One year after the lockdown, how do you see India’s journey?
I am quite satisfied with the way India has managed so far. With the Central and state governments’ concerted efforts, India has recorded one of the lowest cases of infection per million and deaths per million population of 8,542 and 116, respectively. Further, the case fatality rate of 1.36 is also the lowest when compared to similarly placed countries.
Another notable achievement was the Atmanirbharta (Self-reliance) we attained during the process. We succeeded in establishing everything from scratch, be it surveillance infrastructure, laboratory capacity, dedicated hospital infrastructure, logistics of therapeutics and vaccine, and not to forget the creation of the public movement for Covid-appropriate behaviour. With the ‘Vaccine Maitri’ initiative, which has so far supplied over six crore Made-in-India Covid-19 vaccines to almost 80 countries, we have demonstrated the quality of India’s products and generated tremendous international goodwill.
All this has been made possible only due to the able leadership and guidance of Prime Minister Narendra Modi, who led the effort from the front.
In comparison with the US and Europe, India has managed to keep its death rate lower. How would you explain this, given the population density in many parts?
India imposed a countrywide lockdown very early in its response to Covid-19. The emerging evidence through mathematical models suggests that this strategy prevented millions of cases and saved thousands of lives. More importantly, this also gave us time to prepare and establish the requisite infrastructure to manage cases.
The test-track-isolate-and-treat policy, coupled with the containment strategy, identified cases early and brought them to isolation and dedicated treatment facility. We leveraged technological innovations such as ‘Aarogya Setu’ and ‘ITIHAS’ for rapid contact tracing efforts. India curated its Covid response strategy in a manner that could be leveraged against any other such health emergency in future. We developed normative guidelines for every aspect of pandemic management and behavioural interventions.
India embarked on a pre-exposure prophylaxis strategy to high-risk contacts and frontline workers using hydroxycholoroqine and also used it as a therapeutic intervention. There is now increasing evidence suggesting that given early during the course of illness, these interventions have a positive outcome in reducing severity.
We ensured a uniform clinical management protocol, ensured enough oxygen, critical drugs, and intensive care facilities for treatment, coupled with doctors and nurses’ training to manage such cases. Regular gap analysis by death audits and prompt remedial action also contributed to reducing mortality further.
What was the biggest lesson for the country’s health sector?
Covid-19 has proved that the world, including the most advanced nations, is not yet prepared to tackle a public health emergency of this scale. We need to remain ready for such eventualities. It also taught us that we have to be self-reliant, especially with regards to critical equipment logistics. Also, the response expected towards a pandemic is beyond the health sector’s realm alone, and it requires a Whole-of-Government and Whole-of-Society approach. It certainly is advantageous to have in place required policies, plans and procedures. The pandemic also told us that this war has to be fought together with India’s citizens. Further, in this IT-driven era, the use of digital innovations in the health sector proved to be a win-win.
How do you explain the current surge in cases and what steps is the Government planning to contain another wave?
This is indeed a very pertinent question. Historical evidence from past pandemics has shown that pandemic resurgence appears in waves. The reasons why pandemic resurgence comes in waves are that its periodicity and duration are unknown. However, there are speculations such as the emergence of new mutant variants, laxity in following Covid-appropriate behaviour, pandemic fatigue, etcetera.
Till now, the collaborative efforts between the Government andpeople ensured that India remained untouched by the second wave of Covid-19 for almost a year during the pandemic. While most countries have already faced second and even third waves of Covid-19, India has been far resilient in the face of adversity.
We need to now ensure than the Covid-19 vaccine is supplemented with Social Vaccine. Its strict adherence continues to remain highly fundamental in our fight against the pandemic.
Many say we should speed up the vaccination process and open it up for all. Do we have enough vaccines for that?
The role of the vaccine as a strategy for Covid-19 management needs to be spelt out in clear terms. In a bid to control Covid, we followed a multi-phased stratified approach mainly to protect high-risk populations, including vulnerable population groups and frontline workers. We have clear indicators that particular sections of society arefar more susceptible than others. By staggering the vaccination process, we are trying to protect and provide the vaccine to those who need it the most instead of those who want it the most. Having said that, let me assure you that India is committed to providing vaccine to all its citizens and that we have enough vaccines to achieve this goal. The Government has already announced vaccination of the entire population above 45 years from April 1st onwards, irrespective of whether they have any comorbidities. This comprises about 20 per cent of our population. The Government is already planning to widen this umbrella of Covid-19 vaccine beneficiaries in the near future, and an announcement shall be made in the upcoming weeks.
What was the biggest challenge in dealing with Covid-19 in India?
When the Covid-19 pandemic hit, the world was unprepared regarding how the pandemic would unfold. As the pandemic evolved over the last 12 months, the challenges kept on growing as well. India’s pre-emptive, proactive, and graded approach ensured that outside a few states/districts, the country largely remained unscathed through the pandemic.
India has grown from having a single Covid-19 testing lab to over 2,000 labs in a matter of months. Before the pandemic, India had to import facemasks, N95s, and PPE kits. But during the pandemic, we became Atmanirbhar and now an export hub for these medical equipments. During the pandemic, India pretty much doubled its capacity of ventilators. What India achieved in the last 70 years in the medical infrastructure, under the leadership of Narendra Modi, India managed to double, triple, and even quadruple its capacity, becoming a case study for the rest of the world on how to win in the face of adversity.
Despite these ever-evolving challenges, the biggest challenge in managing Covid-19 was to strike a balance between the need for continuing our efforts on pandemic interventions for suppressing/ breaking the cycle of transmission vis-à-vis its impact on the economy, lives and livelihood.
What big step would you like to take after this experience of Covid?
The pandemic is not over yet, so I cannot share my biggest step based on the lessons from this pandemic. Until now, as the pandemic was mostly contained in small pockets across the country, it gave the impression that the pandemic was over, but as we can see from the rising cases, it’s not. However, the most significant lesson till now has been that it’s not over until it’s actually over. And until we all get vaccinated and people truly embrace the new normal, Covid-19 will continue to come back at us in waves after waves.
Has the Government planned any SOPs for such situations?
It was on January 8th, 2020 when we had our first meeting of the expert group on the Covid-19 pandemic. Since then, the journey has been relentless. Since that day, the Ministry of Health & Family Affairs has released several SOPs and guidelines to prepare people for the new normal in parks, offices, malls, residential buildings, etcetera. These SOPs have been updated several times during the pandemic, and the states/districts that have followed these guidelines have found much better success in containing the pandemic than those who don’t. As the pandemic evolves, we will continue to update these SOPs and guidelines accordingly.
Which state in your view has performed well in dealing with Covid-19 vis-à-vis testing and healthcare?
All states have collaborated and worked tirelessly to manage the pandemic. It would be unfair on my part to single out any state for overor under-performance.
How did we ramp up medical facilities in places where they were inadequate?
The Government of India collaborated with non-health ministries/departments, ensuring their medical facilities, such as those of railways, defence, labour, etcera, are put to use for the management of Covid-19. Additionally, there had been best practices such as setting up of jumbo facilities for isolation, quarantine and treatment in stadiums, use of rapidly deployable pre-fab hospitals by DRDO and CSIR. Innovative conversion of railway coaches as Covid Care Centres,all contributed to ensuring adequate medical facilities for people across India.
The world uses India as the vaccine hub. How are these collaborations going to play out for India, particularly the health sector?
We have demonstrated our medical research, development and manufacturing might time and again with India’s ‘Vaccine Maitri’initiative, which has so far supplied over 6 crore Made-in-India Covid-19 vaccines to almost 80 countries. We have demonstrated our products’ quality, generated tremendous international goodwill, and reaffirmed India’s reputation as the ‘pharmacy to the world’.
During the pandemic, we have also seen several partnerships such as Bharat Biotech and ICMR-NIC for Covaxin, SII and ICMR for Covishield, Dr Reddys Laboratories Limited, Sputnik LLC for the Sputinik Vaccine, etcetera. These partnerships have emphasised that an Atmanirbhar Bharat is not a dream but a reality. India has provided a safe haven for collaboration, be it public-private or private-private, where companies can help rebuild not just India but also the world. This is in line with Prime Minister Narendra Modi’s vision of putting humanity before personal gain. India has showcased that that even at the time of a global pandemic, the country can not only support its people but also help the world.
In times to come, we will be supplying huge quantities of vaccine to WHO under COVAX pillar of ACT-Accelerator to ensure equitable distribution of vaccines to low middle-income group countries. This would be over and above our bilateral initiatives. All this would be only after ensuring that our own needs are adequately met.