It is January 8 again, a year since the first meeting of the Joint Monitoring Group under the Director General Health Services was convened by director, emergency response, to formulate the government’s stand on COVID-19, a fast-emerging health threat then. A national task force with experts was also constituted.
Thus began India’s battle against a pandemic, which was not just a public health crisis but also one with economic and social consequences.
Backed by scientific advice and led by the Prime Minister, India’s proactive, pre-emptive and graded response exemplified the myriad fronts on which the central government coordinated policy and implementation across multiple departments and states.
The first advisory was received on January 17, 2020. DG, ICMR, colleague secretary in the ministry, always a phone call away, ensured that testing was arranged at the ICMR’s NIV laboratory. India’s first case came on January 30, a student returnee from Wuhan. Personally, till I handed over charge as health secretary to an able successor in end-July, these seven months were life changing. I had served as commissioner, disaster management, in the combined state of Andhra Pradesh, handled two cyclones, seven floods, a drought, and Zika and Nipah outbreaks, but this was unimaginably different. COVID was an evolving challenge, with no known “right way”, health infrastructure and human resources constraints, no treatment guidelines or training modules, high dependence on imports for essential protective equipment and testing probes/reagents. There was also an “infodemic” to counter.
These seven months taught me much — from lessons in humility to listening more than speaking, the value of collaborative leadership, and admiration for the selfless work of colleagues in central and state governments. I came away with respect and gratitude for the efforts of doctors, nurses, ASHAs, frontline workers, including police personnel and the armed forces, who apart from assisting in emergency operations, opened their facilities to civilians, compensating for infrastructure shortages. There was pride at the capability of our scientists and researchers, the pharma and related industry, which quickly re-engineered their processes to “Make in India” the essentials needed to fight the pandemic. Young journalists on the MoHFW beat kept awake all night to cover the news sent by our team, a media shy joint secretary became the face of the MoHFW. More importantly, I was filled with respect for our people who, ungrudgingly, made sacrifices, and a renewed faith in our resilience and ability to stand together.
Led personally by the PM, the states and the Centre worked in harmony to meet the COVID-19 challenge in a spirit of cooperative federalism. Regular interactions of the PM with the chief ministers, Group of Ministers chaired by the health minister, committee of secretaries under the Cabinet Secretary, 11 empowered groups led by secretaries/member/CEO NITI Ayog, and almost daily video conferences of the minister, secretary and officers of MoHFW with states, enabled a focused response.
Guidance for public health teams, health facilities and service providers and the lay public was given. Testing, quarantine and isolation norms were framed and surveillance and case management protocols drafted. Guidelines were issued for the use of protective equipment, maintaining essential non-COVID health services, wearing masks and maintaining do gaz ki doori. Free helpline numbers were set up for COVID-related queries, specifically for mental health issues. Training resources for volunteers and frontline workers were created via the iGOT platform and human resources were moblised through covidwarriors.gov.in. Safety net packages for the vulnerable were organised (PM Garib Kalyan Yojana, a Rs 1.70-lakh-crore relief package). Guidelines were also issued for highlighting the inspirational work of COVID health professionals, development of the Arogya Setu App, redesigning e-Sanjeevani for teleconsultation, uploading real-time testing data on the ICMR portal and indigenous manufacturing of Trunat and rapid antigen testing kits. Once an importer of PPEs, masks and ventilators, the country became an exporter of these items.
Today, with a population of 135 crore, we have a case fatality rate of 1.45 per cent, a recovery rate of 96.3 per cent, over 15 lakh isolation, 2.7 lakh oxygen and 80,557 ICU beds and 40,627 ventilators. From one lab at the beginning of the pandemic, the country has 2,305 labs, and an enhanced testing capacity of 12 lakh tests per day. Behind this is the untiring work of experts, search for global best practices and consensus-building across stakeholders.
On January 3, India approved two indigenously manufactured vaccines, concurrently making extensive arrangements to rollout the world’s largest vaccination drive. I am sure, as always, together we can.
This article first appeared in the print edition on January 8, 2021 under the title ‘Covid lessons in humility’. The writer is former Union Secretary, Health & Family Welfare.