Often, we think of the “worst-case scenario” during pandemics. This fuels panic and fear and, at times, makes us take decisions that are not guided by prudence, logic and evidence. The COVID-19 pandemic has been no different. India rose to the occasion initially, screening airline passengers and then, suddenly, announcing a nationwide lockdown. In retrospect, we can say that the lockdown restricted movement, made Indians homebound but it also contained the pandemic and, most definitely, saved lives. The trapped migrant workers, however, struggled for livelihood and had to be gradually transported back to their homes — this created a strain for the establishment.
The lockdown gave India time to prepare. But we had to take an economic hit — a transient one, it seems — and ramp up our healthcare infrastructure. The healthcare sector responded proactively across the board; that clearly made a significant dent on the number of infections and helped keep the fatality rate in check. Unfortunately, the sign of a catastrophe often compels us to act impulsively — we tend to forget “balancing” between saving lives and hampering livelihoods. Plans and policies based on mathematical models are, unfortunately, not often valid in the biological world of lethal pathogens like the coronavirus. Systematic evidence-based research in public health can map the pandemic geographically and generate more informed decision-making. The Centre and state governments rose to the occasion, often relying on expert advice. However, the heterogeneity of India and the complexities in our systems made implementation of simple things tough.
So, what are the lessons we have learned from the pandemic? And are we in a position to deal with the health crisis better?
Indians showed enormous resilience. The data speaks for itself — the second-most populous country in the world has one of the best recovery rates and one of the lowest case fatality rates.
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It is often said that we did not test enough. But a careful analysis of the Indian strategy shows that testing was scaled up from a near-absent base to one of the largest testing capacities, with the fastest turnaround time in the world. The COVID-19 antigen test has a response time of less than an hour and the RT-PCR test less than 24 hours — this is something that even large countries like the US and the UK struggle with. We will still need more innovations that produce rapid solutions — saliva tests, for example. The CRISPR-based tests are likely to provide a cutting-edge dimension to the battle against the virus. The need to validate the viral load cycle threshold values is the next research milestone that will help assess who needs extra care among the infected.
As we mindfully unlock the country, it is time to focus on protecting the most susceptible — those above 55 years of age with comorbidities. However, we can’t be complacent about adults and youth, who can be the silent spreaders. They need to follow the COVID-19 kavach mantra of using masks, following social distance protocols and being scrupulous about hygiene. Self-care, self-protection and atmanirbharta (self-reliance) is the key to COVID-19 control. The virus is unpredictable and tricky. Localised transmission is well known in the community and a clear-cut containment strategy is mandatory.
A strict and result-oriented containment plan driven by sound public health science is still needed in hot-spots. The transmission trajectory of the virus has moved from the poorer urban slums to middle-class localities and has seeped into the community. Indians have risen to this challenge, while also negotiating an infodemic that has often been full of myths.
Demystification and allaying fears are important, but we have often seen extreme posturing in the past few months. We now know that the coronavirus is an airborne droplet which thrives in moist environments, and is transmitted via saliva, nasal, throat secretions and cough droplets, apart from physical contact with contaminated surfaces. We need to minimise activities that require physical contact. Exhaust fans and air recirculation in public kitchens and toilets can impact the disease transmission.
Gatherings — small, medium or large — can be potential spreaders. Avoiding crowds and breathing fresh air in well-ventilated spaces is the way forward. Indian culture is full of feasts and festivals and these often involve travel, movement and interaction. The lockdown has impacted minds in a mixed way — people are trapped between fear and recklessness. Remaining within the Lakshman rekha is the key as we embrace the festive season with responsibility and caution. Indians have the highest tolerance threshold for centuries, which now needs to be channelled in COVID-appropriate behaviour and habits.
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Simple habits enshrined in our traditional culture can be re-inducted in our daily lives. Eating healthy protein-rich food — but not in excess — avoiding fried and fast food, as well as not eating excessively will stand us in good stead. Eating slowly, eating on time and focusing on traditional foods that build immunity hold the key. Exercising is important — from a simple suryanamaskar and breathing exercises like pranayama to expanding and improving our lung capacity. Often chanting mantras generates positive energy, reduces anxiety and allows us to focus without fear. Sleeping well, sleeping on time and sleeping early is also important. Humans need at least seven hours of sleep and sleeping early allows us to generate healthy substances which are protective (like IL-10, interleukin 10, a protective chemical). We live in an era of digital overload and it’s important to digitally detox daily by engaging in hobbies, music and activities which enhance positivity.
The only way to conquer COVID-19 is to motivate every citizen to become an ambassador of the war against COVID. It is time that citizens take responsibility for themselves and take care of their fellow Indians, and extricate the country out of the pandemic with grace and dignity.
This article first appeared in the print edition on October 21, 2020 under the title “Every citizen a Covid warrior”. The writer is the dean of Indian College of Physicians and a well-known endocrinologist in Mumbai. He was awarded the Padma Shri in 2014
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Simple habits enshrined in our traditional culture can be re-inducted in our daily lives. Eating healthy protein-rich food — but not in excess — avoiding fried and fast food, as well as not eating excessively will stand us in good stead. (Illustration by C R Sasikumar) 
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