Ear to the ground

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Ear to the ground

Friday, 10 April 2020 | Pioneer

Ear to the ground

Ignore the politics but WHO did misread the pandemic as it evolved. India has done well to rely on its field assessment

First things first. India has no choice but to develop its own template of protecting itself from the monstrous attack of the Coronavirus. That means in a densely populated country like ours, we will need to minimise the rush of people in danger of contaminating each other. Hence a protracted spell of lockdown and a behavioural monitoring, for example, at markets. The other is harvesting available resources in a poorly developed health framework to treat the sick, which means aggressive testing in clusters and faster serology tests besides pool tests in virgin areas. In other words, a tiered approach to the problem. Then there is the larger challenge of enabling the economy at the local level through staggered permits for agriculture and production. And given Indian doctors and researchers have gone on to achieve world acclaim, it is time for us to trust home-grown experience and expertise to fight our battle, both on the medical and economic fronts. Simply because nobody else will fight it for us. Certainly not the World Health Organisation (WHO), which has bungled in estimating the extent of the Wuhan contagion and led many countries to believe that it was a local problem. US President Donald Trump has threatened to cut funding to the world body, saying while his nation keeps it alive, it had been guided by Chinese projections of the virus. While transactional politics should certainly not be the order of the day in this test of survival of the human race, the fact is that the WHO did mislead us by changing its own advisories and delaying the classification of the virus as a pandemic. Had we gone by all its advisories, then we could have gone under. Already the spiral, largely the result of focussed testing, shows how deeply the disease has spread in the hinterland and how an early warning system could have helped us shut down international flights at least two weeks earlier. As late as January 30, WHO Director-General Tedros Adhanom Ghebreyesus said he would not recommend travel restrictions to China. Yet on the same day, WHO’s International Health Regulations Emergency Committee raised a global alert on the need for containment, surveillance, detection, isolation and even contact tracing. India’s first advisory on avoiding non-essential travel to China came before but by then hotspots had sprung up in Europe and the US.

The Government, while taking note of the WHO advisories, has totally relied on the Indian Council of Medical Research (ICMR) and in a collaborative effort is sharing the experience of several State Governments — be it Kerala, Rajasthan, Maharashtra or Uttar Pradesh. The aggressive containment, cluster isolation, aggressive testing and minute observation at hotspots is a story of learning and sharing that has made cooperative federalism the new credo. The all-party consultative meetings are back, too. The Government, alarmed by reports in the US that droplets of infected people could hang in the air for a while, made mask-wearing mandatory while stepping outdoors although the WHO argued against a directive on face covers, saying masks were needed for those who are symptomatic, health workers or caregivers. And while the WHO stuck to the “test, test, test” formula, the ICMR countered that with “isolate, isolate, isolate,” given that we cannot afford to let precious test kits go waste even as we indigenise production. In fact, some States adopted voluntary quarantine even before the national lockdown based on this advice. Simply because the airport screening was not effective in identifying carriers and spreaders. This may not entirely flatten the curve but at least won’t let it bulge and break either, considering we are yet assessing the depth of seepage at the community level. While testing is going on according to parameters, the rapid antibody tests in “areas reporting clusters and in large migration gatherings/evacuee centres” are a faster way of data collection and establishing the right graph. And though the WHO did not recommend a treatment protocol, doctors in Jaipur tried out two anti-virals — lopinavir and ritonavir — in saving patients. Doctors here also worked out a combination of hydroxychloroquine and the antibiotic azithromycin to slow down the progress of the disease. A vaccine and cure are far away and Indian researchers are part of global trials on the disease. But till then, smart COVID management and a ground-up, felt approach will be our only saviour.

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