COVID-19: did we prepare for another storm while dust was settling? A tale from world’s largest democracy

This article was exclusively written for The European Sting by Ms. Aakriti Chopra, a student of MBBS 3rd year, studying at Medical College Baroda, Gujarat, Indiaf Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Emerging pandemic demonstrate that humans are not bullet proof and communities need to be equipped. Situation exposes how weak and hollow our health care system is? India is gasping for air once again, paying the price for keeping health care low on priority, lack of fore vision & public awareness.

 In the Healthcare Access and Quality Index released by the medical journal Lancet in 2018, India ranked 145th out of the 195 countries in terms of quality and accessibility to healthcare, India spends only 1.8% to its GDP on healthcare.

When pandemic stuck in 2020 the government exhibited strong determination and planning to curb the spread of Covid. Measures like strict lockdowns, curfews, declaration of containment zones etc were implemented. However, as they say, one must not waste a crisis.  Indian Government announced many reforms in 2020 like 4 new institutes of virology, PMJAY- Health insurance to cover large population, critical care blocks, mobile hospitals, 17 K rural and 11 K urban public health care centers etc. But the massive spread of the disease and the population size of the country undervalued all the reforms. We turned complacent when we shouldn’t have. In mid-February there were only approx 10K new cases/ day & by third week of April it is > 3 lacs/day.

Our government didn’t learn from earlier experience of serious situations like a mass migration of laborers as well as mass gatherings like Nizamuddin Markaz event. Now, Maha Kumbh, election rallies and mass departure of the migrant laborers is the echo of the recent past events. Due to the lowering of Government curbs, many people started believing that Covid is over. The attitude of the leadership added further to `vaccine hesitancy’. So, many have not come forward to get vaccinated.

A little attempt had been made to identify the asymptomatic and mild cases. Scientists have flagged the surfacing of a double mutant strain in India. Therefore, the first lesson which India could have learnt was to step up genome testing rapidly but since the disease was declining it fooled us into complacency. We were required to not only continue testing and tracing but also to increase our facilities for it. This period should have been utilized for producing a large supply of PPE for the safety of health care workers and also for increasing the number of ventilators etc for the period of outbreak. Since July 2020 it was known that vaccination would be required on a gigantic level. To get to herd immunity in one year, 60% would have to be vaccinated i.e. around 150 million a month. Production of vaccines at this rate and dealing with vaccine hesitancy through better public awareness was essential. However, the policy makers shifted their priority to recovery of economy and now at this stage we cannot predict when we will reach the peak and when the number of cases will start to decline.

Strict lock down, contact tracing and micro containment zones seem to be the only way to immediately break the chain of the spread. Vaccination target should be achieved to curb the disease in future. Country should hit its objective of 2.5% spend on health care to its GDP by 2025.  

References

1. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS assessed on 24 April, 2021
2. https://www.who.int/health-topics/coronavirus#tab=tab_1 assessed on 24 April, 2021
3. About the author
4. This article is written for the European Sting magazine by Aakriti, a student of MBBS 3rd year, studying at Medical College Baroda, Gujarat, India. Besides her medical studies, she has been an official member of MSAI since 2019.She considers MSAI as an opportunity to nourish herself. She dreams of such a world, where no one will be deprived of primary health care; doctor and patient relationships will be more reliable and genuine treatment progress would be accelerated.