From an expert on the panel that released the Covid-19 national supermodel to being member on the Prime Minister’s Science, Technology and Innovation Advisory Council (PM-STIAC) to mentoring City Knowledge and Innovation Clusters, LT GEN MADHURI KANITKAR, Deputy Chief, Integrated Defence Staff (Medical) under Chief of Defence Staff, has been a strong proponent of the need to align medical education and research for public health needs. She tells ANURADHA MASCARENHAS that Pune, with its expertise of academic and research institutions, can show the way forward to encourage innovation through clusters. Excerpts from an interview:
You were in the panel of seven expert scientists that came out with a Covid-19 national supermodel predicting India had crossed its peak by mid-September and will see minimal cases by February. What was unique about this model?
The Centre is keeping a close eye on infectivity and mortality and, hence, it was imperative to bring in a robust forecasting model for predicting the spread and enhancing disease surveillance. The Covid-19 national supermodel helps monitor future transmission and aids decisions involving health system readiness and other mitigation measures. The timing of lockdown was important to flatten the curve. We got time to prepare infrastructure and ramp up testing facilities. What was unique was the Susceptible-Asymptomatic-Infected-Removed (SAIR) model that breaks down the population into broad groups of individuals, depending on their relationship with the infection. So the population was divided into four groups – susceptible (those not yet infected), asymptomatic (those infected but with no or few symptoms), infected and removed (those infected but have recovered or died). The numbers in each category change as the pandemic progresses and the SAIR model helped capture the change in infection rate over time. The mathematical model is important and, if these formulas work, they will get standardised. As more data is added, the model can be fine-tuned for better results.
With the festive season round the corner and winter setting in, do you foresee a second wave of infections?
It is now in our hands. At one of my presentations, I drafted a tagline that the past will not last and the future is in our hands to nurture. Due to lockdown, we got time to prepare infrastructure and ramp up testing facilities. We can safely say the worst of the transmission is done. We cannot keep everything shut forever and it is important for everyone to understand that they are responsible for their health. We do not want another spike, so important measures are needed, such as avoiding crowded places, especially those with poor ventilation. The importance of personal care cannot be stressed enough and it is now each individual’s responsibility to prevent new infections. It would depend on serosurveillance and people really need to be careful. Winter setting in may not make such a huge difference as that would mainly be in the northern parts of the country.
Are we testing enough?
A. We are not doing fewer number of tests. There is a lot of testing in Uttar Pradesh and Bihar and the positivity is not high. We can safely say the worst of the transmission is done for that big outbreak.
The armed forces played a massive role in mitigating the Covid-19 challenge. What kind of effort?
The armed forces have been at the forefront of the fight against Covid-19. Fifty military hospitals across the country were dedicated to treating civilians as well as serving personnel. With about 79 lakh Covid cases in India so far, the armed forces account for about 40,000 cases, including serving and retired personnel, along with dependents. Testing facilities at 28 armed forces locations have been set up, with about three lakh samples tested to date. The AFMS (Armed Forces Medical Services) in conjunction with DRDO (Defence Research and Development Organisation) set up three Covid hospitals, one each in Delhi, Patna and Muzaffarpur. These hospitals are being managed by dedicated teams from the AFMS. Apart from the domestic front, the armed forces also sent medical teams and supplies to various countries like Maldives, Nepal, Kuwait to help them combat the pandemic. Quarantine facilities in 21 cities were set up to handle evacuees from different countries reaching India via Vande Bharat flights with more than 3,500 individuals quarantined to date.
How will the armed forces be involved in vaccine delivery mechanism as being planned by the government?
A. The armed forces has made all preparations and will follow the same guidelines as specified by Ministry of Health and Family Welfare. We will not make a separate policy as to who will get the vaccine first. The armed forces will follow the same protocol and give it to healthcare workers first. We have our numbers ready and our plan under the DGAFMS (Directorate General Armed Forces Medical Services) is ready.
You are the only doctor on the PM-STIAC. What has the experience been and what key projects are being undertaken in future?
The experience has been like opening up a huge Pandora’s box. The STIAC is a massive canvas and there is a potential to do so much. Also, there is a 360 degrees perspective on any subject and decision made. Some include precision medicine and Indian Genome project. The future is going to be personalised medicine and our Indian diaspora is so different that creating this genetic database to arrive at local solutions is an important project. There is another project, MANAS, to create a mental wellness platform. NIMHANS (National Institute of Mental Health and Neurosciences), AFMC (Armed Forces Medical College) and C-DAC (Centre for Development of Advanced Computing) are working on rolling out an early trial with an aim to reinforce positive mental health.
You are one of the key mentors and a member of the committee set up by NITI Aayog for developing City Knowledge and Innovation Clusters. Pune has officially received the tag. How has the city performed?
I am happy that at least six city clusters have been planned. In Pune, it is being mentored and spearheaded by Dr Ajit Kembhavi and Dr L S Shashidhara. IISER and Persistent Systems collaborated with the Pune local government and did fantastic work with the serosurveillance. Pune has shown a way for the city to work together amidst the Covid crisis and a lot of learning can come out of it. We are hopeful that this can be taught in other cities. Pune has the best academic and research institutions and students need to be encouraged to take on summer internship programmes with these institutes. Pune can help other cities as clusters can connect between existing research and knowledge set-ups.
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