What India did — and what it didn’t — in Covid-19 battle

Compared to other countries, India was sooner to enforce a lockdown in order to stifle the spread of coronavirus.

As India prepares to enter the third week of its 21-day lockdown, a deep dive into global response to the pandemic reveals the world’s second-most populous nation could still have done better in dealing with the Covid-19 outbreak.

Compared to other countries, India was sooner to enforce a lockdown in order to stifle the spread of coronavirus.

When I say sooner, it refers to the number of cases and fatalities India had, compared to other nations, while declaring a lockdown. The decision attracted applause as well as criticisms.

Countries have different ways of reacting to a situation that India is in right now. Some resort to a lockdown only as a last resort, some enforce a localised — rather than a full-blown — lockdown and some others may not enforce any at all.

Understanding, planning and execution holds the key. It doesn’t matter what the strategy is. What matters is the adherence.

LESSONS MISSED FROM PAST OUTBREAKS

Looking at such outbreaks strategically, I felt India could have done better had it set up a Disease Outbreak Response System or DORS.

The H5N1, SARS, Ebola and MERS in the past have taught numerous lessons to world nations in combating such situations.

It is about approaching a disease outbreak together as a nation, collaborative and integrated. Let us see what India may have missed in the past few days.

EFFECTIVE RESPONSE SYSTEMS

Be it the issues with migrant labourers, lack of public awareness on the outbreak, the CAA protests, the work-from-home conundrums, the panic buying, the lack of ventilators and PPEs or misinformation campaigns and so forth — a sound Disease Outbreak Response System could have helped avoid all of that.

HOW WORLD RESPONDED TO COVID-19

Some of the best practices when it comes to DORS can be found in the workings of organisations like Singapore’s Ministry of Health, South Korea’s Ministry of Health and Welfare, the EU’s Early Warning and Response System, and Germany’s Robert Koch Institute.

Not only do they have amazingly well-documented literature, but they also effectively implement the same during such situations.

Till this week, Singapore has been without a lockdown in spite of having large number of cases. The city-state functioned exceedingly well without panic or breakdown of services.

South Korea has had a less dramatic and more data-driven strategy to locate clusters early and incentivise self-testing, thereby bending the curve.

The RKI in Germany has been lauded for its efforts in containing the fatality rates in Germany. This because of its decentralised setup, where the affiliate states can function in silos by conforming to the RKI established framework.

WHAT DOES DORS ENCAPSULATE?

A DORS is a framework that has multi-level and multi-layered guidelines on what needs to be done to prevent and reduce the impact of infections or diseases.

Such systems basically cover the following aspects:

1. Outbreak of the infection/disease overseas

2. Rate of transmission

3. How it is likely to impact the country in focus

4. Impact of the same on the people of the country

There are multiple levels per which the guidelines are broken into. The levels usually indicate the severity of the infection or disease.

Below is a typical illustration of the DORSCON (Disease Outbreak Response System Condition) framework followed in Singapore. Source

CAN A DORS WORK IN INDIA?

India had enough breathing space to put in a layered and phased structure for a lockdown after the first three positive cases identified in Kerala way back late January/early February, compared to the drastic shutdown that was announced with mere four hours remaining for people to stock up or travel back home from one point to another.

If this was better planned, India may have had a very effective lockdown as against what is being seen now — many defying social-distancing requirements and heavily-burdened government machinery struggling to ensure compliance.

DORS aids government agencies and the public alike to understand the severity of the situation at hand.

Effective implementation of DORS will enable central and state governments to work in tandem and be on the same page across decisions and implementations.

It will also remove a lot of doubts amongst agencies and the public in terms of preparedness and actions that are likely to be taken.