The relentlessly soaring figures of infection and mortality on account of Covid-19 and the nation’s response to come to terms with them through medical intervention and non-pharmaceutical approaches have been attracting wide public attention. The effect of the pandemic on the economy and the adequacy of government action—through stimulus packages and reform measures—have also formed a major part of national discourse. But the subterranean fear—based partly on reality and partly on perception—that has engulfed the citizenry remains unarticulated.
There are two main reasons behind such public apprehension. One is the uniqueness of the disease that caught even the developed nations unawares. The second is the inadequacy of the executive machinery to assuage the public, with the help of relevant statistics, not to panic but to remain careful. Drawing a line between the two has never been easy.
An article in Nature Medicine by immunologist Thiago Carvalho on June 26 admirably sums up the findings of global biomedical research over the last six months—in clinical testing, drug repurposing, vaccine development, understanding the pathogenesis, immunity and transmission modes. We learn of the important advances since the RT-PCR test and how serological testing has received a boost. And how remdesivir and dexamethasone have been effective under specific conditions. Amongst vaccine candidates, the article suggests Moderna and CanSino have shown promising results.
Besides, passive immunisation through various means like convalescent plasma and hyper-immune serum preparations is also being attempted. As we know, India’s vaccine candidate is also being fast-tracked. No doubt, the world is better prepared now to combat the disease. Science never makes unsubstantiated claims. If one looks at what the US Centres for Disease Control and Prevention says about how Covid-19 spreads, cautious use of words —‘mainly’, ‘The virus is thought to spread…’, ‘It may be possible that a person can get Covid-19 by touching a surface or object that has the virus on it… This is not thought to be the main way the virus spreads…’—indicate that even in scientific circles, the learning process is continuing and therefore, many such advisories are rather probabilistic in nature.
This is because of an imperfect understanding of the whole problem. The WHO’s recent interventions about the infection potential of asymptomatic persons and on airborne transmission of the virus have also not cleared the air altogether. Under such circumstances, what can the executive do in a country with our population density, poverty, illiteracy, poor nutritional status and inadequate health infrastructure? Does instilling fear in the public psyche really help? Since fear begets fear, how can the transmission of pervasive fear be prevented? Admittedly, fear can cause paranoia in extreme cases, but much worse is when the reverse happens, with people tempted to throw caution to the wind. The greater the relaxation, the greater is the need for every individual to follow the instructions of social distancing, wearing of masks and hand hygiene.
The prime minister’s appeal before Unlock 2.0 from July 1 has to be read in this context. The current circumstances, therefore, demand a robust communication strategy to be put in place, the most important component of which would be to share relevant information based on available statistics. We would like to know what has been learnt from the experience so far, both local and global, and how the appropriate practices are sought to be introduced. Has any standard template/protocol for treatment been developed that even physicians in, say, areas like Siliguri, Meerut or Nellore are acquainted with and trained in? Are there channels of communication for experience sharing between apex institutions like the AIIMS and state and district hospitals? With advances in treatment, are the mortality rates showing a perceptible decline? Are there studies about the key modes of transmission in the Indian context? How are the frontline healthcare personnel being incentivised? What are the disaggregated data available that can provide insight into India-specific issues?
Equally important, what are the problems being faced by non-Covid patients? Since senior citizens and others with comorbidities are advised to stay indoors, what kind of health problems are they facing? How effective and widespread have telemedicine services been? In the absence of collection and dissemination of the right kind of information, people tend to feel helpless, and, influenced by television and social media, be unduly panic-stricken. With graded unlocking, there are likely to be further spikes, especially when mass transport like Metro services are allowed. The government should not only be prepared in terms of infrastructure, it should also work with and take into confidence the stakeholders to ensure a people-led fight against the disease.
For instance, many train services were suddenly cancelled, which must be for a justifiable reason. But shouldn’t the railway authorities have explained what prompted this unilateral decision, with facts and figures? Democratic governments are not great communicators. But the present war-like situation demands that decisive action proceeds in tandem with meaningful communication. That will encourage the public to behave more rationally and proactively, freed from undue apprehensions.
Amitabha Bhattacharya
Former IAS officer who has also worked in the private sector and with the UNDP
(amitabha2110@gmail.com)