The Path To Recovery From Covid

The present pandemic fueled by a highly infective strain of the Covid-19 virus is probably one of the worst pandemics in the history of India. Despite the fact that this wave only receded after killing and maiming thousands of people worldwide, particularly in western nations, India successfully navigated through the first wave with little or no scars. Other than human loss, this pandemic also jeopardized and collapsed the entire health system and economy, even in highly advanced countries of Europe and America. As the pandemic continues to wreak havoc in India, the government is making efforts to diminish sufferings and human casualty, though with limited success given the enormity of the challenge. 

Knowledge 

The new strain presently haunting India, christened as 1.617 B, was first seen in October last year. The trouble evidently was brewing for the past few months. This entity has produced a more severe form of the disease than its predecessor. The incubation period of the disease is visibly shorter. Worse still, the pathological damage to internal organs, mainly the lung, is more devastating and quicker. 

Challenges  

Pandemics challenge any health system. To a limited extent, this was evident during the first wave in the US, particularly in New York. The hospitals were full, and people were being treated in makeshift camps.

Even in countries with mature and developed healthcare systems like Spain was buckled and broken, resulting in hundreds of deaths and devastation.

Acute shortages of physicians, hospital beds, personal protective equipment, and all the paraphernalia required to manage this diabolical disease were in evidence resulting in hundreds if not thousands of deaths.

Even after seventy years of independence, India has failed miserably to set up a health system that could effectively sail through such a pandemic. Most political parties in India that formed the ruling dispensation for the last seventy years are responsible. Even though the current government, which got voted only six years ago, cannot be blamed for the past, its inept handling of the pandemic cannot be overlooked.

Threats 

While the western countries were initially failed by the politicians who delayed lockdowns, India did a commendable job. But, India’s lockdown could not keep it safe forever. Whether the political system failed to show reverence to the health experts who handled India's covid plans or was it the lack of experience of these "health experts" to appropriately warn the government, needs a more detailed evaluation to be delineated.

According to Johns Hopkins University, as of May 10, 2021, more than 32.7 million Covid-19 cases and more than 581,000 deaths have been reported, in the US.

As per data provided by the American Academy of Pediatrics, 3.78 million children have contracted Covid and 303 have died globally in the past year. Despite such overwhelming evidence that Covid is less harmful to kids, it is intriguing that many of the experts, including some newly recruited advisors to the government of India on Covid, are pediatricians with little or no experience of adult physiology, much fewer pandemics.

Mandates

The present pandemic necessitates immediate lockdown. It is, however, mandated that it be less rigorous than last year’s. This should include round-the-clock availability of open drug stores in every neighborhood and grocery stores to enable regular availability of life essentials.

While decreasing office attendance is important, physicians and health workers need immunity to report to work. It is now quite evident from examples across the world that lockdowns pose risk to the economy, however, popular narrative of "no lockdown" propagated by ignorant and feigned experts is dangerous and damaging. Most epidemiologists and clinical infective disease experts with experience and knowledge of epidemics like Tony Fauci favour lockdowns to enable a systemic decline in the raging pandemic. It must certainly be done with a humane approach to lessen the ordinary person's suffering to the minimum. There is enough proof to establish that lockdowns help in lowering the number of infections.

The other immediate prerequisite for the government is to revamp its policy to ensure that there are enough health workers to deal with the situation and not a few are not overburdened beyond their capacities. The number of doctors and nurses who have lost their lives has also been staggering and it needs urgent action to ensure their safety to enable the country to navigate this health crisis successfully.

The time is now to use physicians with degrees in Homeopathy, Ayurveda and train them with a four-week training program on covid treatment with a restricted practice envelope. This will ensure that non-urgent, non-emergency, and non-ICU hospital care can continue smoothly, particularly in far-flung areas. Their service can also be used in a restricted fashion as appropriate in hospitals to tide over acute health worker shortages if needed. While given the nature of their training, they certainly cannot replace appropriately trained allopathic physicians but certainly provide help to the nation with their service in these trying times. This would mainly alleviate the exhaustion of doctors to an extent and leverage the presence of hundreds of other health care workers not trained in modern medicine. 

Harness competency and skills 

India is a large country with highly trained physicians in all specialties. Thus, it is of utmost importance that we harness this band of highly trained individuals with competency and skills and not limit ourselves to just "eminent physicians" who unfortunately are unskilled to deal with a pandemic.

Even in the past, many physicians less eminent but skilled in infective diseases, social medicine, and epidemiology have complained about the lack of attention to their advice. This perception, whether this is true or false, needs to be amended. These are the real experts acquainted with ground realities, not media-painted celebrities.

In my opinion, the restriction of vaccine manufacturing to two companies is a mistake. Based on the model in the US, the Indian government should now at least broaden the vaccine manufacturing base to include other players. This will enable a more robust supply system where the market will be served by the competitive eagerness of private players, as evidenced in the US. The only hope to quell the present pandemic and prevent a third one is rapid vaccination of the masses of all age groups.

Conclusion 

Despite the praiseworthy handling of the first Covid wave, India is facing a much more dangerous second wave. The blame game, as is apparent in India's political circle, should not be the call of the day. The nature of this virus is unknown, and even the most advanced countries have fallen prey. It is now time to bring collective consciousness together to fight this epidemic at the federal and state levels. India has the resilience to fight this successfully and it will.

(The author is a Cardiac Electrophysiologist and A Professor of Cardiology and Public Health. He is based in Memphis, TN, USA. Views expressed are personal.)