Combating COVID-19 by getting public health right

I have been a proponent of defeating COVID-19 by evidence based public health strategies. Much of this boils down to creating task force that is medically driven and not politically driven as they drive decisions around the table. Among this, it is further important and necessary that a task force is public health driven and not driven by other disciplines of medicine.

You can’t get an electronic engineer to design and bring up a building! right? Healthcare is also like that. Medical science has number of branches and pandemics must be handled only by community medicine doctors and public health professionals. Others such as an infectious disease expert, a microbiologist and virologist may add on. Anyone else interfering to design strategies for India’s fight against COVID-19 is like getting a football referee to umpire a cricket match.

India must urgently undertake the following measures:

Create task force that have competence and integrity

Building task force with competence and sharpness constructed on sound field knowledge in disaster and public health, managerial skill sets and research acumen remains necessary to guide the journey ahead.

The challenge of COVID-19 is not an opportunity of a lifetime, it is the most sincere struggle of our age. Families broken, children orphaned, jobs lost and utter devastation that will possibly never heal in our lifetime. How we handle this, what we prioritized and why we did, what we did will be the question that we may need to answer now and for the times to come.

So, build a task force championed by community medicine doctors and public health professionals with microbiologist, virologist and infectious disease expert. Dissolve existing cosmetic ones.

Vaccinate Tier I and Tier II cities before October

Complete the vaccination drives for adults from age group of 18-70 before October across Tier I and II cities. This will significantly leapfrog our battle towards our goal in fighting COVID-19.

Run mobile healthcare vehicles to treat mild and moderate COVID-19 patients

 Run mobile healthcare vehicles to treat mild and moderate covid-19 patients and use the human resource of nurses, nursing aides and medical students who could be on the vehicle in teleconsultation with doctors to guide as appropriate. This will decrease hospital case load and also ensure optimal monitoring.

Run several mobile vans in every taluk of India and focus on taluks with high positivity rate. Run this with organizations and hospitals competent in public health, not with others who may see opportunity in the process.

Add ICU beds to Tier II and tier III cities

Add and empower district hospitals and taluk hospitals having ICU set ups and increase the bed number to handle surge in cases. So a 20 bedded ICU can be made into a 30 bedded ICU. This will increase capacity to a great extent.

Hon’ble Courts of India must interfere where necessary

Hon’ble Courts must interfere when it senses non-public health approach to COVID-19 and must spare no Government or official for the same. The callousness and distress the country faces today is a direct outcome of unscientific and emotionally driven approach to public health.

Un-used international aid

Number of media agencies have been reporting of unused aid and that must be re-distributed to areas where such can be put to optimal use. While we gratefully acknowledge and respect global solidarity for a humanitarian crisis of our lifetime, it must also be put to use for our civilians when needed the most.

Plug bottlenecks & communicate effectively

Too many orders, too little implementation marks the story of India’s bureaucracy. This can be turned around by improving communication, looking outside of national and state capitals and going to the ground.

Stop the lockdown harassment

Don’t lockdown just because it is an easy solution. The coronavirus has taught human kind that we can’t even deal with a virus, so let us be modest and not hide our failures by locking down. Rather engage in masking vigilance and not encouraging huge gatherings irrespective of location, nature and culture. Saving lives and re-booting livelihood is more important that optics.

Convert cricket and football stadiums into makeshift hospitals

Identify cricket and football stadium in every district and convert it into a makeshift hospital till COVID exists which will successfully ensure public don’t panic, surplus beds can be made available and supply chain can be prevented from collapsing.

At the end

This will in broad-stroke guide India’s trajectory in a decent manner and we may be able to survive the on-slaught of the 3rd wave if sincerely adapted to. Coming generations will then be grateful, because we acted and the youth of India will re-kindle the faith in our systems, that now stands shaken. For the sake of all, we must deliver.

About the Author: 

CHD - Dr Edmond Fernandes

Dr. Edmond Fernandes

Dr. Edmond Fernandes is the CEO, CHD Group, India Country Office & Senior Fellow – Atlantic Council, Washington DC. Views expressed in personal capacity.

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