The year 2021 may go down as one of the most painful years in recent memory for India. From languid, weak and financially drained family members scurrying around for hospital beds to embittered young minds bearing the brunt of a strained and stretched healthcare lattice, it was all along a story of sorrow unfolding. In a matter of just four months, what began as an uptick in Covid cases in late February culminated in distressing images of dead bodies strewn across rivers banks. While the calendar year has thankfully concluded, the story of the virus, its variants and their sub lineages is far from over.
We head into 2022 with unsettling fears of what could be instore with the new and highly transmissible variant, Omicron – named after the fifteenth letter of the Greek alphabet. But if progress is about learning from past and getting better equipped for the future there is much that 2021 can offer.
To most experts, the big lesson from 2021 is the ill-effects of vaccine supply inequity. Had the vaccine supplies been managed better between countries and within countries then perhaps the story of the emergence of variants could have been different. After all, as the argument goes, when a virus is circulating widely and swiftly the chances of it undergoing changes or mutations only increases.
Dr Soumya Swaminathan, chief scientist at the World Health Organisation (WHO), prefers to read in this a larger message of the need to address the inequities in healthcare overall globally across nations and geographies. “The existing inequities between countries and within countries were exposed and therefore any initiative for the future must take into account the aspect of addressing these inequities,” she says.
Leveraging tech beyond Covid
Dr Swaminathan, also clearly sees a growing role of technology in healthcare and the need to leverage it in the coming year for health applications beyond Covid. In India, which in some cases took an early lead with its teleconsult app or eSanjeevini app or the contact tracing app called the Aarogya Setu app used during Covid, she feels, could be leveraged in other areas such as tuberculosis (an ailment which is a major killer in India – one death almost every minute on account of TB). However, running in tandem, has to be element of ironing out glitches, if any in ensuring patient privacy. Once that is sorted out, what really matters then, she says, is going beyond collection of data to actually getting to use it much more effectively for better healthcare outcomes.
Power of Partnerships
Another aspect that stood out in the concluding year and may need to be built on in the coming year is strengthening public-private partnerships. “When there is public-private partnership there is lot that you can do in terms of trying to develop new drugs and vaccines,” she says even as regulatory agencies get to keep pace in ensuring the required criteria are well established, decision-making has to happen in a timely manner.
Reducing Premature Mortality
The other lesson she points to is centered around ways to reduce premature mortality. This she feels is most effective if efforts are in place to get people to change habits and make behavioural change in improving public health. For instance, coming up with ways to effectively communicate so as to sway people towards better health – be these through changes in the dietary habits or reducing dependence on alcohol or tobacco – for that will alone help in primary prevention and get better prepared to handle the high burden of non-communicable diseases (NCDs) such as diabetes and hypertension. This in turn helps avoid premature mortality (estimate of the average number of years a person would have lived contracted the ailment). Apart from these, Dr Swaminathan also sees the need to address ways to deal with misinformation.
New Year & The Viral Journey
What to expect in 2022? The new year, says Dr Swaminathan, should see the pandemic coming under control primarily because of increase in vaccine coverage. She feels the virus may become endemic and much like any other manageable respiratory infection.
Pandemic & Its After-Effects
In the new year, there is a good chance that one may get to see the after-effects of the pandemic taking effect. For instance, because of increase in poverty, we may see more cases of malnutrition. Then, there would be more instances of ailments like cancer or tuberculosis which perhaps got neglected during the pandemic. Children who have escaped the basic immunization cover may run into other risks as there could be potential danger of measles outbreak. “We have to be prepared for setbacks in other diseases,” she says. India, for example, she feels, may need to review its nutritional indicators and try and address the gaps. What also may be hard to ignore in the new year, she feels, would be preparing to handle more mental health issues, especially among young people.
Gather Data But Share It Quickly
Dr Gagandeep Kang, eminent virologist and a staunch believer in data and the resultant evidence-based healthcare planning, says, “I hope this (the move now in India to provide an additional dose of vaccine to health care workers and the elderly with comorbidities) is used as an opportunity to gather data on say whether the booster doses are working or not and if so to what extent.
Looking back at 2021, Dr Kang, who is also a professor at the Christian Medical College, Vellore, says, “we did a wonderful job with vaccination” – having crossed a billion doses – but then “we did a terrible job in terms of global solidarity to ensure vaccine equity.” She feels much more could have been done to reach out to countries badly in need of vaccines. Also, she hopes the new year will see more learning on the benefits of not just gathering and leveraging data but also the advantages of sharing it early. Here, she compares India and South Africa and says, “in India we had delta for almost two months before it was admitted that there was a problem whereas in South Africa, we had information in two weeks and I hope this is a lesson for the future and that we should not only focus on collecting data but also share it quickly.”