5Ms for emerging out of the second Covid-19 wave

While India is expected to have nearly half a million Covid-19 cases each day in the coming weeks, it is pertinent to examine the priority actions we ought to follow to exit the second wave.

These can be summarised as 5Ms: Mask, Mass vaccination, Mobilising oxygen and drugs, Manpower strengthening and Money allocation.

Mask mandate: Despite self-sufficiency in PPE kits and masks, the governments have not been fully successful in enforcing strict compliance of wearing masks in all the closed and public spaces. As a society, we cannot let some people be callous and keep spreading the virus without wearing masks, including those vaccinated. Very often, the simplest solutions are mostly ignored. Masks are our best chance before everyone gets vaccinated.

Mass vaccination: Now that the Government has announced universal adult vaccination, strong micro plans and intensive mobilisation are the way forward. At the current rate, it will take years to vaccinate everyone. Decentralised planning and implementation under the supervision of district task forces can guide implementation at local levels. Aiming for complete coverage in each ward, sub-centre and gram panchayats can help achieve the goal. A strong communication plan, coordination among all the departments and civil society is needed for accelerating the pace of vaccination.

Mobilise beds, oxygen and drugs: In the first wave and to a large extent in the second wave, our systems have struggled to manage the case surge due to shortage of beds, oxygen and drugs. We need the support of industries to set up plants in each taluk to ensure sustainable oxygen supply. The Government should develop a strong plan for managing future waves and pandemics by maintaining details on the additional bed and drug mobilisation when needed. This should have details on the production and transportation of life-saving drugs during the crisis. A greater number of Advanced Life Support (ALS) ambulances can add life to a strong health emergency response.

Some of the confusion is due to the demand for drugs and therapies with little or no evidence. So, the Government should enforce evidence-based medicine by standard treatment protocols and continued education to healthcare workers, especially while fighting the pandemic.

Manpower strengthening: Pandemics come and go, but the scarcity of trained human resources will remain. Public health strengthening should be prioritised by focusing on disease prevention and health promotion. Setting up and scaling public health cadre should be the top priority for all governments.

Money allocation: India ranks 179 out of 189 countries when it comes to prioritising healthcare in the government budget. The government has to shift its focus from merely reimbursing expenditure for clinical care in private facilities, which is done at the cost of ignoring the primordial and primary healthcare. Currently, the public healthcare infrastructure cannot handle a near-normal situation, let alone handling the pandemic. Can we hope that we will be better ready for the next wave or wait for another pandemic?

(Giridhara R Babu is a professor of Epidemiology, and Deepa is a research fellow at the Indian Institute of Public Health, PHFI, Bengaluru)