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Tuesday, May 24, 2022

The virus is here to stay. We must learn to live with it

🔴 C K Mishra writes: If we can implement a curfew, would it not be easier to control gatherings rather than impose blanket restrictions that will inconvenience all and rob daily wagers of their daily bread?

Written by C K Mishra |
Updated: January 18, 2022 10:25:25 pm
A health worker tests a sample for Covid-19. (Express Photo: Tashi Tobgyal, File)

It has been a long time since January 2020, when the first case of Covid-19 was reported in India. We’ve come a long way since those early days of uncertainty, when there was no treatment and no vaccine. Things have changed in many ways since then, but they do not seem to be changing quickly enough.

Everyone is aware that the Indian government, the healthcare and frontline workers and doctors have done a commendable job. However, as we look back and take stock, there are a few questions we must ask. Have we done well? Yes. Have we learnt our lessons well? Yes and no. And last but not the least, have we anticipated challenges well? No. We were not the first country to bear the brunt of the virus — and it was possible to learn from other countries. In the first wave, for example, we managed to keep casualties low with the use of steroids — a lesson that Italy had learnt the hard way and we had learnt from them. But that is an exception rather than the rule. One can argue that we had meagre resources in terms of health infrastructure and while no one can ramp this up overnight, one can certainly look at prudent optimal utilisation. Facing a third wave now, we may need to act differently.

Despite good intentions and efforts, there were multiple times when we did not act swiftly despite adequate, reasonably accurate information available on what was headed our way. We came up rather short in our preparations for the second wave, whether we choose to admit it or not. Our vaccination related decisions always followed, and were taken, post the rising number of cases. This was the case before the second wave, when we tiptoed around with the vaccine against a raging super-cyclone or now with the vaccination decision on “precaution” doses. Policy and interventions have not had a reality check. Our interventions do not always match up to the changing on-ground situation, even though we are up against a virus that is a nimble operator and has already seen so many mutations.

Let us look at the evidence. Only masks and lockdowns have been conclusively proven to slow down transmission. Why this predilection of many states then with night and weekend curfews? If they were indeed effective — and given the number of times we have taken recourse to them — we should by now have generated enough data to defend or junk them. Our policies and actions have to be flexible and adjust to the changing face of the pandemic.

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We should not resort to the same steps just so it appears we are doing. Responses that do not make any material difference, and are yet repeated over and over again, create fatigue in people and precipitate violations. Particularly so when they impact daily lives and livelihoods. In our obsession with keeping people’s spirits high and getting on with life, we trivialised the pandemic and failed to teach people to live with it safely. We oscillate between the two extremes of unreasonable panic and wanton carelessness. The path to follow is the middle one, and each state government should take a call on this based on their ground realities.

Even from an implementation perspective, night curfews make little sense. After all, how many late-night winter gatherings happen? If we can implement a curfew, would it not be easier to control gatherings rather than impose blanket restrictions that will inconvenience all and rob daily wagers of their daily bread? There are many who still refuse to wear masks, and are a threat to others and should be treated accordingly. We need to curb violations and not necessarily movement. But let us also pause for a while to think about why people are violating the rules. Where is our communication strategy?

We need to accept that we are way past the stage of containment and the need of the hour is mitigation. Instead of shouldering the entire responsibility, the government should shift the onus of keeping the pandemic at bay to the people but be prepared to step in when people need medical help. To do that the narrative has to change. The tone of communication has to be less patronising — we need to bring in a novelty of approach to get people to listen. If there was ever a time for innovative public health communication, it is now. We need to publicise the science — only what is proven beyond doubt.

We also need to recalibrate our testing strategy in line with changing realities. Or at least debate whether it is still “test, test and test”. We have done phenomenal work on vaccinations and 150 crore is a good number. This is the time to build on it. Full coverage (the second dose) is still some distance away in India while some countries are providing a fourth dose. There is enough vaccine availability. Why are we moving so slowly on boosters? We need to make them available for all and create an enabling policy environment so that people protect themselves and the government does not even have to pay.

The last couple of years have shown us that pandemic control decisions are critical. We really need to debate if now is the time to think of a policy de-control. Many epidemics end either with the disease being eradicated or the disease becoming endemic. We now know that we have to adapt to living alongside Covid-19, and we need to shift from viewing it as a one-time threat that defines society to seeing it as a part of everyday life. Vaccines are reassuring in preventing severe cases and will help in normalising life. And that is what we should aim for.

This column first appeared in the print edition on January 18, 2022 under the title ‘Living with Covid, without panic’. The writer is former secretary, Government of India and founder and co-lead, Partnerships for Impact.

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