According to WHO, India’s massive challenges are its “population”, the geographic variety, heterogeneity and the truth that it has a number of epidemics happening in each state.
The WHO appreciated the Indian authorities’s sturdy political management to deal with vital issues like creating and scaling up diagnostics and unlocking the nation in an organised method.
In an unique interview with ANI, WHO chief scientist Dr Soumya Swaminathan stated, “The Government of India took extremely serious steps from the beginning and put in place certain measures in January itself based on the WHO recommendations. Today, India is doing more than 2 lakh tests a day. Now, India is developing testing kits. It is a big achievement for India that in the last couple of months it has become self-sufficient.”
“However, I would like to say that there should be focus on data. By that, I mean that we need to have a systematic approach to looking at the data,” she stated.
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She stated that it we begin specializing in the entire variety of instances and deaths, we are going to solely get a part of the story.
“There needs to be some kind of national guidelines on how you report data. Otherwise, you cannot compare. Everybody is reporting things in different ways,” she stated, citing an instance that WHO has beneficial sure standards that the federal government can use to evaluate the place the pandemic is.
She stated that the very first thing one should know is the epidemiology of the illness, i.e. the place and what’s the variety of instances per million inhabitants and all of it relies upon upon the checks.
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“If we do not test, we are not going to find the case. Reporting of the case alone is not sufficient. We need to know how many tests have been done. Most importantly, we need to know the test positivity rate. This should be under 5 per cent. We also need to know the percentage of positivity of disease surveillance. SARI and ILI surveillance should be under 5 per cent. Then, we need to keep track of the doubling time,” Dr Swaminathan acknowledged.
“So, instead of focusing only on numbers, all we need to know things like – how the epidemiology is going. Is it going up or down or is it on a plateau. That is what we need to know,” stated the WHO chief scientist.
Highlighting the significance of public well being capacities in India, Dr Swaminathan stated that it is rather vital to know what number of contacts are traced for each case and what number of of them are quarantined and inside what time period.
Dr Swaminathan defined, “If you can do it within 48 to 72 hours, then only it is helpful. There is no point tracing contact after 10 days. It is too late. As soon as cases are detected, we have to trace the contacts and the higher the number of contacts you trace, the higher number you can put in quarantine. This shows how well our public health system is doing.”
“Another set of criteria in our clinical care is to know what is the bed capacity for mild/severe cases, what is the ICU occupancy and then, of course, the death rate. The death has to be calculated properly because deaths follow after two or three weeks of the occupancy. You take as a numerator the number of deaths and denominators should be the number of cases you have two weeks ago, not today. That actually reflects your mortality rate/case fatality rate,” she stated.
Epidemiological parameters to detect the prevalence of antibodies in the neighborhood are important to know the pattern. “Like the ICMR did serosurvey – something you need to do periodically to see how much of the population has been exposed,” Dr Swaminathan stated.
She added, “We need to have a dashboard of criteria which every state should have and it helps every state to monitor how they are doing. This also helps to compare data across the states and the government can give more resources to those states which need more strengthening, like in terms of bed shortage, ICU.”
Besides, states may assist one another. Narrating an instance of the way it was accomplished in Europe. Dr Swaminathan defined, “When there was an acute shortage of beds in France, the government actually moved patients from France to Germany for ICU care. States could also help each other out.”
“So, there is a need to develop this kind of mechanism because Covid-19 is going to stay for a long time,” she stated.
She added that the healthcare system must also present different companies.
“We cannot just focus on Covid-19 alone because we have other health problems in the country. Otherwise, those health problems such as TB, vaccine-preventable diseases like measles, institutional deliveries, elective surgeries and rehabilitation may get worse than Covid-19. So those things have to be brought back to normal and capacity of the healthcare system has to be increased,” she stated.