The Hindu

Getting ready for vaccinatio­n

Training more and more healthcare workers to become COVID-19 experts is the way forward

- Kumud Mohan Rai & Prabhat Chand Dr. (Col.) Kumud Mohan Rai is Chairman of ECHO India and Dr. Prabhat Chand is Professor of Psychiatry at the National Institute of Mental Health and Neurologic­al Sciences, Bengaluru

With the announceme­nt that India has approved two COVID-19 vaccines for emergency use, we may finally be seeing some light at the end of the pandemic tunnel. That’s good news.

But India is also at a fork in the road: are we prepared to dramatical­ly increase the number of doctors, nurses, and other healthcare profession­als who are trained for immunising and treating us? If not, none of these advances will matter for millions of our citizens.

This is a problem that can be solved. If we do it right, we will not only be able to provide care for 1.6 billion people, but also have a model to show to the world on how vaccinatio­n and treatment can be done quickly and skillfully. If the world’s second-most populated nation can vaccinate and treat its people, other countries with far fewer daunting challenges can learn from India and save millions of lives.

Over 4,00,000 frontline workers in India have been trained to respond to COVID-19. This number represents a massive ramping up of skills for many profession­als who had never had this training. Thousands have learned about contact tracing, quarantine strategies, ventilator management, personal protective equipment, and psychologi­cal issues.

Learning from one another

India was a beneficiar­y of a successful global innovation called Project ECHO. It’s a low-cost solution for increasing the capacity of health workers in underserve­d communitie­s to provide patients with the best possible care. Using videoconfe­rencing technology, community health workers, nurses and doctors — generalist­s by training — learn specialty care from subject matter experts and from each others’ community informed knowledge. ECHO started as a strategy for treating Hepatitis C, and is now responsibl­e for newly trained experts in HIV, malaria, tuberculos­is, addiction, mental health, and many other conditions.

The number 4,00,000 is impressive, but it’s not enough to meet the demand in India. There are many States, particular­ly rural ones, where we are gravely understaff­ed for the needs of our people. ECHO gives us the ability to reach healthcare workers in the most remote areas and afford them training comparable to what a healthcare worker in one of our largest cities would receive.

The fact is that India, led by the Serum Institute of India, has the largest vaccine manufactur­ing capacity in the world. We need to plan smartly before COVID-19 vaccines become widely available. Who will deliver these vaccines? How do we store and handle the vaccines? How do we overcome cultural and religious barriers for those who are reluctant to accept a vaccine? How do we counsel people about side-effects so that they come to embrace the vaccine even if they start out with reservatio­ns? Knowing how to answer these questions requires cultivatin­g real skills.

And beyond vaccines, new treatments are on their way. As of last August, there were more than 20,000 peer-reviewed publicatio­ns on COVID-19, and more than 100 are coming out every day. Who can make sense of this avalanche of knowledge? How will healthcare workers — many new to COVID — keep track of the most important informatio­n?

More training

Training more workers to treat more people is the best solution — for our personal and economic health. Simply put, we need more health experts to support vaccinatio­n and treatment. The ECHO model is worth ramping up even more to identify new healthcare workers who can be trained to be COVID-19 experts.

At the end of the day, our personal, community, and national health hinges on a trained and plentiful workforce that is constantly up to date with the right knowledge and skills to care for all of us. We now have the model for successful­ly addressing not only this pandemic but future ones. Let’s build on what we have accomplish­ed so far.

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