Covid response should be driven by data

The rapidity and scale of the spread of the second wave of the Covid-19 pandemic has caught India by surprise. It has overwhelmed the nation’s overstretched health infrastructure. The hospitals are overflowing with patients, with many more struggling to get admission. Health facilities such as medical oxygen and medicines are running out of supply. Patients are dying in large numbers and the suffering — physical and mental — inflicted on families and society at large is beyond words.

How did we get to this situation? Multiple factors are responsible for the current wave. One is the emergence of new strains of the virus, which are at least 50 per cent more transmissible and could, at times, be more deadly than the virus seen in 2020. Besides those originating overseas, we have some homegrown ones, all of which are of great concern.

Moreover, many of us, over time, have developed a sense of complacency and pandemic fatigue. People are no longer following the basic Covid-prevention protocols such as mask-wearing, social distancing and hand hygiene. We have had many social functions, festivals, and sporting events, all of which created an environment conducive for the virus to spread more quickly and widely.

Young people seem to suffer from the delusion that ‘it cannot happen to me’ and do not follow the appropriate behaviour, thereby putting the elderly at home at risk. Mass gatherings during the Kumbh Mela and electioneering in four states and a UT have not helped matters at all.

Also, we did not learn from Europe and the US that were battered by various waves of the pandemic. We did not utilise the relative period of lull before the second wave hit us to strengthen our pandemic-preparedness and response capacities, including the ramping up of health facilities and supplies such as oxygen that could save lives. Precious time was lost due to administrative apathy and lack of accountability.

So, how do we now tame this wave? First, to face this public health emergency, we need to work in solidarity and with mutual support. The immediate priority is to create makeshift hospitals by building new structures or turning the existing ones such as schools, banquet halls, hotels etc into hospitals or care centres to cater to the huge surge in cases. At the same time, make all-out efforts to procure enough supplies of hospital beds, oxygen, PPEs, medicines, and ventilators. All this must be done in a war footing.

We also need enough caregivers such as doctors, nurses, paramedical workers, etc. At present, there are not enough of them available and hence we need to find innovative solutions. The governments must not only fill the vacant posts of doctor and nurse without delay but also urgently enroll for Covid hospital duty the final-year MBBS or nursing students who are doing internship or are about to enter it.

Doctors in private practice and those retired from government service and have received the two doses of vaccine can be roped in to work in Covid hospitals to tide over the crisis, with training and generous incentives.

The second priority is to scale up the vaccination drive. Presently, we have vaccinated only 2 per cent of our population. Comparatively, with 40 per cent people in the United States vaccinated, the numbers of deaths and hospitalisations there have diminished remarkably.

We must do everything possible to prevent or reduce deaths from Covid-19 and save lives. Given that the elderly and those having chronic non-communicable diseases, referred to as comorbidities, are most at risk for severe disease and mortality, attention is needed to protect this vulnerable group.

Thirdly, we must remind ourselves that ‘prevention is better than cure’. We need to focus on behavioural change, communication, trust-building and community engagement. A societal approach is the bedrock of Covid prevention. The people of India must not fail in their social responsibility and follow Covid-appropriate behaviour: by using masks, maintaining physical distancing, frequently washing hands and avoiding crowded areas, including social gatherings.

Finally, all those eligible must get themselves vaccinated. Community-based organisations must help bring about behaviour change in the community with inter-personal approach.

Fourthly, the pandemic response should be driven by science and data. The government must bring in more transparency by sharing real-time epidemiological and genome-sequencing data and place it in the public domain. It must embrace modern technology such as big data management, artificial intelligence and communication and information technology for good impact. International collaboration and coordination in science and technology can help in the rapid sharing of disease data and scientific progress, ensuring development and equitable access to new diagnostics, treatment and vaccines.

In the intermediate-to-long term, the government must invest more in the public health system, the central and fundamental building block of which is the public health workforce, in particular epidemiology and laboratory services. This can help us build public health surveillance that is sensitive enough to detect an outbreak early on and initiate a response rapidly so that firefighting comes into play locally before it turns into a wildfire.

The strategy of ‘test, trace and isolate’ is critical for this purpose, especially at the district and primary healthcare levels.

Finally, all sectors, be it government, private, civil society, academia, media and the community, must face this national crisis together and in a coordinated manner. As a resilient society, we have faced crises before and together we can overcome this one too.