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Pandemic preparation: a wake up call

Amidst the chaos of the COVID-19 pandemic, the World Health Organization (WHO) called for countries across the globe to step up preparations for future pandemics during its 73rd World Health Assembly.

pandemic preparation waving colorful national flag of india on a gray background with text coronavirus covid-19 . concept.. COVID-19 cases in India illustration. Indian COVID-19 cases concept. Cases of COVID-19 crisis in India concept. Image credit: luzitanija / 123rf. Used to illustrate one million deaths due to the pandemic.
Image credit: luzitanija / 123rf

The WHO noted that “the COVID-19 pandemic is a sobering reminder that health is the foundation of social, economic and political stability”. Prospects in India appear to be looking up with a vaccine on the horizon that will be a major boon to efforts to suppress the spread of COVID-19. However, the chaos caused to both the health system and to India’s economy following the onset of COVID-19 highlight the need for greater preparedness and planning should such an outbreak occur in the future.

Since the spike of cases that occurred in September, India has shown progress in curbing the pandemic. Though India remains the second worst-affected country in the world in terms of confirmed cases, behind only the United States, the active case burden has reduced dramatically. In terms of active cases, it is the seventh worst-affected country behind the United States, France, Italy, Brazil, Belgium, and Russia according to Worldometer.

India’s peak during September saw daily increases in cases rise to 100,000, before following a steady decline that — as of yet — has shown no signs of a second peak. Second, and even third waves have been a major issue across much of Europe and the United States. With a vaccine well on the way, India may avoid such a scenario.

Despite India’s current progress, the early stages of the COVID-19 pandemic in the country were marked by disorder. Compared to most other nations, India held out far longer without having a severe surge in cases. This is practically miraculous given its proximity to China and the early withdrawal of Indian students studying in China that had the potential to spread the disease. However, once cases began to increase, the imposition of control measures caused outright chaos.

The imposition of strict lockdown measures saw an unprecedented movement of people, in stark contrast to the aims of the quarantine preparation. As reported by Health Issues India earlier in the year 

“Reports at the beginning of June indicated a surge in COVID-19 cases in rural communities, precipitated by the influx of approximately forty million migrant workers into their native villages following a mass exodus from the cities. This has grim portents for the health of India’s rural communities during the pandemic.”

India’s considerable number of day labourers residing in cities were left with no source of income — often leaving them without food or shelter — in a matter of hours. The mass exodus from the cities presented perfect circumstances for the virus to spread from cities to remote rural villages with very little health infrastructure.

This presents multiple areas in which India is particularly vulnerable to sudden outbreaks like that of COVID-19: its vast number of day labourers and migrant workers who are left with no support net should employment suddenly cease, its villages with little to no health infrastructure, and its lack of surveillance capacities in rural areas.

ThePrint.In notes other issues, such as India’s considerable lack of doctors, resulting from a lack of pay — particularly in the public sector — which has resulted in a notable talent drain across the country. Many doctors outright refuse to work in rural areas due to some facilities lacking even basic supplies.

It was also highlighted that India’s COVID-19 pandemic preparation and response was largely guided by legislation dating back more than a century, the Epidemic Diseases Act of 1897, along with provisions of the Disaster Management Act of 2005.

With a vaccine on the way it is possible that India is now over the worst of the pandemic. However, the issues experienced across the year highlight that India needs effective legislation in place. In addition, public health infrastructure needs to be expanded, and be made more effective in rural areas. Should a disease outbreak occur with no possibility of a vaccine — potentially resulting from drug resistant strains, many of which already exist in the case of malaria or tuberculosis — surveillance in rural regions must be strengthened. Without doing so could risk these regions acting as reservoirs for repeat infection and resurgences. 

The COVID-19 pandemic has been a tragedy, with more than a hundred thousand dead across the nation, we can at least learn from previous mistakes, and make preparations should a similar situation occur in the future.

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