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3rd Covid wave by Oct, predict medical experts

Saturday, 19 June 2021 | PNS | New Delhi

India is likely to be hit by a third wave of Covid-19 by October, and the pandemic will remain a public health threat for at least another year, according to a Reuters news agency’s poll of medical experts.

The June 3-17 snap survey of 40 healthcare specialists, doctors, scientists, virologists, epidemiologists and professors from around the world showed a significant rise in vaccinations will likely provide some cover to a fresh outbreak.

Of those who ventured a prediction, at least 85 per cent of respondents, or 21 of 24, said the next wave will hit by October, including three who forecast it as early as August and 12 in September. The remaining three said between November and February.

But more than 70 per cent of experts, or 24 of 34, said any  outbreak would be better controlled compared with the current one, which has been far more devastating — with shortages of vaccines, medicines, oxygen and hospital beds — than the smaller first surge in infections last year.

“It will be more controlled, as cases will be much less because more vaccinations would have been rolled out and there would be some degree of natural immunity from the second wave,” said Dr Randeep Guleria, director of All India Institute of Medical Sciences.

Meanwhile,  a set of experts have recommended that decentralisation of essential health services such as ambulances, oxygen and essential medicines, a transparent pricing policy and wider spread  of clear and evidence-based information on the management of Covid-19 to prevent its resurgence.

These are among the eight suggestions that a battery of experts the likes of Biocon’s Kiran Mazumdar Shaw, cardiac surgeon Dr Devi Shetty and microbiologist Gagandeep Kang have for the Centre.

Authored by 21 experts, a commentary on the website of medical journal ‘Lancet’ said that the essential health services must be decentralised. “A one-size-fits-all approach is untenable since the numbers of Covid-19 cases and health services differ substantially from district to district,” said the health experts.

 Also, they added, “there must be a transparent national pricing policy and caps on the prices of all essential health services-eg, ambulances, oxygen, essential medicines, and hospital care. Hospital care should not require any out-of-pocket expenditure and costs should be covered by existing health insurance schemes for all people, as has been done in some states.

“All local Governments must be allocated their grants as recommended by the Fifteenth Finance Commission to ensure they have the resources to augment COVID-19-related health services in their jurisdictions.”

Yet another suggestion included adoption of clear, evidence-based information on the management of Covid-19. “This information should include suitably adapted international guidelines for home care and treatment, primary care, and district hospital care in local languages that incorporate local circumstances and clinical practice. The guidance must also emphasise what not to do, and ensure that only evidence-based therapeutics are used,” they said.

 All available human resources across all sectors of the health system, including the private sector, must be marshalled for the Covid-19 response and adequately resourced, particularly with sufficient personal protective equipment, guidance on the use of clinical interventions, insurance, and mental health support.

The experts suggested that central systems to procure and distribute Covid-19 vaccines free of cost should be established in a departure from the current policy of decentralised procurement through state governments.

“Such an approach would optimise prices and minimise cross-state inequities that may result from differential fiscal and capacity contexts,” they added.

 Given that community participation has played a vital role during the first and second Covid-19 waves, the community engagement and public participation must lie at the heart of India’s Covid-19 response. Grassroots civil society has historically had a crucial role in people’s participation in health care and other development activities, such as in strengthening the Covid-19 response in Mumbai, they added.

Also, said the expert panel that there must be transparency in government data collection and modelling to enable districts to proactively prepare for the likely caseloads in the coming weeks. “Health system personnel require data on age and sex disaggregated COVID-19 cases, hospitalisations, and mortality rates; community-level coverage of vaccination; and community-based tracking of the effectiveness of Covid-19 treatment protocols and long-term outcomes,” they said.

Last but not the least, the experts suggested that amidst gloomy scenario, the profound suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India’s vast informal economy who have lost their jobs, as is being done by some state governments.

“Formal sector employers must be required to retain all workers, irrespective of the status of contracts, through a government commitment to offer compensation to these companies when the economy revives,” said the group.

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