As we continue to test our strength against SARS-CoV-2 in what appears to be a prolonged tug of war, yielding ground in some months and gaining ground in others, I was curious to check what winning tactics are recommended in the real sport. Having rather feebly participated in a picnic game in school days, I had no clue other than to believe it was mostly about strength. However, there must be strategies that help some teams beat opponents who have more muscle. So, I turned to Google to get enlightened by tips from those who took it seriously.
Three key messages were conveyed by the experts: (1) Keep your strongest player at the back, to hold ground firmly without falling when the opponent is tugging vigorously; (2) When you think you are in a position to win, take small baby steps backward, for you are very likely to trip and fall if you suddenly take huge steps and (3) Teamwork is important, for everyone should pull at the same time. The winner overcomes the opponent only by exerting a greater force that is distributed both on the rope and on the ground. The tension on the rope and the friction force on the ground are opposing forces, the balance of which decides whether you win or lose. So, the winning strategy has to combine both the resolve to hold your ground against the adversary on firmly planted feet and use of upper body strength to steadily wear them down.
How do these tips apply to our test of strength against the virus? We should position our strongest and most resilient at the back of the line for vaccination, because they can hold the ground much better than others. We did that from January to April this year, by prioritising the age group above 45 years of age for early vaccination and keeping the younger age group for later. We then suddenly decided to open vaccination to all adults above 18 years of age, even as the virus was vigorously imposing its strength on us. That caused confusion in the strategy, with even the head of the national Covid Vaccine Working Group, Dr N K Arora, saying later that he was not in favour of the decision to open up vaccination to all age groups without fully covering the most vulnerable.
Even as we exerted our strength against the virus through vaccination, we needed to hold ground firmly by adopting Covid-appropriate behaviour and preventing slippage through superspreader events. We did that fairly well in 2020. However, we thought we were firmly grabbing victory in January 2021 and took big steps too suddenly by fully releasing ourselves from restrictions. We were befooled by spectators shouting that herd immunity had already given us the power of guaranteed victory and urging us to move fast. We slipped and stumbled into a second wave that the virus had dragged us into. We lost ground because of overconfidence and haste. Now that we have regained some ground, we should proceed cautiously and not move too hurriedly and slip again. We should carefully open up in small steps, lest the third wave drag us in the other direction.
During the first wave, we exhibited good teamwork. There was coordination between the Central and state governments, resulting in a synchronised response. During the second wave, that harmony was missing. People too responded in different ways; some continued to practice prudent precautions while others completely cast caution to the winds and behaved recklessly. With all the team members pulling in different directions without coordination of effort and timing, the virus could not be offered resistance as it came supercharged with the strength of new variants.
As we prepare for the third wave, we need to exert our power against the virus through the vaccines. That upper body strength has to be provided by the government, which takes policy and implementation decisions on vaccine production and distribution at the higher level. The two hands that must pull together are the Central and state governments. That coordination will help us to destabilise the virus and make it cede ground. The lower body strength, required for us to remain grounded and stable during this whole effort, is that of Covid-appropriate behaviour by the people. That will protect us from the pull of the virus.
These are the simple lessons I got from the tactical guide to the game of tug of war. They seem suitable for adoption in our strategy to combat the Covid pandemic. In the game, victory is declared when the white mark on the rope crosses the central point separating the teams. Perhaps the white mark for us is a vaccination coverage of 80-85%. So, let us pull with vigour, while standing strong and steady on the legs of Covid-appropriate behaviour.
(Views expressed are personal)
Dr K Srinath Reddy
Cardiologist, epidemiologist and President, Public Health Foundation of India (PHFI)
(ksrinath.reddy@phfi.org)