This is a tough time. Perhaps the toughest medical crisis as far as I can remember. WHO says 197 countries across the globe are infected with coronavirus disease (COVID-2019). Globally, 537,042 people have been confirmed positive for the disease and 24,110 people have already died due of this pandemic. India has 719 confirmed cases and 16 deaths so far. World’s largest democracy is trembling with fear of doom. Prime minister has declared a nationwide lockdown to control the situation.
Let us have a comprehensive look at ten countries having most confirmed cases and also India. I have put ten countries at the top and India at the bottom. The first coronavirus case was reported in an unconfirmed manner somewhere in late October 2019 from China. Today, the situation is grim: world’s so called second best healthcare system in Italy is fighting a tough battle, with highest death rate from the disease as of now (10%). Old age population with multiple comorbidities may be one of the reasons, other reasons being the lack of far sight on the part of Italian administration.
Let us shift the attention to India: 138 crore people are spending their nights and days in anxiety, sitting in front of news media or reading coronavirus updates with few defying lockdowns and enjoying joyride! The entire nation in an unprecedented manner supported the decision of lockdown hoping that the misery would come to an end after three weeks. Let me be a pessimist and show my inner anxiety: what if things go wrong and why it may go wrong?
1. The virus has an incubation period of 1-14 days. That means symptoms can start anytime within this period after being infected. So, practically the true reflection of the benefits of this lockdown will be appreciated at the end of 14th day and after that. What, if we lift the lockdown after that, open the international airspace and borders and invite fresh infections from rest of the world? Will we see a second peak? Scientists all over the world are learning about this infection and no one has the answer to this question right now.
2. What if the virus does not give rise to herd immunity? Being under lockdown, it can be assumed that not enough number of people will be exposed to this virus. So, will there be any herd immunity developed to protect the nation?
3. What if the “God in White Coat” is not properly protected? Who will take care of the patients?
4 Do we have enough life support and ventilator system available in this country to manage the catastrophe if it arise?
5. What if it starts spreading inside a slum!
Every return from hospital is a potential risk to family and such risk is being faced by every healthcare worker right now.
Immediate Action Plan:
1. Continue and implement stringent lockdown. This is the need of the time. If people do not interact, community spread will be reduced during this period and the benefit may extend few days after that.
2. Buying and supplying more testing kits across the country. This will help identify cases, isolate them and prevent transmission.
3. Providing PPE (Personal Protective Equipment) of adequate quality to the doctors, nurses and other health care workers working in hospitals. The supply should be flawless. Loss of one trained physician or health worker during this battle will be a costly affair.
4. Maintain continuous supply of all utilities — water, electricity and gas or other necessary requirements.
5. Maintaining supply of necessary things for livelihood to the people. This is particularly important for people living in shelter homes, poor people not being able to meet their need, people unable to go out for any reason etc. Administration may take help of local resources to identify such areas and need and address them accordingly.
6. Asking industrialists, business tycoons, uber rich, celebrities to donate generously like others are doing in different countries. This is the time when they should come forward with their wealth for the benefit of the nation.
7. Prevent black marketing of goods.
1. Identifying focus and clusters of infection after 14 days. New clusters should be reinforced with further lockdown (if required with police protection) and a surrounding buffer zone can also be monitored. People working on public health and community health can be of great importance to share their views and planning such things beforehand.
2. Improving sanitation in slum areas. One single infection in a slum area can be dangerous for the country just because of huge population density. The rapidity with which it would spread will be unimaginable.
Long term Plan:
1. More of hospitals and health infrastructure with adequate facilities. This pandemic taught us what should be our priority.
2. Also, this episode showed us the importance of ventilators. They are not the means of sucking common people’s money. They are lifesaving equipment and should be available amply.
Let us all share our good thoughts, constructive ideas which can reach our leaders, policy makers and concerned persons dealing this situation so bravely and nicely. All of us will get enough time to oppose someone, do politics, criticize others and so on, if only we survive.
(Dr Dodul Mondal is a Delhi-based Oncologist. Views expressed are personal. Figures have been uodated)