, there is every possibility that the next wave, if it comes, may disproportionately affect the small towns and villages. Hence, health facilities such as primary health centres, community health centres and district hospitals must be urgently upgraded with adequate numbers of doctors, nurses and other essential equipment and facilities.

Finally, experts, for years, have been warning of an impending pandemic as new infections continue to emerge. Hence, preparedness of the highest order is imperative at all times if we are to avert or respond effectively to such an eventuality.