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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