As the second wave rages on, could we have avoided this. Being a very opinionated society, we read a lot of opinions and conjectures.
There are broadly two types of messages – one compares the cases and deaths per million population of India with the western countries. This is to reiterate that India is in a better position compared to them. But these countries have already had their devastating second and third wave, while we are still in the midst of second wave. We will have to wait and compare the figures at the end.
The other messages compare our rate with our neighbouring countries and wonder how our cases are high. Reasons range from failure of the govt to sabotage. Viruses have a tendency to mutate for their survival. Around December the UK variant B1.617 entered and started spreading in India. This virus has 3 variants, one of them is B1.617.2. This one has outgrown the other variants. After mutating it has acquired the capacity to spread faster and easier. It is responsible for the devastating second wave. This has not yet reached the neighbouring countries that’s why their numbers are less, as of now.
I would like to differ from both these groups and compare Indian rates with other East Asian
countries. Like us they have a rich culture and tradition. Taiwan, Vietnam, Thailand, South Korea, Japan have very low death rates per million population. One reason being, these are all small countries. The larger Indonesia and Philippines have a rate similar to India. Nevertheless, the smaller countries offer us a lesson or two.
Taiwan was one of the first countries to make national face mask compulsory. Early on the gov’t banned the exports of masks to make them available for their citizens. Vietnam does 3 degrees of contact tracing for each patient. In fact, they have the highest COVID tests for each confirmed case. As of Dec 29 2020, it was 1000, while Taiwan did 166, UK 21 and India 16. Thailand success can largely be attributed to its efficient public health system.
In addition, all these countries had “Clear Consistent Creative Public Messaging”. Simple messages
like masks, physical distancing, sanitising, early testing, isolation and treatment were highlighted again and again.
I think India did very well to manage the first wave. But as economic recovery took precedence the systems set up were slowly dismantled. Disarming in the middle of a battle is fatal. The new UK variant added to India’s misery.
The messaging was all wrong. There were vaccine sceptics, dispensers of magic treatments, BCG protection, natural immunity, herd immunity, large gatherings……. By February even though cases began to rise we let our guard down.
We are a diverse country with people of all levels of understanding and intelligence. The confusing messages misled the public into a false sense of belief that the pandemic is over. In April it struck with a vengeance. Then panic set in.
I practice in the heart of Bangalore. Most of the patients, I see have had symptoms for 5 to 6 days. I ask them why they didn’t turn up on the first day. The classic answer is they thought it was the regular flu or Bangalore allergy. This is atrocious, we are in a Pandemic. By this time they would have infected all their family and many in the office. This is how a tsunami builds up.
In the barrage of information we got, we were worried about Remdesivir, plasma, oxygen and ICU.
But we forgot the simple things like early testing, isolation and simple treatment.
Could the second wave have been avoided, maybe not. But we could have been better prepared. I hope we learn our lessons before the third wave strikes.
So vaccinate yourself when you get a chance.
-Dr Sanjay Subbaiah.