India’s Covid catastrophe and the lessons for governments around the world on preparing for the next wave.
I arrived in Delhi with my wife on 15th April 2021 as the Covid-19 pandemic had started to rage through our country. Our only motivation was to be with our respective mothers who live alone in Delhi. When we landed in Delhi, things were relatively normal, and on the surface, it was almost business as usual. The first telltale sign of the impending chaos was when we did not get our test reports from the PCR tests that were taken on arrival in Delhi. The word ‘normal’ is relative, as for most other countries in the world, 250,000 cases a day would have been catastrophic. In a matter of two weeks, and as I write this piece, the cases crossed 400,000 on 30th April 2021 with no end in sight. Our hindsight pundits say that the peak will signal approximately 500,000 cases a day or over 3.5 million cases a week. The scale of this problem is gigantic and as news has spread across the globe, people are shocked and the affected are incensed and outraged by the lack of preparedness.
There was no reason for a country like India to not be prepared. Just a few months back, we had proudly positioned ourselves as the vaccine capital of the world. How did we go from being the hunter to the hunted in three months? How did we ignore the words of the Director-General of the World Health Organization who categorically stated that the next wave was going to be deadly?
I have watched the news over the last few weeks and sadly seen that the finger-pointing does not stop even during times of calamity. With all the human suffering that we have witnessed, there is no one who has the moral courage and integrity to accept that he or she has made an error in judgement. Our judiciary at the highest level had to point out to the Election Commission of India that they failed the people of the country by continuing with elections in three regions. The only people that have stayed the course are the frontline workers who have remained resolute in their resolve to help save human lives. The poor as always face the brunt of any calamity and this has been no different in this case. However, for once, the rich have not been spared either. People with millions in their bank accounts have fallen prey to this pandemic as in the end all they needed was an extract from freely available air and yet it was in short supply. No amount of money could help people source oxygen or find a hospital bed. The current virus is far more contagious and spreading faster through the air. The catastrophe has seen no caste, creed or economic disparity; everyone has suffered. The agony and despair of the people of our country have been beyond any human suffering that I have witnessed during my life. And yet, we will get past even this; such is the tenacity of human beings.
The citizens of India have suffered as a consequence of serious and inexcusable omissions and negligence on the part of the national and state leadership; every one of them. However, the people of the country must take responsibility for their reckless conduct leading to this disaster that will set our country back from its path to recovery. Not adhering to social distancing and taking the vaccination drive seriously are two major errors of judgement by the people. When disaster struck, everyone wanted to be vaccinated at the same time causing a system overload. I would like to take this opportunity to highlight some of the immediate actions that African and other governments must take on a war footing.
The biggest failure is stakeholder communications. The people of India were given to believe that the pandemic was over in February 2021. Politicians thumped their chests as they did their victory laps taking credit for beating the virus. This gave a false sense of security and people put their guards down and started behaving like it was business as usual. Clear communication from the government must continue indicating in no uncertain terms that the crisis is far from over.
Until a majority of the population has been vaccinated, all major events (of whatsoever nature including weddings, sports, religious or political campaigning) must be cancelled or held virtually. For everything else including office and other entertainment, dining and retail activities, all social distancing protocols must be followed meticulously. We have learned from 2020 that 100% lockdowns may not be necessary and to find the right balance, where needed, consider localized restrictions in infection zones. Lockdowns should be used as a measure of last resort as they are likely to do more damage than good.
Linked to vaccinations is the importance of testing. Governments must set up more labs for testing at reasonable costs and continue testing its constituents for the infection and also determine any variations or mutations to the virus until the vaccination drive is conclusively completed.
All governments must revert back to March 2020 and begin ramping up their healthcare infrastructure. This is the time to build additional ICU capacity in hospitals and infrastructure at several temporary purpose-built facilities that can take on overflows from hospitals. Some facilities should be built beforehand and others must be stored in semi-knocked-down condition in warehouses should the need arise. All hospitals must have adequate ambulance services available to move people as necessary.
“The pharmaceutical sector must be given incentives in Africa so that capacity to produce medicines is enhanced exponentially. Collaboration must be set up with international companies to enhance both patented and generic medicines so that developing countries are not treated with lower priority when it comes to healthcare; all human lives are equally valuable.”
Ramp up oxygen production capacity and ensure that the storage of 50% excess capacity than normal national utilization targets are kept in reserve. This has proven to be the lifeline for Covid patients. In the same vein, all other oxygen infrastructure should be ramped up, including concentrators and other devices that can be used at home by people. The experience in India has been that for this particular virus, home care has been far more effective for a majority of the cases. For that, freely available support systems for home use are invaluable.
The only cure to the pandemic is an aggressive vaccination policy. There is no cure other than getting vaccinated and governments must procure vaccinations and make them available at a reasonable cost (if not free) to the entire nation. Countries that are behind on the vaccination drive must ramp it up and carry out a campaign to educate people on the urgent need to get vaccinated. There is clear evidence of lower incidences in countries where the vaccination rates are high. For Africa, I believe that the DFIs must immediately look at setting up infrastructure to become self-reliant on vaccines for the future. This is not an option; if anything is to be learned, no time must be wasted on this. It’s not rocket science and immediate action must be taken to develop the pharma industry expeditiously.
The pharmaceutical sector must be given incentives in Africa so that capacity to produce medicines is enhanced exponentially. Collaboration must be set up with international companies to enhance both patented and generic medicines so that developing countries are not treated with lower priority when it comes to healthcare; all human lives are equally valuable. Capacity must also be built for other hygiene products including masks, sanitizers, PPEs and other essential items.
An area that needs attention is the training of healthcare workers. The pandemic is contagious and care-givers need to be trained to stay out of harm’s way. The only way this can be done is to improve the quality of training of all frontline workers.
My next comment is on the role of the media. Being a media owner myself, I understand the need for accurate and actionable news but there rests an enormous responsibility in finding a balance between highlighting negligence and fueling chaos. Remember one thing always, that no government or administration ever wants to harm its people; this must remain an intrinsic belief at all times. As a case study, in India, over the last two weeks, there has been a frenzy in the Indian media regarding lapses in the preparation and the state of affairs at hospitals. While on the one hand, it served the very important purpose of holding public servants accountable for the absolute mismanagement of this crisis, the media created unintended fear in the public. This fear resulted in people going to hospitals the minute they tested positive thus clogging the system; there was a run on oxygen cylinders and concentrators as people began hoarding them and finally, there was a run on pharmacies that ran out of essential medicines because even people who did not need medicines, as a precaution, began storing them. What then emerged was a black market that has preyed on the sick and despondent.
It is my request to all media businesses around the world to begin devoting more than a cursory mention to the awareness campaigns around the pandemic. More inventory needs to be devoted towards educating people on the actions to be taken when the next wave arrives, the importance of vaccination and most importantly, on responsible social behavior. The best cure still is wearing masks, social distancing and sanitizing one’s hands regularly. If and when the next wave hits, the media must spend more time on educating people on taking precautions and symptoms management so that everyone does not run to hospital. If you can educate even a few people, you would have done your duty to humanity. Remember this is far from over and the lessons from India must be taken seriously by all governments around the world. Prepare for the next wave or history will repeat itself.
– The writer is the Founder and Publisher of FORBES AFRICA