Strategic response to contain Covid-19 pandemic

Covid-19 pandemic flares up and seems to continue for a longer period than it was expected. So, it needs a strategic response plan to cope up with. The plan outlined here has three objectives upfront. 

• Contain virus transmission
• Support improved clinical management
• Get the economy recovered

Covid-19 is a new disease. Information is evolving every day about its causative organism Coronavirus (SARS-CoV-2). But it is not difficult to understand that the human body is its main host. As a zoonotic disease, the bat is it's another host that does not come into consideration under the circumstances. 

So, the virus finds no chain to transmit around if it is kept away from its host. In this process, the virus dissolves in the environment automatically within a couple of weeks. 

We like to utilize the edge to contain the virus in isolated localities. How can we do that? 

Given that vaccine is not available, isolation and quarantine of case and contact could do that respectively. 

Lockdown is a mass quarantine for clustered cases. But long endured total lockdown would end up hurting the economy. 

So, limited lockdown at hotspots may be considered. In our country, the surveillance system has to learn a lot to make it happen. Information technology may be a game-changer if it supports surveillance moving through. Thus digital tracking reaches out to cases and contacts most successfully as it happens in Kerala.

Improved clinical management and diagnosis may be obtained by strengthening the health system. It includes deep development of manpower, logistics and infrastructure. 

Health professionals need impeccable skill for working on and off ICU (Intensive Care Unit). Necessary expertise may be provided to them. But we must deploy right the men behind the machine in our preparedness to heal ailing people. Logistics like drugs, protective materials and accessories should be made available in every centre. 

We know that vaccine is the right answer to this pandemic. But having a vaccine will take one to one and a half year. In the absence of a vaccine, some remedies like antiviral, immunosuppressant, convalescent plasma are out there at the moment.

However, not every centre needs to be equipped with a ventilator down the line. Only a few patients require ventilators. And the outcome is miserably poor as only one out of ten returns from this machine, even in an accomplished centre. So the measure does not comply with the rule of triage in lower centres.  

The central oxygen may rather be extended to affordable hospitals to support critical patients. Testing facilities should be handed over to secondary level health care facilities. 
Infrastructures need to be updated to take on an upcoming load of patients with smart infection control in command. 

We have learnt many lessons in this pandemic. One of them is not to depend on the global market because it often struggles with short supply in a crisis moment. So, domestic capacity must be developed to have a sustainable supply chain in place.

Health is important, so is the job. People must be allowed to work to earn livelihoods. 
The state cannot take responsibilities of feeding people for an unlimited time. After all, the state depends on her economy to generate resources. 

A towering lockdown may lead to famine as an after effect. Our economy must get going to fight hunger as well. 

However, some anti-pandemic measures must be pursued to negate the propagation of the disease. Overcrowding should be severed until the crisis is over. 
So, a balanced strategic response with several checks in the row may help to fix the issue. 

It is going to be long havoc ahead. We need to adapt to it and engage in thoughtful management that minimizes loss of life and wealth.

The author is an epidemiologist and former director of Health.