Dr Apurva Jain, MPH candidate at the Tata Institute of Social Sciences, Mumbai speaks about the lessons learnt from the COVID 19 pandemic
Five months since our first case was detected, the biggest disaster has already given us opportunities to learn the new and reflect on the old. It has exposed our ignored public health system and overwhelmed medical health system in a way like never before. This can no more be ignored.
Public health lessons
The pandemic has falsified all previous beliefs and proved that such novel infections do not differentiate between the notions and concepts of a developing or a developed nation, the rich or the poor, the white or the black or the male and the female, but respect only evidence-driven strategies, strong leadership and community participation.
A basic emergency response strategy has to be in place which will enable us to respond to a future epidemic at the earliest without wasting precious time. Once the pandemic has struck, a good surveillance system, risk communication, contact tracing and disease testing would aid in mitigating and containing the virus by identification of suspected, probable and confirmed cases, followed by their isolation from the healthy community and their treatment.
Besides while designing strategies, intersectoral coordination is crucial. International policies and best practices need to be tailored for local context, rather than directly replicated. Strategies need to be dynamic, changing constantly with newer evidence and changing situations.
Medical System Learnings
The skewed doctor to patient, bed to population ratios and the unequal distribution of the resources and infrastructure throughout the country have yet again proved to be a matter of concern. Measures to overcome these issues on a temporary and urgent basis are been tested on a large scale. Such measures include roping in more healthcare workers to prevent fatigue of manpower, bridging the gap between the traditional systems and allopathy system of medicine, adopting innovative ad-hoc arrangements.
A well-established triage system backed by clinical reasoning to strategies resource allocation can be adopted. Co-ordinated referral systems between rural and urban healthcare systems, adequate number of vehicles for the transport of patients and technology-driven modern solutions like telemedicine can be used for inaccessible and remote areas. Incidences of violence on healthcare workers, violation of social distancing norms, spreading of fake news which increased panic – are all matters of concerns which need to be addressed in real-time as the pandemic continues. There is reaffirmation on the importance of developing a strong immunity on an individual basis to prevent acquiring such infections in the first place.
Collaboration and convergence of the public and the private sector can help us overcome some of the issues arising as a result of a shortage of resources.
Lessons beyond health
The pandemic has shown us that national manufacturing of medical equipment like Personal Protective Equipment (PPE) and ventilators is possible at a lesser cost and time, provided there is strong political will.
The social crisis of migrants during the pandemic has been highlighted yet again in the form of the presence of stark inequity in society. Though every person goes through the same symptoms from the virus, they do not face the same impact from the pandemic – both, in terms of either ability to seek treatment or to bear the effects of the lockdown. Media reports have adequately exposed the helpless condition of the migrants. Exploring more relevant policies like ‘One nation, one ration card,’ which could support the migrants are solutions. The need to formalise the informal sector should now gain attention.
In addition, The Epidemic Act, 1897 was amended by an ordinance in late April 2020 in an attempt to curb the violent attack on health workers. The reliance on this 123-year old colonial law in itself throws light on the lack of emphasis on health in India.
The pandemic has popularised the ‘Work from Home’ culture. Companies such as TCS, HCL and Facebook now plan to allow a majority of their employees to Work from Home.
The way forward
Pandemics are novel and hence their treatments are undiscovered; however, community ownership, evidence, and data-driven decision making and investment in relevant health research can help us to a certain degree. The money on health and health from the money, have to be increased. The pandemic has thus proved to be a classic example of health having an influence on all spheres of life.