Reject, Revive and Innovate: What The Coronavirus Pandemic Teaches Us
Definitive lessons gleaned from India’s fight against the pandemic
The COVID-19 pandemic has been fought by every citizen of India. While health and essential services workers are at the frontline, it is the adoption of non-pharmacological interventions of face masks, hand washing and physical distancing by people, which has equally contributed to halt the spread. In Dharavi, Mumbai, the approach of ‘Test, Trace and Isolate and Treat’ was only partially successful till the strategy was modified to ensure community participation. The pandemic has underscored that good health is only possible with active community participation. That is the first learning.
In the early phase of the pandemic, health facilities were overwhelmed in nearly all countries. However, Thailand and Vietnam are being touted as success stories. They used lessons from the 2002-04 SARS outbreak for an effective COVID-19 response. These countries increased and sustained their funding for health services and primary health care, as well as strengthened their public health services. The healthcare staff was trained in public health activities of community surveillance. On the contrary, countries which solely focused their attention on hospitals have struggled and are facing a second or third wave of the pandemic now. This is the second lesson: Countries with stronger primary health care and robust public health systems are more effective in tackling a pandemic.
A high level of political leadership at both union and state level, partnership between public and private sector for COVID-19 testing and treatment services, government and industry partnership for development of testing kits, manufacturing of PPEs and vaccine research have contributed to the fight against the pandemic. The initial shortage, and subsequent restoration, of sufficient PPE supply indicates that with coordinated efforts, it is possible to create a safer work environment for healthcare workers and ensure sufficient medical supplies. The pandemic has also demonstrated...
The COVID-19 pandemic has been fought by every citizen of India. While health and essential services workers are at the frontline, it is the adoption of non-pharmacological interventions of face masks, hand washing and physical distancing by people, which has equally contributed to halt the spread. In Dharavi, Mumbai, the approach of ‘Test, Trace and Isolate and Treat’ was only partially successful till the strategy was modified to ensure community participation. The pandemic has underscored that good health is only possible with active community participation. That is the first learning.
In the early phase of the pandemic, health facilities were overwhelmed in nearly all countries. However, Thailand and Vietnam are being touted as success stories. They used lessons from the 2002-04 SARS outbreak for an effective COVID-19 response. These countries increased and sustained their funding for health services and primary health care, as well as strengthened their public health services. The healthcare staff was trained in public health activities of community surveillance. On the contrary, countries which solely focused their attention on hospitals have struggled and are facing a second or third wave of the pandemic now. This is the second lesson: Countries with stronger primary health care and robust public health systems are more effective in tackling a pandemic.
A high level of political leadership at both union and state level, partnership between public and private sector for COVID-19 testing and treatment services, government and industry partnership for development of testing kits, manufacturing of PPEs and vaccine research have contributed to the fight against the pandemic. The initial shortage, and subsequent restoration, of sufficient PPE supply indicates that with coordinated efforts, it is possible to create a safer work environment for healthcare workers and ensure sufficient medical supplies. The pandemic has also demonstrated the need for positivity and correct information dissemination to fight stigma and discrimination. The seven P’s: Primary healthcare, Public health, People, Political leadership, Partnership, PPE and Positivity are all needed for effective health services—that is the third learning.
But, the real hope of fighting off the pandemic hinges upon scientific research. It is expected that with availability of vaccines (a by-product of scientific research), the pandemic would be over by late 2021. Science plays a pivotal role in keeping a population healthy. That is the fourth lesson.
The pandemic slowed down economic growth and several economies shrank. India’s growth witnessed the highest quarterly contractions in the last 24 years. The pandemic has once again proven that there is a strong interlink between health and the economy. Government investment in health services helps the economy as well. That is the fifth lesson.
At the start of the pandemic, the discussion on the need for strengthening health systems focused only on increasing hospitals, ICU beds and ventilators. Strengthening health systems is a much broader enterprise. Policy makers need a deeper understanding of what constitutes an effective health system, which is vital to make the Indian healthcare system ready for a strong pandemic response. That is the sixth lesson.
Health is a state subject and urban local bodies (ULBs) are responsible for public health in urban settings. Therefore, to improve health in India, increased funding, coordinated action and leadership is needed from all three agencies of union, state and ULBs. That is the seventh lesson.
COVID-19 has ensured that hand washing and respiratory hygiene have been adopted widely. A few studies have attributed the reduced incidence of flu cases this year to some of these behaviours. Hand-washing practice has the potential to reduce many infections and reduce deaths. Good respiratory hygiene can reduce the transmission of infectious diseases, such as tuberculosis in the general population.
Pre-existing health conditions have been identified as a major risk for contracting severe COVID-19. It reminds us to get regular treatment and take measures to reduce co-morbidities. Arguably, there was never a better incentive to stay healthy than now. Several countries, including India, have a high burden of non-communicable diseases such as diabetes and hypertension. These diseases can be prevented through proven preventive health interventions such as a healthy diet, exercise, no smoking and moderate or no alcohol consumption. If a healthy lifestyle is adopted in the same way in which people adopted COVID-appropriate behaviour, India can reduce the burden of non-communicable diseases as well.
Soon, there will be a few vaccines against COVID-19. It is time the value of vaccines for adults and high-risk groups is recognized. Vaccines are amongst the most powerful public health tools. They reduce hospitalization and save lives. We need to increase their use.
The SARS CoV-2 virus is still around. We need to continue to follow COVID-appropriate behaviours. At personal and societal level, we should use the challenge posed by COVID-19 to start afresh. The new normal should not be the old normal.
An approach of reject, revive and innovate can make the difference—reject harmful habits and practices, such as the destruction of the environment or an unhealthy lifestyle. Revive everything which is good for the individual and society. Innovate and find new solutions for old challenges. That is the potential this ‘pause’ created by the pandemic has for the planet, to transform for the better.
Dr Lahariya, MD, is a leading public policy and health systems experts. He is the lead co-author of Till We Win: India’s Fight Against the COVID-19 Pandemic, Penguin Random House India.