- India’s coronavirus tally crossed the 93 lakh mark
- Dr Guleria says India should focus on strengthening its healthcare systems
- Vaccines/testing are the tools that will help India win COVID war: Expert
New Delhi: What is the road ahead to the pandemic that many of us have not seen ever in our lifetime? As we deal with something that happens once in a century, which is the reality now and prepare ourself for more such pandemics in the future, NDTV speaks to top medical experts – Dr Randeep Guleria, Director AIIMS; Dr Gagandeep Kang, a vaccine scientist, former executive director of Translational Health Science and Technology Institute (THSTI) and current professor at Christian Medical College, Vellore along with Dr Chandrakant Lahariya, an expert on public policy and health systems, to know more about the road to recovery from #COVID19.
NDTV: When will India win a war against coronavirus, what is the road ahead?
Dr Gagandeep Kang: Science and technology will going to provide solution to this virus. We have seen already that the damage this virus is doing is much less than it has been projected and with vaccine and the work we have done on standard public health measures such as diagnosing, isolating and tracking. We have done a pretty good job so far and I think, our interventions will only going to be better and better now. Better treatment and prevention is our road ahead. Talking about the timeline, this is the virus that spreads very fast so we will see the surge in cases, but we have already got hold of the mortality rate which is less and now the next step is to get hold of the spread and control the speed at which it is spreading. I am anticipating that we will see some results by the beginning of next year and vaccines and diagnostic will be the tools that will help us get there.
NDTV: What will be the vaccine for India and how it will work?
Dr Gagandeep Kang: Let’s first start with how dangerous this virus actually is, if you look at SARS and MERS, two related coronaviruses, they had a mortality of 10 per cent and 30 per cent, meaning 1 in 10 or 3 in 10 infected with those viruses were dying. But if you look at the mortality of COVID-19, we are looking at a rate, which is much less than 1 in a 100, so this is not the deadliest among coronaviruses. The reason we are seeing so many cases is the fact that it spreads very fast. If the bulk of people who are infected are going to survive this virus, all this could have been worse, we could have an Ebola or influenza, or MERS that kills at rate much higher than this. This is a warning, a wakeup call for all of us but having said that it is not that bad as a situation. Now talking about the vaccines, I trust PFIZER vaccine a bit more because its numbers are little more than Gamaleya results. They had 94 patients, which is pretty high number for a vaccine trial and they are showing 90 per cent of efficacy and this is the proof of principle that vaccines will work to kill this virus. However, India should look at vaccines that are more suitable for our population, a vaccine that requires -70 degree storage and is as expensive as PFIZER vaccine, may not be the best choice for us. I think, we should wait and weigh all the pros and cons for the particular vaccine and then choose the one which allows us to reach the maximum number of people with the kind of resources we have.
NDTV: When will coronavirus vaccine will be available off the shelf? Will common people have to wait for the vaccine till 2022, which means 1 and half year more for the coronavirus scare?
Dr Randeep Guleria: The easy availability of coronavirus vaccine, which means people can buy it easily just like they get flu vaccines, will take time because the first thing that we need to do is to vaccinate those who are at higher risk and those who have the higher chances of getting infected like elderly, people with co-morbidities, healthcare workers or the individuals who are getting exposed to COVID-19. It is only after vaccinating all these group we can say anyone who wants to get vaccinated for COVID-19 can just go and get themselves vaccinated. This stage will probably come at the end of next year or early of 2022, when we have enough of doses of the vaccine globally that it can be available off the shelf. Our priority in infection has to be in decreasing the mortality and infection rate further.
Regarding when will the pandemic will end that is a difficult question. We may have two phases where we will see the pandemic is over – one when we reach the stage with the vaccine coming in when we accept the new normal of living that is with social distancing and masks on, this we can anticipate till mid of next year. However, returning to pre-covid era will take a long time.
NDTV: In India, public health gets low priority and the irony is that we have realised it when we faced a pandemic like COVID-19?
Dr Chandrakant Lahariya: During the pandemic, much of the discussion has been about increasing beds, facilities, ventilators and COVID-19 testing. However, health system of any country is much more than this. It is about leadership, governance, service delivery, improving medicines, vaccines & supply. In our country, there are many health components which are not fully understood and that is why the outcomes are not achieved. Healthcare is just not about medical care, it is about public’s good health overall and till we don’t achieve that one overall thing, we will not be able to win war against anything.
Dr Randeep Guleria: Health has to become a priority issue for all governments and policymakers that is very important and that is what the pandemic has brought into the limelight. A lot has to be done in terms of health in our country and there is lot that has to be done as far as preventive healthcare is concerned as a lot of diseases can be prevented, especially the non-communicable diseases that are now becoming the highest burden on our country’s healthcare system. Preventive healthcare includes clean air, sanitation and water. Till now, health was not in our priority, it has always been growth, housing etc and because of the economic growth we have comprised our health and environment and we all are paying the price for that.
Every year we talk about air pollution in Delhi, we see air quality index deteriorating, we see AQI going to a category of severe and sometimes going upto 999, the highest that the metre can calculate and then we forget about the issue in march/april, when winters are over and air quality has improved. There has to be a sustainable plan that needs to be implemented and be available to tackle such issues at all levels.
NDTV: Other countries compared to India, seemed to be more equipped in managing pandemics like coronavirus well. Is this the time to start putting healthcare systems in place in the country?
Dr Chandrakant Lahariya: We are learning from our own experiences now and from our neighbouring countries like Vietnam and Thailand. Some countries have managed the coronavirus really well like Taiwan and Thailand. Even in India, in past 10 months, we have realised the importance of community participation such as practising social distancing and wearing masks. What we now need is stronger healthcare systems that can help tackle such pandemics. India’s national health policy in 2017 recommended government to spend 2.5 % of GDF on health, despite this, it is a known fact that India spends the lowest amount of its GDP on health as compared to other developing countries. It was also said that all states should have public health cadre but despite the government suggestions, only 2 or 3 states in India so far has that in place. We have learned enough from this pandemic, what we need now is stronger primary and public healthcare system.
I think India should look at the Dharvi model of community participation and how it won the war against coronavirus, we need to include the community in the healthcare service delivery in order to achieve overall good health.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.