COVID 19: 5 Things We Did Wrong and What We Should Have Done Instead

The world is currently fighting a great pandemic. And for a lower-middle-economy like India, there is a lot more to do to prepare for the peak of COVID-19 and its aftermath.

Chronology

Chronology is important for us to decide upon future steps and further preparedness.

1. China first spoke about the COVID-19 outbreak to the WHO on December 31, 2019.

2. China locked down close to 50 million people on January 23. This was the first warning sign. Clearly, it would not have ordered a complete shutdown just for a few hundred deaths. Perhaps, this is where WHO’s role came under suspicion.

3. By January 20, 2020, this virus had already spread to about 25 countries

4. The WHO declared COVID-19 as a Public Health Emergency of International Concern by late January.

5. On January 30, India reported its first novel coronavirus case.

So, let’s have a look at 5 things that went wrong and what can be done instead.

1. When China ordered the world’s factory shutdown, it still hadn’t shaken the global hamlet. The global response towards this pandemic reconfirms the failure of systems, science, and strategy.

It definitely would have been great if it had suggested specific steps rather than just ‘keeping countries updated’.

The WHO should have prodded the countries to take steps for containment and reversal with specific action points for every country.

1. In India, the cases started counting up and spreading beyond just Kerala, from just one case on January 3, three cases in February to around 34 cases in the first week of March.

The trajectory points towards an increase of more than 11 times in just the first week of March. The warning was not just serious, but unambiguous.

India should have stopped all flights from major global transit hubs like Dubai, London, Paris, Munich, and New York as well as entry of people with a travel history to these places and other affected countries immediately.

Also, it should have kept updating it as per the daily WHO country spread bulletin.

This coronavirus strain has raised the alarm

Credits:  Wikipedia

                                Alt tags: Coronavirus death toll

1. In January, WHO stated that the risk at the global level was ‘high’. Sometime around mid-January, WHO, in its bulletin, said ‘the New epidemiological information reinforces the evidence that the 2019-nCoV can be transmitted from one individual to another’.

Clearly, the trajectory was scary between February 15 and February 29, and WHO was clear when it raised it to ‘Global – High-Risk’ by the end of February.

We should have instead been pre-emptive in our approach and initiated’ international isolation’ by the beginning of March.

1. On March 01, WHO issues a report stating that the disease had spread to 58 countries, and the risk assessment was ‘Very High’ at the global level.

Even if all international flights had been stopped by March 08, India probably wouldn’t have to announce a lockdown for domestic flights.

Joint Secretary, International Health and Secretary should have been more realistic and quick to inform the PMO that the situation was getting worse and suggested steps but clearly, they failed in their basic responsibility.

1. By, March 15, the number of cases had increased to 112, an increase of over 37 times from the beginning of March.

So, a lockdown was needed in certain key states with mass transit and slums a week earlier than it had been announced.

What happened is all behind us, and now it’s time to brace ourselves for the new reality.

Whether we’d call it local transmission or stage 3, it does not matter. What really matters is, how we are going to deal with it.

Here’s what we need to consider:

1. Though the world is asking for extensive scale testing and isolating, it is necessary to use our existing capabilities and create an online, mobile-enabled risk assessment tool.

Nowadays it is quite easy to create a tool with a set of questions backed by an algorithm that evaluates the risk level of an individual.

1. Those who are at high-risk need to immediately move into home isolation to avoid further spreading, and only these people and their immediate family members need to get the screening done.

So, like in the other states, for example, Chennai, it is not necessary to screen the entire population.

1. Now is the time that the government starts funding COVID-19 testing kits for high-risk individuals and not just those covered under PMJAY.

It is impractical to expect people to pay Rs 4500 per person to get themselves and families tested in a private lab. Also, the government must negotiate ongoing testing rates.

India’s Strategy

India’s strategy to consider should be:

1. Homemade masks for all

2. Health Risk Assessment tool (HRAT) as per case management tools – defined clinical protocols

3. Screening

4. Self-quarantine at home and isolation

5. Treatment

6. Screening at from households across the country

 Caption:  To be safe people should act responsibly.

Credits: Freesvg

                       Alt tags: Covid-19 vigilant

Also, a calibrated uplifting of the lockdown would be a good approach.

Cities that are densely populated, have mass transit systems, and slums must continue with the lockdown with a focus on ‘high-risk areas’ being ‘sealed’ for another month.

It should be made mandatory for all individuals to do a self-assessment symptom check every week for the next two months.

Also, it would be prudent that India does not export any goods related to COVID management until they have buffer stock. Efficient planning must be done keeping the worst-case scenario in mind.

Managing the COVID-19 pandemic is the test of our understanding, system’s strength, resilience, solidarity, and national leadership.

India can certainly win this global fight sooner than the rest of the world with a bold leadership at their disposal.