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By Dodul Mondal
May 3 (IANS): So we have entered the third phase of the national closure to contain the COVID-19 pandemic. The initial turmoil has now been largely established in terms of people’s acceptance and willingness to follow this blockade. In addition to some stray incidents of rule violations, India has been much better than many other countries in the world, better than many first world countries.
The rate of increase in active cases is also not very high and we have hoped to see a flattening of the curve in the near future. There is a steady increase in the total number of positive cases and death, albeit at a slow rate. The time to duplicate cases is 11 days, and it is expected to increase further. Some sites are actively spreading the infection and containment zones have been created based on the number of positive cases in that area.
The blockade has been extended for another two weeks, and is likely to last until May. The new guidelines have relaxed permitted activities in three zones: red, orange, and green. Let’s discuss from a different perspective and share my views. What should be the “priority” in this 3.0 lock!
1. Resumption of non-COVID medical care for acute illnesses: Although every health facility is doing its best to provide adequate emergency care, it may not be the same as the pre-closing condition. I am concerned about thousands of patients with stroke, heart attack, acute surgical conditions, acute metabolic disease, and many other emergency health issues! It is a growing perception among the medical fraternity that non-Covid healthcare is not receiving the proper priority at this time.
2. Resumption of non-COVID care for chronic diseases: As a cancer specialist, I can see the difference in care that cancer patients receive across the country compared to the time before closure. Cancer patients require different types of treatments including surgery, radiation, chemotherapy, immunotherapy, etc. Additionally, treatment should begin and end in a timely manner to provide adequate benefit of treatment. I am afraid to see many premature deaths in cancer patients in the coming days whose cancer will progress to an advanced or final stage in the absence of timely treatment.
The same is true for other life-threatening chronic diseases like kidney failure, where patients survive depending on regular dialysis! People with hypertension or diabetes also need adequate care to avoid premature death due to a sudden heart attack or stroke or kidney failure or metabolic complications in the absence of regular supervised treatment.
Globally, 5.5 million children under the age of five die from malnutrition. This number can greatly increase after this pandemic ends. They also need priority to access food not only after lifting the block, but also during this phase.
These patients also have a right to survive and this is just the tip of the iceberg!
3. Resumption of treatment and prevention of communicable diseases: in 2018, more than 1,40,000 people died of measles; in 2017, 13 lakh people died of tuberculosis (data source from the WHO website). Measles is a vaccine-preventable disease. Among tuberculosis patients, many are MDR or XDR that require intense controlled treatment. Many other deadly infectious diseases can be prevented through vaccination only. Routine immunization, including pulse polio, is greatly affected due to blockage. It is now important to safeguard millions of newborn children and others by resuming vaccination by providing treatments (such as DOTS in tuberculosis patients or antiretroviral treatment in HIV / AIDS patients) at the right time in the right way. Otherwise, there is always the fear of seeing thousands of deaths from such conditions (many will eventually go unnoticed since not all of these are analyzed or controlled as rigorously as in COVID-19).
4. Resumption of blood donation services: there is a crisis of blood and blood components. Sufficient blood donations are not possible during this blockage due to fear of the spread of infection. It will be important to resume such activities with priority. The demand for the same will be high after lifting the lock.
5. Resume the industry related to emergency care: not only for money, the industry and businesses must function to serve people in many ways, including the manufacture of essential items, food, machines necessary for different sectors involved in the emergency care and routine livelihoods, etc. A tiered government plan already exists. Over time, many more sectors will need to function. It is important to establish the structure of such functions to avoid infection between these groups.
6. Restricted closure survey: Wuhan in China followed a restricted closure survey model to avoid further increase in cases. Public transportation, including railways, airlines must frame and implement physical distance regulations even after this block ends. Gathering in public places, gatherings should be banned even longer until the virus is under control. The necessary public awareness and preparedness campaigns must start beforehand to sensitize people.
7. Encourage work from home: This blockade has shown that, at least in some cases, work from home is a reasonably valid option. That will not only reduce the risk of infection, but it will also reduce car loading and road transport and subsequent contamination. Studies show that contamination worsens the coronavirus outbreak. Let the world breathe.
The world will not look the same after this blockade ends. It will look good in some ways; it will look terrible on others. Priorities should be based on the need for a particular geographic area, its people, its lifestyle, etc. However, few things remain basic as always. They have access to food, a roof over their heads, clothing for modesty, and life-saving medical services. And we have to keep our compassion intact. Rest can wait.
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