The pandemic and the contours of a health response- THE HINDU-15-04-2020
India is facing the worst public health crisis in its independent history which pales the earlier ones such as AIDS, SARS and H1N1 into insignificance.
Time to strategise:
While this has confined the pool of infected persons to their homes, the aftermath of the lockdown when they will start moving out will pose enormous challenges. Central and State Governments should plan to adopt a public health approach to address the situation and use days ahead to ready with the strategy and tools for rolling it out. We should realise that despite the best response, the epidemic will not be going away for all time to come. This will need a carefully planned public health approach which identifies the risks based on evidence and pro-actively intervenes to mitigate them.
They need to be immediately quarantined either in their homes or in community care centres identified by the State and district authorities.
Only the serious cases among them should be referred to hospitals for treatment. The intermediate step of quarantine will check a huge rush of patients even with minor symptoms to hospitals, choking health-care facilities and depriving the more serious and needy cases of emergency medical care.
Focus on counselling:
As the flood of patients starts increasing in hospitals, counselling services for patients and members of their families would be of utmost necessity. Until they show symptoms of COVID-19, they need to remain in isolation and at the same time look after their wards who are admitted in care centres and hospitals. Local communities are best suited to provide support to the families of infected persons and ensure that they are not stigmatised in the locality or neighbourhood.
A critical gap in the level of response is the limited testing facilities available for people to know their COVID-19 status. As these test kits become available in large quantities at a lower cost, community-level testing can be introduced to enable people to check their COVID-19 status if they get accidentally exposed to the risk of infection. This measure will also help in normalising the disease in the community and lift the stigma and fear surrounding it to a great extent.
Large-scale migration of daily wage earners and construction workers from metropolitan cities, in the aftermath of the lockdown, has resulted in enormous challenges for the administration. The fight against COVID-19 can only be won when we get a preventive vaccine or a therapeutic drug on hand. Only a measured public health approach with community participation will help the government in ensuring a sustained response to stem its tide. Prasada Rao is a former Health Secretary, Government of India.