Covid19 Wave 2 has had a significant impact on the social psyche and fabric of India. Statistically, a fatality rate of 1.2% is less when benchmarked with even developed countries, but emotionally it has taken a toll on society.
As we look back and attempt to learn some lessons, a few things stand out
a) India's 4 tier administration system - The executive has four layers -
1) Central Govt
2) State Govt
3) District or Zilla
4) Wards or Panchayats
When dealing with a pandemic, you need access to real-time time in terms of infections, available hospital beds, oxygen supply etc. All this information is available only at the Ward/Panchayat level, but the decisions get made at the State level. There is a lag between ground reality and the data on which decisions get made.
b) Role of State and Central Governments - Both Health, as well as Law and Order, are state subjects per our constitution. The Centre has a limited role of play except encouraging research in the development of tests, vaccines, etc. Most non-BJP state governments were complaining during Wave 1 that the Central Government is interfering in their area. Even today, many people are not clear on who is responsible for what.
c) Micromanagement - Managing a pandemic across a country like India requires micro strategies. There is no one size fit all model as the health care facilities are unique to every state and district.
Reason for the late response to Wave 2 -
Given the multi-tier administration structure in India, even state governments were clueless that they were in the middle of the second wave. Some districts would have known this but would have no clout or resources to convince the state governments to act.
The Central government depends on state data and saw no alarm bells ringing. Even in mid-April most CMs were confident and were proudly giving advertisements on TV on how well they had managed COVID. By mid-April, Wave 2 had reached epic proportions. It was by now beyond the capability of the states to respond. Today as the Centre provides more supplies, the states are still figuring out micro-level strategies.
How should India prepare for Wave 3?
a)The only viable option for being prepared for the next wave is to focus on getting real-time data and empowering District level officers to make decisions.
b) The central government should establish a digital health hub in every district which should monitor and publish data in real-time. The healthcare budget which is managed at the state level should be centralized.
c) Based on real-time data and needs, the central government should allocate funds and supplies straight to the districts.
Many may see this as a murder for democracy but it is better than the murder of our population.
1. Allow all international vaccine's into the country, Without too much rigidity
ReplyDelete2. Reach out to Countries which manufacturer medical aid & get them ( not oppose them be Chinese or Americans)
3. Bring talent into cabinet. Not run it like Ji Huzuur cabinet.
4. Give advance money to Indian vaccine manufacturers ( like other countries did) . New ones like zydus cadila to aid research & production
5. Use 10 billion dollars of the Countries reserves to fund all vaacines & immediate Medical equipments for state & center. We have 500 b $ reserves
6. Vaacinate top 4 hot spots ( Delhi, Mumbai, Bangalore , Chennai) .
Not favor Gujarat for eg ( Karnataka only 3000 18 to 44 vaccination done , Gujarat 1.5 lack done )
7. Call for all party meeting & ask cooperation of states . Let states manage vaccine distribution . Center Not try managing themselves ( This point is partially Done) .
PM cares funds should reach states based on the number of equipment the states order will lead to better utilization. Rather center buying and putting PMO logo & sending which will be of no use
8. There are 1.6 lack Doctors ready to join after NEET . We should not post pone exams . Do it online & move on.
9. Place Oxygen concentrators order 10,00,000 from USA , Germany . China other places immediately. Using revers funds . Don't let states fend for themselves ,
10. Why has international aid received from abroad , aid not reached hospitals . Reduce the beuractic TAT
12. Pvt players companies should be allowed to buy vaccine's directly At premium price from any global players . As companies want to vaccinate their staff to get productivity back.
If the Union & State Health Ministries were doing their job, publicly available data published daily by JHU as early as early-to-mid March should have given them a strong clue as to what's just around the corner.
ReplyDeleteAnybody can check this quickly: do a Google search for "India Covid cases". See the graph. From early to mid March, the daily new case count was consistently greater than the 7-day moving average. And the variance only got worse from there on.
If the people responsible for public health had done their job, they should have been double clicking on this data to understand what's happening at the ground level, where are the hotspots contributing to this trend, etc. And just like they did on the 1st wave, early enforcement of containment zones, prioritization of vaccines to hotspot zones, etc. could have made a huge difference.
Yes, hindsight is always 20-20. But lack of foresight is always 0.