IASbhai Daily Editorial Hunt |Social Vaccine for Covid-19| 3rd June
“Things work out best for those who make the best of how things work out.” –John Wooden
EDITORIAL HUNT 87 :“Scripting a new narrative for COVID control“
SOURCES: THE HINDU EDITORIAL/EDITORIALS FOR UPSC CSE MAINS 2020
M.S. Seshadri is Retired Professor of Medical Endocriniology, Christian Medical College, Vellore and now Medical Director, Thirumalai Mission Hospital, Ranipet, Tamil Nadu.
Scripting a new narrative for COVID control
If social vaccine is the legacy of HIV control, that of novel coronavirus control ought to be more far-reaching
SYLLABUS COVERED: GS 3:Diseases:Social Vaccine for Covid-19
“Social vaccine” stimulates society’s protective knowledge and practices countering major health threats. Discuss (GS-3).
In this Article you will learn about How A social vaccine for COVID-19 can be designed .
- A breif comparision in approaches of HIV vs COVID-19
- Lockdown effects
- and most important a practical approach of owning a social vaccine for COVID-19 !
- India had warning about the COVID-19 epidemic in China spreading to neighbouring countries well ahead of virus importations; yet, the nation faltered.
- STRATEGIC PLANNING : Strategy planning is dynamic, with revisions as the ground reality changes.
“In preparing for battle, I have always found that plans are useless but planning is indispensable.”-Eisenhower
- UNDERSTANDING THE OUTBREAK : India’s early strategy (traditional pandemic control: prevent virus importations from China and neighbouring countries and interrupt importation-related local spread) succeeded,
- UNCONTROLLED OUTBREAK : Importations from the West and West Asian countriesbefore they were red flagged seeded local outbreaks in several places.
- ABRUPT CALLS : As transmission is through social contacts, social distancing in its extreme form (a nation-wide lockdown) was declared early and abruptly, from March 24 midnight.
THE HIV PLAN
- MULTI-PRONGED INTERVENTIONS : When HIV importations and local spread were detected, Indian experts studied the situation, and, rejecting advice from the World Health Organization (WHO) for only “syndromic diagnosis” of AIDS, devised — “social vaccine” including hospital infection control and innovative laboratory-testing tactic called sentinel surveillance.
- INFRASTRUCTURE : For safe blood transfusion, lab-testing was mandatory.
- SPECIFICITY : Sensitivity and specificity of HIV lab tests were near 100%.
For COVID-19, polymerase chain reaction (PCR) tests were necessary to detect importations and contact screening.
FLAWS IN ASSESSMENT OF COVID-19:
- MONITORING APPROACH : Epidemics were asynchronous in different States; the simplest way to monitor epidemic growth was criteria-based clinical diagnosis and confirmation by PCR when deemed necessary. Instead, India blindly continues WHO advice: “test, test, test”.
- NEGLECTING COMMUNITY SPREAD : COVID-19 community spread was denied for too long, promoting epidemic expansion and deaths particularly among health-care personnel.
- TOTAL TEST : By May 18, testing covered 0.17% of India’s population, detecting almost 100,000 infections.
- We cannot use such data to assess the magnitude of the epidemic.
- BEHAVIOURAL PATTERNS : Community transmission of HIV was the signal for the public to change behaviour and take precautions.
- AWARENESS : Early warning and public education would have slowed the epidemic and saved lives.
LOCKDOWN VS. MASK WEARING
- ANCIENT JAIN WISDOM : Jain munis, realising there are organisms in aerosols and droplets, wear masks to avoid inhaling them — a unique preventive measure born out of ancient wisdom.
- UNIVERSAL MASK : Hong Kong and Taiwan demonstrated the value of universal mask-wearing to mitigate the current pandemic.
WHY SHOULD COVID-19 BE MANAGED DIFFERENTLY?
MORE GAINS AND LESS EXPENSES:
- MILD SYMPTOMS : Home quarantine of all with mild symptoms is simple and safe.
- SUPERVISION : Their medical supervision should be through daily phone calls with the assigned doctor.
- SCANNING : For those with breathing difficulty, a chest X ray or CT scan identifies pneumonia.
This approach would have fetched us more gains for less expense.
- REDUNDANT TESTING : The original testing policy was essential at first, but became redundant and misleading by end-March.
- EVAPORATING MONEY : Why evaporate the public exchequer for little or limited public benefit? Now the best use of tests is to confirm clinical diagnosis.
We have far fewer citizens above 60 than the United States and Europe; flattening the mortality curve is eminently feasible and culturally appropriate.
- RISK OF HIGH MORTALITY : Those over 60 years, and those with diabetes, hypertension, heart disease, chronic respiratory disease and obesity.
- SOCIAL NORMS : The norm in urban middle class and rural families is to protect old parents and vulnerable family members.
- COCOONING :This demanded cocooning (reverse quarantine) the elderly and the vulnerable.
- MOBILISATION : Social mobilisation subsumes public education for attitudinal and behavioural changes to overcome social determinants of microbial transmission.
A PRACTICAL PLATFORM
- LOCALISED DECENTRALISATION : A COVID-19 committee as a practical platform in every district, with representation from civil society and various other platforms will be a practical platform.
- MICROBIOLOGICAL CLEANLINESS : With a wider agenda, the fruits of their labour, improved health and education, nation-wide implementation of visionary concepts such as Swachh Bharat for microbiological cleanliness at home will be ready for harvest.
We have a unique opportunity to script a new narrative to win the present struggle and perpetuate its legacy, with will and wisdom.