A robust public healthcare system with primary, secondary and critical levels connected through surveillance mechanisms could have helped the country deal with the current COVID pandemic better and certainly would be able to tackle any next pandemic, was the common refrain from scientists and public health experts to policy makers on Thursday.
“Primary healthcare could have helped us detect early waves, help us do early interventions, remove the fears or stigmas associated with the virus. We need to strengthen it in both urban and rural areas even as the focus is on hospital beds and ventilators,” asserted president of Public Health Foundation of India Dr. K. Srinath Reddy.
Public healthcare personnel are needed for early detection of cases, contract tracing and monitor those in home care. While the focus on economy is there, there is a danger of it to “keep slipping on the banana peel of lack of public healthcare”, he warned, participating in a webinar on ‘COVIDwise: Lessons learnt and unlearnt” by the Atal Incubation Centre - Centre for Cellular & Molecular Biology (CCMB).
Dr. Reddy pointed out that new infections are predominantly because of zoonotic (animal) transmissions because human beings have created conditions for the spread through afforestation and so on. He also advised healthcare professionals to adhere to both evidence based practice and vice versa due to the complexities associated with this coronavirus.
It was not right to go by sero-positivity ratios to come to a conclusion on herd immunity as the benchmark has crossed to 90% and presence of antibodies was no guarantee of automatic immunity. Countries like Brazil had shown immunity through vaccination works better and so this strategy coupled with public health control measures could keep probable third wave into a trickle.
CMC-Vellore virologist Jacob John said the missing elephant in pandemic management has been the absence of public health initiatives through the Ministry of Health and Family Welfare and not the National Disaster Response Management Agency (NDMA). This led to the real time disease surveillance data not coming in and hence, the onset of the second wave was missed. Sewage surveillance is also an invaluable tool.
“We need to focus on public health urgently or we will forever be a developing country. There was no mechanism to advocate social vaccine, and biological vaccine was not planned by NDMA and there was no mechanism to educate public about vaccine hesitancy, efficacy and safety,” he said.
CSIR-CCMB director Vinay Nandicoori said sewage sample surveillance can give early warnings and serious efforts were on to make it into a future strategy of taking samples from 14,000 treatment plants spread across 4,000 cities and towns across the country to test in labs in collaboration with other departments. C-Camp’s Lalith Kishore and AIC-CCMB CEO N. Madhusudhana Rao also spoke.