As India reels under a massive second wave of the coronavirus pandemic, the positive cases and deaths are rising alarmingly, forcing many states to impose limited lockdowns once again in order to curb the spread of the virus. It is required to learn and implement lessons from previous pandemics and other natural disasters.
Lessons from 1918: The Spanish Flu pandemic data shows that the second wave was the deadliest as it affected and killed more people in a short period than other waves during the entire pandemic. As data has shown so far, many countries have already experienced a major second wave and some a third one; hence, there was no reason for us to believe that the situation would be different in India. The Covid-19 cases in India are now at their highest level since the beginning of October 2020 and complicating matters further, some new variants of the virus are thought to be responsible for the sudden spike. Even though we were victorious in handling the first wave, we should have prepared for possible second and third waves knowing fully well from history that subsequent waves are almost a certainty and have invariably been much deadlier.
Public health planning and communication should have been strengthened after the lull in cases between November-February instead of sending out mixed messages and dismantling emergency medical infrastructure deployed during the first wave and removing physical distancing restrictions too quickly. While this is certainly not the time to look in hindsight and blame governments for not doing enough or people themselves for not adhering to Covid-appropriate behaviour, we need to quickly learn and make amends—all of us!
Disaster preparedness and building redundancies: While we are dealing with the pandemic largely under the ambit of the Disaster Management Act, 2005, which established the National Disaster Management Authority (NDMA) besides the Epidemic Diseases Act, 1897 (as amended last year), all our effort after the first wave has been confined only to post-disaster response and restoration. We should have considered the other essential elements of a natural disaster management system like pre-disaster preparedness and mitigation. This was all the more important because while we confronted the first wave without any preparedness due to the once-in-a century pandemic’s novelty, we could have used that experience to ramp up preparedness and mitigation measures for a possible second or third wave by building the requisite redundancies.
We should prepare a full-fledged preparedness and mitigation plan alongside a post-disaster response and recovery strategy nationally, broken down to region-wise micro-strategies framed in consultation with the states just as we currently do for a natural disaster like cyclones or floods. As a part of disaster preparedness against cyclones and floods, Odisha constructed close to a 1,000 multi-purpose cyclone shelters after the super cyclone of 1999 which, though they remain unused for most part of the year, are like hot sites ready to start functioning as and when a cyclone or flood strikes. We have seen the results of such preparedness by Odisha in the form of near zero loss of lives and property in calamities after calamities, which has been repeatedly applauded by the UN and other international agencies.
Since the 1990s with the SARS, MERS and Ebola viruses creating havoc in localised regions, the possibility of such events (pandemics) occurring had increased manifold all over the world and hence, our systems and structures like the NDMA should not look at these redundancies as a wastage of resources. If the NDMA had prepared such a plan, it would have most possibly built these redundancies to fight the sharp increase in the demand for oxygen, hospital beds and ICU facilities being faced now.
For this reason, temporary pandemic care centres at panchayat, block and district levels have to be identified and kept ready for operation at short notice; adequate supply of oxygen, oxygen beds, and equipment like ventilators and ambulances with oxygen facilities have to be ensured and deployment plans for doctors, nurses and paramedics kept ready just as Odisha had done during the first wave of the pandemic. Even though it was confronting a pandemic for the first time, the Odisha government used its previous experience in handling natural disasters to involve community and build community resilience to manage Covid, particularly in rural areas—starting from involving women SHGs for spreading awareness and distribution of ration to delegating power to district magistrates and sarpanchs. There were also separate Covid and non-Covid hospitals, and data and modelling were used to decide micro-containment strategies and plans.
Conclusion: As things stand, we should hope for the best with respect to the current second wave, and at the same time prepare for the worst, for what could be coming, possibly a third wave or a variant that beats the acquired or vaccine-induced antibody regime that has been discussed by experts as a distinct possibility. Governments across states should look to build medical infrastructure and redundancies in our health systems so that in future, we are not overwhelmed during such a crisis. States should be empowered to not only dip into the State Disaster Response Fund (SDRF) without awaiting approval from the Union government but also use the funding available to scale up and build acceptable levels of redundancies in medical infrastructure in the longer term.
We should continue to reinvigorate smart testing and tracing, with firm messaging on social distancing and masking. Genomic surveillance should be scaled up to track variants as early as possible to assess the efficacies of the various vaccines a priori. Supply chains for production and manufacturing medical APIs, PPE kits and medical oxygen facilities have to be augmented manifold all over the country, in every state and district.
Make no mistake, there will be subsequent waves, and India must heed the lessons from the current wave and the 1918 pandemic or else, all our efforts will be futile including vaccination.
Amar Patnaik
BJD Rajya Sabha MP from Odisha and a former CAG bureaucrat
(amar_patnaik@yahoo.com)