Hyderabad: The process of unlocking after the second wave must be slow to control the Covid-19 situation, and lift of restrictions must not allow the formation of new variants of Sars-CoV-2, the Coronavirus strain which causes Covid-19. Experts state that if there is crowding and even small gatherings in poorly ventilated spaces, coupled with ignoring the face mask, there are chances of spread of the Coronavirus and Covid-19 super-spreader events.
To prevent this from happening, the local administration must be empowered to take action. The measures that are to be taken were supported by lessons provided by the Birhanmumbai Municipal Corporation, Nandurbar district in Maharashtra and Kerala, where surveillance was used to control the second wave.
Effective surveillance helped in controlling panic by building faith among the people that the administration would provide them access to healthcare facilities and timely treatment. These models used technology to guide people on the availability of beds and oxygen concentrators and provided the right picture with regard to Covid-19 data which helped in handling the situation.
“These three models show that the local administration was able to build confidence in the people and reduce panic,” explained Dr Rajan Shukla, associate professor of Indian Institute of Public Health.
“State and local administrations have to learn to pre-empt or nip panic in the bud. Hiding information does not help. Instead, it leads to mistrust and increases desperation in the community. Public health systems are based on transparency and effective communication," Dr Shukla said.
Districts which continue to report a large number of cases must be mentioned clearly, and there must be measures taken to control Covid-19 spread to other districts. Effective management of the local administration along with state and Central governments is important in controlling the spread of Covid-19.
Strict implementation of Covid-19 appropriate behaviour (CAB) by engaging police, food and civil supplies and agriculture departments along with the women and child welfare department and gram panchayats is the way forward.
In a recent all-India survey by medical colleges it was found that 50 per cent of the people were wearing masks, of which 15 per cent were not wearing them properly. This means that only 35 per cent were wearing masks properly. The other half of the population was simply not wearing masks.
Experts said this would allow for opportunistic movement for the Coronavirus whose transmission process becomes easy. To prevent this, awareness campaigns must be conducted by ASHA, anganwadi and local administration workers on wearing masks and wearing them properly.
There is a major concern for rural areas in the recent reviews taken up by public health specialists, infection control specialists and senior doctors across the country wherein they insist that severe acute respiratory infections (Sars) must be continuously surveyed and reported.
This will help in early identification of cases and assist in tracking, tracing and treating of small pockets of infection early, as they arise. Public health centres and primary health centres in rural areas must notify these cases to nodal centres immediately.
Experts state that in the rural areas people are not aware of home-testing kits and ASHA and anganwadi workers must be equipped with these kits.
Providing isolation for Covid-19 patients in the second wave was found to be a challenge in rural areas, especially where the infection was seen as a taboo. A senior government official in the health department explained, “It affected their psychology and acceptance was a challenge. It has to be dealt with in a better way as treating a patient in that manner leads to trauma."
The hope is that vaccination will reduce the burden of severe disease and that will ease the pressure on the healthcare systems and social lifestyles. To achieve this maximum people have to be vaccinated and till that is done CAB must be followed religiously, they said.
What experts say
How to handle the ‘unlock’ process
- Reach out to recovered patients to understand gaps in healthcare system
- The hurdles that volunteers and family members faced must be revisited for better understanding to create effective systems.
- Weekly tests per million population and test positivity rate are important parts of the surveillance scheme
- Unlocking from the second wave must be measured with the behaviour of people and it must be slow.
- Preparing for the next wave till vaccinations are completed must be the goal as till maximum people are vaccinated safety will be a challenge.
Inputs by Heart Care Foundation of India Dr K.K. Aggarwal Research Fund