Although vaccination is the most attractive strategy, it is impractical to administer it to every citizen in India in a short time, said V. Ravi, senior professor and head of the Department of Neurovirology at NIMHANS.
“We need to prioritise and we hope there will be herd immunity by the time the priority group is catered to,” said Dr. Ravi, whom the State depended on for establishing testing labs after the pandemic hit Karnataka in March, in an interaction with The Hindu . The doctor, often referred to as “Virus Ravi”, is set to retire this month.
Dr. Ravi, who launched the State’s first virology lab in 1985, has been tasked with the responsibility by the Indian Council of Medical Research (ICMR) of mentoring all the private and government laboratories across Karnataka to establish COVID-19 RT-PCR testing facility. He was key in developing 164 (58 govt. and 106 private) ICMR-approved laboratories in less than six months.
Dr. Ravi, who is also a member of the State’s COVID-19 Technical Advisory Committee, said: “In my opinion, while vaccination is essential, strengthening public health infrastructure so that we do not have to scramble during a crisis is most important. Having said that, vaccines should be made available to everyone; whether the government provides it or people buy it is immaterial.”
Pointing out that healthcare workers are the priority group all over the globe, Dr. Ravi said: “As most studies show that the elderly and those with comorbidities are the most vulnerable, they will be the next priority groups followed by pregnant women. By the time these groups are vaccinated, we may get herd immunity.”
Basal health intelligence
“Throughout my 35 year career as a virologist, I have seen that as a country we are capable of managing outbreaks. But, in between crises we do not have a good inter-epidemic surveillance plan. We should have a basal level of health intelligence so that the next time a pandemic hits, our response is quick,” said Dr. Ravi.
“A continuous structured surveillance system should be in place and we should watch out for emerging and re-emerging pathogens. We should collect samples of seasonal ailments and test them for all known bugs. If a majority of the samples test negative, then it means a new pathogen is on the prowl and we should immediately become alert,” he explained.
Asserting that allocation for healthcare has to go up both at the national and State level, Dr. Ravi said: “COVID-19 has given us a lot of lessons. Over 40% of our district hospitals did not have ICU facilities and 60% had no piped oxygen supply apart from lack of trained staff. We had one or two virology labs in February. But now, we are well-equipped and we should use the existing facilities for structured surveillance of febrile, haemorrhagic and respiratory illnesses apart from encephalitis. So far, we have only been able to handle gastroenteritis without any problem.”
Better equipped now
Expressing confidence that the State is capable of handling the second wave efficiently, Dr. Ravi said: “In the event of a second wave, we are better equipped now and we can quickly ramp up hospital bed allocation but our efforts should not be to wait for a second wave but to avert it. This can be done by continuing with the same level of testing and giving appropriate messages to people to behave responsibly.”