The Lancet is right, fire-fighting isn’t sound pandemic response
Stinging rebukes in editorials such as The Lancet’s and recent court orders should have made it amply clear to the government—largely the Centre, but also states—that it lost the plot on Covid-19 after the September peak last year. A course correction hasn’t yet been entirely forfeited. But that has to begin with an honest acknowledgment of how dire the situation in the country is right now; to that end, states must test more to catch cases that otherwise would have gone unreported, record Covid-19 deaths accurately; that is, they must maintain robust, real-time data. This needs to be then followed with bolstering healthcare infrastructure and other capacity.
The complacency of both the government and the public soon after cases started dwindling November 2020 onward has resulted in daily new infections reaching 4 lakh now. A cocktail of people’s Covid-fatigue (the massive Kumbh and election-rally attendances), emerging variants like the double-mutant, and policymakers and authorities misreading/ignoring warnings against dropping of guard—Union health minister Harsh Vardhan’s ‘India in the endgame of the pandemic’, the Election Commission refusing to ban rallies till April 22—has ensured that healthcare in major cities is overwhelmed. Indeed, if a Reuters report has it right, the government even played down the threats from variants flagged by Insacog, even as Insacog was functioning well below its target. The shortage of oxygen, key drugs, personnel that showed up soon enough revealed how the momentum that had been noticed in the early days of the pandemic in the country had fizzled out soon after. There was palpable energy from the government and corporate/start-up India on manufacturing (and innovation) of a large array of healthcare products, from ventilators to oxygen generators, when the pandemic hit India and started spreading. But, as Srikant Sastri of I3G Advisory Network points out in an article in The Times of India, these products that we needed so badly in this second surge are simply not there! All that momentum got swept away by the tide of complacency that set in as soon there was a bit of a let-up in the situation; the fact that contracts, because of various conditions such as L-1, got awarded to companies that had no proven record of such manufacturing, didn’t help either. As a result, India has had to reach out to other nations for aid to beat the shortages that have marked the second surge.
There is a crying need for proactive pandemic-response measures; a third wave can be better managed if the response is stragetgised now rather than mounted post facto. Sastri cites the example of Odisha’s cyclone-management, that has relied on building key infrastructure, putting in place early warning systems, and community outreach. While recent government measures, like the incentive-scheme for medical device manufacturing and roping in of final-year nursing/medical students is expected to bring significant gains, a lot of other things need fixing, from a broken regulatory system to overcoming the L-1 addiction for public procurement, from protecting our scientific advisory bodies from political pressure to effective community mobilisation. Else, firefighting will remain the default response.