COVID times are here to stay. The first wave was scary and everyone observed lockdown protocols and also expressed solidarity as one nation on an evening, clapping and clanging, as a sweeping national fervour was generated. The COVID-19 numbers built slowly but steadily in India as opposed to global pandemic statistics, but the end state analysis point to lives and livelihoods being widely affected.
The roadshows of migrant labour walking endless miles were heart-rending. However, a fairly professional response, as a nation, was on display in managing the onslaught, both by the Centre and the State. The world appreciated India’s matured handling and well-calibrated response. A nation of 138 crores demonstrated a resolve to combat the COVID pandemic and gave the world a model of unity worth emulating.
The vaccine phase had a mixed response. The predicament was that no vaccine in history has achieved decisive results in the short span of a year or so – hence, how can we be so confident about a vaccine for COVID-19. The negative fallouts of certain vaccines created apprehensions on one hand, while the variety of vaccines available, created a decision dilemma on the other. The senior citizen vaccination drive, followed by a 45 plus drive with effect from 1 April and now the 18 plus drive with effect from 1 May is a mammoth exercise. The vaccine is an important milestone of the present-day personal health package and must form part of a volunteer ‘TO DO’ list of every citizen. It would be more rational if the vaccination drive can be funded for low-income groups through Government schemes and paid for by higher-income groups.
The second wave has now engulfed the nation like a tsunami. The spike in COVID-19 cases is the biggest challenge for India. A full-grown coronavirus second wave has reached the contours of a national emergency. The reasons for the spread include complacency and inability to predict. Concurrently, there is a shortage of bed space in hospitals and shortages in life-saving medicines has resulted in a parallel black market. Certain issues merit consideration.
- Availability of beds in COVID hospitals, oxygen cylinders and concentrators, ventilators, nebulizers and related assets required are stretched to their seams; exacerbated by unserviceability or lack of maintenance. Medicines and injections are being sold at exorbitant prices. There is a need for a centralised information system/ Apps like Aarogya Setu to coordinate resources and ensure serious cases are given priority.
- By the time a 1000-bed DRDO hospital was breaking news, the number of ambulances that were lined up at the gates of the facility out-numbered the number of beds actually available. And, this is true for all such ad hoc facilities that are coming up. There is a need for a major exercise on COVID asset management to include hospital and nursing homes, ventilators, oxygen cylinders/concentrators and allied COVID hardware and a system to ensure continuous monitoring.
There is a need to take control at the Centre and formulate structures and policies to not only contain and manage the ongoing COVID wave 2 but also have a design ready to combat likely future waves. The following are some issues requiring focus for ‘Mission Covid Samadhan’.
- A National COVID Response Group with the Ministry of Health and Family Welfare or HRD, as a lead, comprising professionals, doctors, hospital administrators, asset management/ MRO / supply chain experts and other SMEs, both serving and veterans need to be brought on board to prepare a long term strategy for combatting the COVID pandemic.
- A pandemic action plan would comprise a nation-wide infrastructure appraisal for emergency response, hospitalization and critical care surge creation of capacities and capabilities, training of paramedics, essential services – ambulance, hospital and home care, COVID tests, handling mortal remains etc.
- A strategy for R&D on coronavirus and its variants, mitigation strategy including vaccination drive, protocols and policy document on lockdowns and essential services management is also required.
- COVID-19 standards and protocols for medical care units and hospitals need to be defined by Indian Medical Association and strictly enforced. A number of COVID care facilities have been observed to be grossly inadequate.
- COVID Co-ord Centre with integrated information and decision support system based on data analytics of all critical COVID assets, action plans and control mechanisms need to be institutionalized. In an era of digital transformation, these software-based information systems are an easy fix for effective and efficient response.
- The veracity of information in an era of information overload is important. The integrity of information from trusted sources must be ensured. Whether it is hospital bed state, availability of oxygen cylinders, nebulizers or ventilators, information capture must be authentic. Information input agencies must be accountable for their inputs. Media management on COVID also needs formal consideration.
- The medical necessities for COVID must be centrally controlled through Government-e-Market (GeM). All authorized sources of supply must be verified and registered so that the common man/ woman can go to the GeM for their medical necessities. Zinc based and other multi-vitamins and many other COVID medical essentials went out of stock but were available through unauthorized sources of supply at exorbitant rates.
- CSR funds of corporates must from a major financial enabler in 2021 and all-out focus must be on this mega challenge. In any case, Covid Samadhan must be a major program for some years till adequate infrastructure is created.
The time has come to act based on our learnings today, to manage the second and possible next waves effectively, as also evolve a vision and a long term strategy for tomorrow.
It may also be important to consider a strange hypothesis that comes to my mind. The fact is, the COVID-19 virus is mutating into variants. An artificial virus, in case COVID is one, has gone into mutations. Should COVID-19 be a laboratory-created virus, it could be akin to computer viruses. All those who use IT devices know that a large number of anti-virus vaccines have proliferated over the past two decades while the mutations of computer viruses are an unending journey. The moot questions are – Is there a correlation between COVID and a TROJAN. What COVID is to man is what Trojan is to computers? Will the present set of vaccines ‘in use’ be a panacea to mutations of COVID-19 or will humans keep embarking on a continuous ‘vax journey’? These questions are best left to professional doctors and scientists to unravel.
Lt Gen Anil Kapoor (Retd)
(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of BharatShakti.in)