India despite its vast population, kept the surge of Covid-19 cases in check after the first peak in September, 2020. After initiating the vaccination drive for the general public in mid-March, an unprecedented ‘second wave’ has resulted in making the country the most vulnerable in the world at present. No one is to be blamed! India’s management of the infection was lauded right from the decision of a timely lockdown, crowd management to vaccine diplomacy, resulting in near disappearance of cases in New Delhi to as recently as February, 2021. The upsurge has been a human result of ‘post vaccination overconfidence syndrome’ to lack of self-discipline in three basics we were taught in the beginning of the pandemic: proper masking, physical distancing and hand-washing, which were to continue despite complete vaccination!
As India grapples with the stress of this health emergency, there are some strategies that could be explored culling into the competence of Make in India to partnering with last-mile connecting private players and expanding the frontline workforce for public outreach.
1.Testing: The present RT-PRC testing mechanism, although decentralised may further increase chances of exposure in testing centres and has been subjected to state-pressures on delayed testing results taking as long as 3-5 days. With excessive sample loads, time lapse between date of collection and analysis is believed to give unreliable report.
Strategies: Self testing kits, popularised in many developed countries need to be replicated logistically in India at the earliest. Two indigenous kits meeting the gold-standard of RT-PCR testing, out of which ‘Feluda’ using latest CRISPR technology have already been developed. The results take only between forty-five minutes to one and a half hours, not days. The manufacturing of both these kits need to be urgently scaled up and made available to general public both OTC and online. This is an urgent step to curtail spreading, early isolation and treatment.
2.Vaccination: The third phase of vaccination, open to everyone over 18 years would be beginning from May 1. With close to 40 percent of the population over the age of 45 being eligible, nearly 20 percent between the ages of 18 and 44 would be added to the system, contributing to already overloaded public health infrastructure. Large crowds gathering for jabs, would only lead to upsurge in cases.
Strategies: Further decentralising the process of vaccination is the need of the hour. Similar to door-to-door testing, a vaccination drive on these lines needs to be explored, by expanding robust mobile refrigeration and mass deployment of qualified personnel. RWAs could play a leading role in managing this drive. Existing scale of vaccine needs to be ramped up, especially of Covaxin that has promised to increase capacity by 6-folds by July, still reaching only up to 70 million doses per month. Although manufacturing partnerships have been established with two leading public sector companies taking the combined capacity of Covaxin to 100 million monthly doses, through additional licensing the supply could be further increased to match that of the Covishield – the other available vaccine.
3.Rules on Masking and Public Management: With lives getting endangered and panic amongst public, fines on improper masking and physical distancing is no more sustainable, especially for the affected parties.
Strategies: Governments, private, public and social institutions along with general public at this stage must invest in setting up free vending machines of sorts for masks, sanitisers and other essential equipment in emergency clusters. Effective disposal strategy of used masks and equipment is an inseparable aspect for ensuring safety.
4.Parallel Healthcare: While healthcare system is overburdened with a large crisis, other critical cases tend to get neglected.
Strategies: While having dedicated hospitals for Covid-19 seems far-fetched at present, separate entry/ exit points for non-Covid cases with high-quality ventilated spaces is essential. Highest facilities need to be extended to non-Covid healthcare service providers such as accommodation, transport and meals to prevent the general healthcare system from collapsing. Governance discretion, public resource management and stakeholder cooperation must be utilised for overall healthcare more than ever.
5. Partial Lockdown: With healthcare remaining a state-subject, public gatherings without state control have proven to give leeway to hotpot clusters.
Strategies: As Nagaland becomes the newest State to impose partial lockdown, all public gatherings including places of worship must remain closed in totality in all zones till period of normalcy is attained. Section 144 and night curfews may be imposed, without shutting down businesses, shops and malls during the affected period.
Amidst rising number of cases, several solutions get caught up due to political differences. Governance must come into play where people cannot self-manage. There is a dire need of coordinated governance at all levels, irrespective of the government. Testing times give strength, and the current crisis poses a war-like challenge for India which it has the capability of handling with solidarity.
Payal Dey is a final-year PhD candidate at IIT Delhi. She was a Fulbright-Nehru Doctoral Researcher at the Massachusetts Institute of Technology and pursued an MSc in Public Policy and Administration from the London School of Economics and Political Science in 2014. She can be reached on LinkedIn and Twitter @payal_dey.
