The Bottom-Up Fightback

Context: To address the Covid surge, district-level taskforces must be empowered.

Challenges faced by the administration in the handling of the pandemic

• Fast ascending infections in rural areas dominated by poor medical infrastructure.
• The shortage of vaccines and the expected year-long timeframe to vaccinate all eligible individuals.
• Vaccine hesitancy.
• Constraints on sourcing of ingredients needed to make vaccines.
• Deadlier variants of the virus and the ominous possibility of the virus impacting children.
• The inadequate healthcare infrastructure for dealing with such a situation.
  • As per the latest Human Development Report 2020, India has eight hospital beds for 10,000 people; in comparison, China has more than four for just 1,000.

Measure taken: A National Task Force (NTF) has been constituted by the Supreme Court. It is, however, equally important that a matching, proactive executing mechanism is simultaneously thought about.

Remedial bottom-up strategies to deal with the pandemic

• Strengthening and refurbishing the local public health centres (PHCs):
  • Should be equipped/manned to deal with all emergency medical care, except for rare occurrences.
  • No patient has to travel beyond 10 to 15 km in urban areas and 20 to 25 km in rural regions for healthcare.
• District headquarters as the epicentre: Which will coordinate, facilitate, and organise all activities.
  • A managing group (headed by the DM) can be created, comprising representatives from various departments/organisations, including stakeholders like NGOs and social activists,
  • Powers and mandate of this group can be:
    1. To notify and commandeer all or listed medical care centres within the district territory, public or private, to provide notified medical services during the public health emergency.
    2. To make all logistics arrangements well in advance by engaging public and private assets.
    3. Develop medical centres with required specialisation services and the capacity in anticipation of the demand.
    4. To maintain and upgrade existing (PHCs), ensuring, particularly in rural areas, replacements for missing medical officers, engaging additional medical and technical staff.
    5. To declare containment zones and to also ensure that citizens meticulously abide by the precautionary advisories and instructions.
    6. To tackle cases of leakage, black-marketing of essential medical supplies.
    7. To fix priorities and place special focus on rural areas in terms of speedy testing, tracing and vaccinating.
    8. To keep the general populace informed daily of the medical and other facilities available.
    9. To meet daily to ensure clearing of bottlenecks and to course-correct if needed.
• At the State level: Each state/UT should develop an action plan, in view of its challenges, and in consonance with the public health programme laid down by the Centre.
  • Should constitute an exclusive public health emergency cell, comprising senior officials from all related departments, to be the focal point of decision making.
  • Should also share information and progress through dashboards and other technology tools and invite suggestions.

Conclusion:

• It needs to be underlined that dealing with a public health emergency requires nothing short of a “perfect administration”.
• A bottom-up approach will not only help blunt any possible surge in the Covid wave but will also build the much-needed health infrastructure.