As with most other things these days, there are strong disagreements among various stakeholders over the response measures being applied to contain the Covid-19 outbreak. This trend is not limited to India or any other individual country, but is pervasive in most mature democracies. In some cases, this disagreement erects major obstacles to the execution of a results-oriented Covid strategy. Unfortunately, a commonly agreed framework and model for dealing with the crisis is still lacking.
A common framework is essential to provide vision and strategy. Stakeholders are unlikely to align on a common vision unless they are convinced of the effectiveness and importance of this minimum viable framework and model.
A useful example in this respect could be the presence of the army. In most countries, almost everyone is aligned with the military because the threat perception is shared by all stakeholders. It’s almost unlikely to see individual regions bickering over keeping part of the army for their small stakes. Covid is no different. With lives, livelihoods and economies devastated, we should, at least now, realize this as a potential threat to the nation and align ourselves with a shared vision, a common framework and a shared model. The creation of a shared vision will encourage the adoption of preventive measures and the reduction of compliance.
I want to name a few areas where we can benefit from executing a well-thought-out collective vision, strategy and framework.
Vaccination strategy, in most cases, is equated with prioritization of vaccination in older age groups and those with comorbidities or other vulnerabilities. While this is a useful tactical decision, it alone cannot constitute a long-term strategy. In simple terms, a strategy can be defined as the structured way of anticipating and achieving the desired vision. These are not milestones or immediate goals. Since it is focused on the desired vision, it provides resilience with permutations and calibration of options to achieve the desired goals.
A Covid mitigation strategy should help us minimize the impact and implications of the outbreak on lives, livelihoods and the economy. Thus, staying ahead of the Covid curve becomes imperative. At the same time, the anticipation of a demand-supply shock or a sudden explosion of regional clusters should be anticipated with a mitigation plan that should start with minimal delays, just like a runbook.
A vaccine strategy must consider availability, logistics and execution time. We cannot ignore vaccine reluctance among certain groups of people, because the reluctance of a few to get vaccinated contributes to the spread of the virus.
Those who refuse to be vaccinated may be deprived of certain privileges. The refusal of vaccination can be likened to situations of drunk driving or tax evasion. An individual has the right to drink, but not to drive while intoxicated. Anti-vaccines should be considered equivalent to those found in non-compliance with tax laws.
Similarly, identifying and containing hotspots should become a national priority, not a regional or local concern, as we have seen local hotspots trigger national waves.
Value chain analysis
While all efforts are understandably focused on strengthening healthcare infrastructure, an effective strategy would require the idea of Covid infrastructure to be expanded to include all essential services needed for continuity. business and minimizing disruption to economic activity.
Thus, electricity, water, roads, transport, essential supplies, financial institutions and many more should be considered as part of the essential infrastructure needed to deal with the epidemic. A value chain analysis should be carried out in these areas to identify weaknesses and prepare for contingencies.
Our experience with this pandemic so far tells us that we should continue to expect the unexpected. This means that we need to have fairly robust surveillance and intelligence, which can alert us to new variants in time for us to take preventative action. Testing and contact tracing should be supplemented with other monitoring methods, such as regular testing of sewage from multiple locations. In addition, sentinel surveillance based on the clinical profile should be followed officially in each part of the country.
Dr. Shashank Heda is the founder and CEO of CovidRxExchange, a global non-profit organization registered with the US government, which works to spread expertise and knowledge about Covid-19 medical care.