One of the most discussed issues at present is the spread of the new virus, COVID-19. It has spread across the globe and taken thousands of lives. It has also reached India, and the question of the hour is whether the time has come to declare a national health emergency. New cases of the COVID virus have been detected in some states, including Kerala, Delhi, and Andhra Pradesh.
There are debates on the need for a planned approach for such medical outbreaks. Such discussions have raised concerns about the nation’s preparedness for medical calamities, and whether a structured approach is helpful. The recent coronavirus spread, which has managed to affect more than 90,000 people, covering all continents except Antarctica, makes these questions pertinent. Can this be an opportunity for greater preparedness in dealing with calamities, including medical ones?
As countries grapple with containing the spread of the disease, densely populated countries like India face graver consequences. With a population of over a billion, further spread—it has been limited so far—poses a danger of potentially epic proportions. In developed countries like the UK, the strategy against epidemics has been to try and kill the germs, thereby limiting the spread of the disease, and adopting sanitary precautions. The “sanitary movement” involves radical changes in citizens’ beliefs about disease causation, and their health behaviours. It has been accepted that the most effective approaches to improving population health are those that prevent, rather than treat, the disease.
Health policy in India has always focused on curative measures rather than adopting a preventive approach. However, critical measures will have to be adopted to stop an epidemic spread, as the country’s health infrastructure will be compromised. Many feel that compared globally, India is ill-equipped to fight the disease since it has no mitigation strategy to deal with such medical outbreaks.
India may have improved its disease surveillance network, but reducing and limiting disease outbreaks requires several other measures, such as sanitation, and awareness about precautionary measures. Also, many people are outside the coverage of the healthcare system. If a set of resilient strategies is put in place, mitigation is possible. Similar to a natural calamity, there must be a tiered approach to dealing with the situation.
First, epidemic risk reduction requires hoarding of medical tools and equipment—gloves, masks, medicines, etc—in a quarantined place. India must have a strategic national stockpile—a national repository of life-saving medical countermeasures for use during an emergency severe enough to cause local, and state supplies to run out. The Government of India must commit to this exercise, and finance it at the national level to improve India’s health security. This epidemic resilient strategy, like disaster resilient strategies, require allocation of separate funds.
Second, there is a need for special shelters—designated school buildings and other institutions—that can be changed into hospitals very quickly. This is similar to shelters built for dealing with natural disasters, such as the multipurpose cyclone shelters, which have been quite successful in Odisha. Wuhan has constructed special hospitals to deal with the coronavirus. India also needs to secure funds to create capacity to build newer spaces to quarantine patients, thereby preventing further spread of the disease. There should be at least one hospital, or an area per city equipped with extra quarantine facilities and tools that can be used during an emergency outbreak.
Third, as in the process of Disaster Risk Reduction, community-based programmes should be put in place to increase local capacity for dealing with an epidemic. There is capacity for dealing with outbreaks when they occur, but not to prevent them from occurring. Public health services have long been neglected in India. These include assuring food safety and other health regulations, vector control, monitoring waste disposal and water systems, and health education to improve personal health behaviours and build citizen demand for better public health outcomes. There is a need to design specific methods for educating the masses about precautions, and hygienic methods for prevention during outbreak. The country needs to focus on improvising its health infrastructure by strengthening the finances for health expenditures, and preparing preventive tools for an outbreak.
Lastly, updation of the National Disaster Management guidelines is needed for the management of biological disasters. A mechanism that mainstreams biological disasters in the centrally sponsored schemes—that not only deals with medical outbreaks but is also built on the idea of strengthening the immunity of the society by adopting better public health services—is long overdue. A resilient and robust healthcare system, backed by a strategic reserve of critical medical supplies with adequate financial protection of its citizens, will boost India’s prospects of becoming a $5 trillion economy, with the agenda of development as its very core.
Authored by Saon Ray and Samridhi Jain–Ray is Senior Fellow, & Jain is Research Assistant, ICRIER for Financial Express