COVID and Healthcare Infrastructure

India has to substantially scale up its health infrastructure to protect lives and livelihoods.

The COVID-19 pandemic has sharply brought into focus how intrusions into natural landscapes are not just environmental concerns, but are also intricately entangled with public health. Little attention has been paid to systemic causes such as large-scale biodiversity loss that underlie the emergence and re-emergence of these diseases. Institutional networks of public and animal health in India that are involved in the surveillance and control of zoonoses are outlined herein. It is shown that the lack of a systematic framework that explicitly involves institutions that manage biodiversity and wildlife health leads to gaps in operationalising a One Health framework in India. Addressing these lacunae requires a supra-ministerial mechanism that brings together public health, ecology, and veterinary and social sciences to combat the threats posed by existing and emerging zoonoses.

The evolving COVID-19 pandemic requires that data and operational responses be examined from a public health perspective. While there exist deep contestations about the epidemic control strategies to be adopted, past experience seems to be corroborated in the present epidemic that a contextually rooted “shoe-leather public health” approach provides the most effective interventions and operational strategies, more so in a society as diverse as ours. Drawing from this, an analysis of the COVID-19 situation in India is put forth, and debates on mitigation strategies, optimisation of testing, and the essential steps for a comprehensive set of interventions in order to minimise human suffering are addressed.

Odisha, in spite of a poor public health system, did well in managing the pandemic in the initial month. This is on account of three reasons. It drew from its now globally recognised swift disaster preparedness and management aimed at zero casualty. It adopted a proactive, as against reactive, course, which in itself is a difficult proposition in such an uncertain and dynamic scenario. It took lessons from success stories and challenges based on happenings elsewhere.

Countries across the world are relying on trial-and-error interventions to arrest the COVID-19 pandemic. But, even as health systems are close to breaking down and economies are flailing while underprivileged citizens are battling unprecedented social and financial catastrophes, most governments are failing to provide appropriate social security and relief.