Editorials/Opinions Analysis For UPSC 25 January 2022

Editorials/Opinions Analysis For UPSC 25 January 2022

Contents:

1. Strategy to Tackle Omicron wave

Strategy to Tackle Omicron wave

Context:

Omicron has been identified in almost 171 countries and India now is in the middle of the third COVID-19 wave

Relevance:

GS Paper – 2: Health

Dimensions of the Article:

1. Understanding the new variant
2. What are the reasons?
3. Lessons from South Africa
4. COVID-19 Third wave in India
5. Pandemic response strategy
6. Way Forward

Understanding the new variant:

Omicron (B1.1.529), a variant of SARS-CoV-2 has been identified in 171 countries. The countries are reporting highest daily new COVID-19 infections since the start of the novel coronavirus pandemic. It has become a dominant variant in many countries.

There has been better understanding about the new variant and its spread.

• The Transmissibility of Omicron is three to four times higher than Delta Variant.
• Majority of cases continue to remain asymptomatic.
• Epidemiological data points to a ‘decoupling’ of Omicron infections from the hospitalisation and deaths.
• The symptoms are mild in most of the cases- at least in those fully vaccinated.
• Omicron wave intensifies in two to three weeks with an equally steep decline.

What are the reasons?

It has been two years into the pandemic, yet many countries including the high income countries are still struggling in their response to contain the spread.

• Reasons:
  • It has been termed as a ‘medicalised’ health system response
  • Insufficient adherence to COVID appropriate behaviour by citizens

• Examples of medicalisation of the pandemic:
  • Administering Booster Dose: Even though two doses of vaccine continue to provide protection from the severe disease, hospitalisation and deaths, administering booster dose helps to increase the level of antibodies.
  • Testing: Despite the limited public health benefit of COVID-19 testing in halting transmission, it is being promoted to carry out routine activities of daily life

Lessons from South Africa:

South Africa is the country which first reported the Omicron variant. The fourth wave begun by this variant is already over. It clearly has some lessons for others.

• Imposition of minimal restriction which were lifted quickly
• Revision of strategies with regard to the isolation, quarantine and the contact tracing based on new epidemiological understanding
• There were no reports of excessive use of blood tests, CT scans or unnecessary medications or hospital admissions.
• Schools remained closed for very short period, was quickly reopened by the Government.
• Introduced COVID-19 vaccine booster dose.
  • Reason being that one of the vaccines being used in the country is a single dose vaccine (Johnson & Johnson), with lower efficacy.
  • Essentially, for that vaccine, a booster means a total two doses.
• What can be the response to Omicron surge?
  • Continue old strategies of ‘test, trace, isolate or treat’ but review and update all public health policies to factor in new epidemiological and scientific evidence.
  • Prepare for COVID-19 endemicity in the country setting.

COVID-19 Third wave in India:

• India is more likely to follow an Omicron wave trajectory that is similar to South Africa. The reason being that India has many similarities with South Africa (than European countries) in factors like –
  • median age,
  • population density,
  • health system infrastructure and
  • natural infection rate
• As the third wave is likely to affect Indian States in phased manner (major cities, followed by urban settings and then rural areas), States can benefit from putting the learnings so far into practice.
• ‘Decoupling’ Infection and hospitalisation: considering the infection and hospitalisation ‘decoupling’ in this wave, the old indicators- namely new daily COVID-19 cases and test positivity rates are not the best parameters for decision-making.
  • Renewed focus: The new indicators to track the pandemic should focus on
    • daily symptomatic cases,
    • hospital bed occupancy,
    • intensive care unit admissions and
    • Pattern and outcome of infection in high risk groups (unvaccinated, co-morbid or elderly) and non-high-risk groups, amongst others.
• Revision of Policies: The Government should focus upon developing science and evidence-based case identification and treatment plans and ensure that they are strictly adhered to, by both public and private health-care providers.
  • Some of the policies on testing, isolation and hospital discharge have already been revised, recently.
    • However, there is a need for further revision in admission policies and clear articulation of the contact-tracing approach.
  • Adhering to the latest official testing, admission policies and treatment guidelines should be ensured through effective monitoring and better enforcement of health-care regulations.

• Economic activities: All possible effort should be made to continue economic activities.
  • There is very limited relevance of any type of COVID-19 curbs with the only exception being large public gatherings, in which physical distancing is not feasible.
  • Other essential activities like elections can still be planned by adhering to COVID appropriate behaviour.
• ‘Infodemic’: The ‘Infodemic’ continues to be a major challenge in this pandemic. It is necessary to scale up credible, timely and transparent science communication from trustworthy sources.
  • This approach should continue till the COVID-19 pandemic becomes endemic.
• COVID-19 endemicity: The number of new infections in the ongoing Omicron wave might have been very similar to previous waves driven by the Alpha, the Beta or the Delta variants.
  • But there is sufficient epidemiological evidence to conclude that Omicron does not cause severe disease, at least in fully vaccinated individuals.
  • It also implies that while responding to the ongoing surge, it is time to get future ready and prepare for COVID-19 endemicity
• Analysing the data:
  • The most important step would be to use the data on COVID-19 infection, hospitalisation, deaths as well as clinical and vaccine-related aspects, which should be analysed proactively.
  • This will enhance Policy formulation and decide and plan evidence-informed strategies
• Scientific study:
  • The new scientific and epidemiological understanding should be used to ensure that social and economic activities return to normalcy.
    • To facilitate the process, there has to be a renewed focus
      • on improving ventilation of especially indoor spaces and
      • effective public health communication for calibrated COVID appropriate behaviour, commensurate with the local COVID-19 transmission.
• Incentivise: The Government should incentivise to increase adherence to COVID appropriate behaviour
  • It can explore public subsidies for masks, including provisions for free mask distribution.
• Essential health services: There is a need to ensure that non-COVID-19 essential health services are not disrupted, in any subsequent surge of COVID-19.
• Other measures:
  • Testing is done in a targeted manner for high-risk populations;
  • Genomic sequencing is optimally used
  • Setting up of waste water and sewage surveillance for tracking SARS-CoV-2 transmission in communities.
• Alongside, countries that are having a surge of Omicron should not be in a rush to introduce booster doses for healthy adults or to vaccinate healthy adolescents or children.

Pandemic response strategy:

• Impact on Children:There is sufficient evidence that children are at lowest risk of poor outcomes of COVID-19.
  • However they are worst impacted by the pandemic because of disruption in in-person schooling.
  • Hence the focus of every country and society should be on how to keep schools open.
  • Schools in Indian States should be open urgently. In any future COVID-19 surge, schools should be last to close and the first to open.
• Strengthen primary health-care systems: From the lessons learnt from past two years of the pandemic, strengthening primary health-care systems could be the core strategy to be followed in the post-pandemic period.
  • The pandemic response strategy should be revised to ensure that the majority of infections are detected and COVID-19 cases attended at primary health-care facilities which are closer to the people.
  • In fact, the proportion of all COVID-19 cases detected and managed at peripheral facilities could be a performance indicator of the health-care system.
  • The pandemic should be used as an opportunity to train and retrain (in clinical skills and various aspects of COVID-19 case management) and empower general physicians, family physicians and primary-care providers in every setting.
• The post and long-COVID conditions as well as mental health and school health need to be given renewed policy attention.

Way Forward:

• It is time we stop giving ‘royalty’ status to SARS-CoV-2.
• Unlike other viruses that cause illnesses in humans, the world knows lot more about this coronavirus.
• The world has enough scientific and epidemiological understanding which should be used to respond to the current surge and prepare for the post-pandemic period.
• The low-income and middle-income countries need to show leadership in bringing the world out of the pandemic.

-Source: The Hindu