Shadow of the pandemic
More than three years after COVID-19 was declared a public health emergency of international concern, the WHO announced this month that the pandemic is no longer such a problem. COVID is now in the endemic stage globally, something experienced in India almost a year ago. But, TA Ghebreyesus, Director General of WHO cautioned that even though the alarm bells have been turned off, COVID is still a global threat. Scientists have said that at any time, we could have a variant that is not only more transmissible, but could also cause a spike in clinical severity of the disease. For people exhausted by lockdowns during peak-COVID, the announcement of the downgrade appeared to be a sign to move on. That might be easier said than done. India had borne witness to harrowing scenes of death and devastation, when terms such as vaccine apartheid and vaccine diplomacy were thrown around.
The competence of the scientific community was put to test as an unprecedented challenge was thrown their way. India, faced with the insurmountable challenge of inoculating a billion plus had shone through by deploying a digitally-aided vaccination programme. It proved that if we put our collective minds to it, providing universal healthcare would not be such a far-fetched dream. Now that COVID is no longer an emergency, and might soon be accorded a status akin to that of the seasonal flu, the lessons from the contagion need to inform our public health policy.
We must stop encouraging knee-jerk, unscientific responses to surges in COVID cases. The spike in March-April 2023 was one such episode which witnessed an uptick in viral flu and COVID cases that catalysed school closures in some cities and states. We must factor in local context when rolling out policy interventions, deploying preventive advice, or communicating risk with regard to outbreaks and epidemics. There cannot be a one-size fits all response to contagions that occur across different pockets of the world, which is why one country cannot blindly replicate the damage control measures employed by another. A case in point is how China faced a wave in December last year, but no other nation did.
We also must consider the question of waning immunity. Currently, the policy dictates that people get their primary dose of vaccination, which includes two doses, coupled with a third or booster shot. The uptake for the booster shot has been extremely low in many geographies, including India, where the percentage of those vaccinated hovers around 20%. Even among high risk groups, it’s just about 30%. The WHO’s technical advisory group on COVID will inform the public if we require new and adaptive vaccines.
On the national front, the genomic surveillance network set up by India (INSACOG) should be integrated into a comprehensive viral disease surveillance network. This way, the capacity built by the government to deal with COVID-like emergencies can be efficiently utilised, alongside the expansion of public health labs. The government must also offer formal training courses on principles and practice of epidemiology to prepare the nation to deal with outbreaks and epidemics in a planned manner. Last, but certainly not the least, we need to focus on R&D to create more antivirals as well as maintain a vigil over the emergence of new variants, and frequently test the preparedness of institutions to deal with such emergencies.