While applauding India’s “remarkable success” in containing the spread of the novel coronavirus disease in the first phase of the outbreak, David Nabarro, the World Health Organisation’s (WHO) Special Envoy on Covid-19, said the key to success in the next phase would be the preparedness of local governments in suppressing and managing outbreaks at the community level.
Nabarro, a British physician and public health professional who was in the race for the top post at WHO, is one of the six special envoys named by the WHO director general in February to provide strategic advice to countries and engage in high-level political advocacy on Covid-19.
In an interview given to The Indian Express, Nabarro, 70, said India had done remarkably well so far to slow down the spread of the virus, and to keep it contained in some urban pockets. But as the lockdown is lifted, it is “inevitable” that outbreaks will take place in many other areas, he said — and everyone in the country needed to be educated about what was happening, and prepared to deal with the crisis.
“India can live with Covid and can really keep the virus at bay only through doing the following. One is that every single person in the country needs to be made aware of the virus so that they know the importance of interrupting the transmission as soon as an outbreak builds up.
“And, second, every single panchayat and zilla parishad in India should build up capacity to suppress outbreaks quickly. That, of course, would have be accompanied with providing support to the people who are affected by this suppression because poor people get so much hurt by it. But having this capacity to suppress the outbreak while protecting the poor is the second requirement that India must have,” Nabarro said.
“If you have everybody on alert for interrupting the transmission and have widespread capacity to suppress outbreaks, which will involve restricting movement like in the current lockdown, but at very local level, then the rest of the society can go about their lives normally, can be joyful, can have their jobs. It is not going to be comfortable, of course, and the first few weeks and months after the (current) lockdown ends, are going to be tough, but it is doable,” he said.
Nabarro said it was this kind of approach that had helped China keep a tight lid over the resurgence of the epidemic.
“What I am hearing of China from my Chinese colleagues is that they have really implemented a nationwide network of community health personnel who are keeping a close watch on the cases. The moment they find a case, they isolate the patient immediately. They have really managed to get this right, across the country. This is what I am told.
“They (China) have also made sure that the entire population knows how serious this problem is. And then, they also seem to be very, very cautious. Because they know they will have new people coming into the country, and they are mindful of the fact that there will be multiple resurgences coming. And they are getting ready to contain them as quickly as possible. I think India would also have to do the same,” he said.
Nabarro said the way India had handled the epidemic so far gave him enormous confidence that it would be able to successfully manage the next stage as well.
“One of the things that I look at from your country is the doubling time of the number of cases. I was finding out, as of a few days ago, doubling time in your country seems to be about 11 days. That is a really good, because what we know from other places is that if this virus does what it wants to do, and there is no effort to limit transmission, then the doubling time is about every two and a half days. So if you have a doubling time of 11 days, then what it means is that opportunities for transmission have been substantially reduced,” he said.
“An 11-day doubling time is quite remarkable. It means that there has been a real effort, and a successful effort, to slow the spread of this virus. I have said this earlier that I see signs of an incredible achievement in a country that is normally very populous in urban areas, and there is usually a lot of movement of people,” he said.
Nabarro said while lockdowns could be “brutal”, and in general was a “terrible thing”, it would not have been a wise decision to let the virus spread without any intervention.
“Let me tell you that if this virus was allowed to move across the world with no effort to contain it, it would cause, we believe, an enormous number of people to become ill and die. We don’t yet fully understand many things about this virus. It seems to be capable of causing more than just respiratory illnesses, and it could have other impacts as well. All of us who have been working with this virus, and other coronaviruses as well, have learnt to be extremely cautious about these viruses,” he said.
He also said he did not see a vaccine coming to the help of people before the next two years, and it was better that countries and people learnt to live with the virus at least for that long.
“I am encouraging everybody to think in terms of living with this virus for at least two years. And that applies to all 7.8 billion people on our planet. It is going to be a universal learning process,” he said.
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