By Major General S B Asthana
India is in a state of biological war against an invisible enemy (coronavirus), which has imposed an unprecedented overall health emergency of this century. While the magnitude of instances and sudden spike, in the second wave, has pushed quite a few nations into insurmountable shortages, it does place a query mark on handling of the pandemic this time, in comparison to a great deal greater handling of the pandemic last year throughout the 1st wave by India. While specialists could cite quite a few factors for such hike, from double mutation to casualness by all, like election rallies, religious gatherings, and slowing down of momentum in capacity creating for forthcoming second wave therefore, revisiting current management responses, in context of indigenous finest practices/structures is essential to boost the circumstance.
Centralised Versus Decentralised Control
An unending spike in present COVID-19 infections with nearly 4 lakh folks obtaining impacted every day, adding close to roughly one lakh instances and 4000 deaths per day, for more than a week, in spite of recoveries, has place the complete COVID-19 management program in India out of gear. While each and every agency in the nation is struggling to make up shortages and create capacities, a significant quantity of friendly foreign nations have also dispatched overall health appliances and material, which have been/are becoming distributed.
During the 1st wave last year India was grossly unprepared, but the handle of COVID-19 management program was central. The centralized lockdown and management helped India to handle the spread and produce requisite capacity to deal with the case load throughout the method of unlocking. It did save quite a few lives and the response was nicely appreciated globally, providing a hope that India could be the savior of the world in managing the pandemic. Unfortunately, in a democracy, the credit searching for politics echoed the voice of overall health becoming State topic, have to have to decentralise, collectively with troubles of migrant labor, forced the nation to adopt decentralised management program, as India unlocked.
It is understandable that the unlocking was necessary for livelihood and obtaining the economy back on track, but stretching it to heavy crowding for events like elections was gross casualness, which coronavirus was in no mood to pardon. It also brought a weakness in response with Centre and State governments waiting for other folks to take actions and blaming every single other for shortages and follies, along-with the factors described earlier. Today a popular man is suffering from shortages of Oxygen, hospital beds, ventilators, and other appliances apart from inadequate quantity of vaccines. Cases of hoarding/black-marketing and advertising of overall health appliances, Oxygen, and hospital beds, indicate leakages and inadequacy of the program of management of this crisis.
Despite improve in national availability, shortages at the level of popular patients raises query marks on efficiency and transparency of current logistics systems. Currently each and every agency is working challenging, but in silos without the need of visible central coordination placing the preferred output to sub-optimal level. A case in point is folks dying mainly because of shortage/more than hiked rates of ambulances in Delhi, which has innumerable flatbed automobiles with movers and packers, which can be made into makeshift ambulances by placing handful of mattresses and oxygen cylinders inside, supplied the RTOs are tasked for it by suitable authorities.
How can India Manage it Better?
With a third wave of pandemic on the horizon India wants to acknowledge it as a warlike circumstance and every person has to respond accordingly. Currently a significant quantity of agencies are working challenging for COVID-19 management at national as nicely as state level in silos, without the need of a centralised strategic program, with small coordination, resulting in leakages, inadequacies and non-availability of sources to patients requiring it most. The reality that the Honorable Supreme Court of India appointed National Task Forces to handle allocation and distribution of Oxygen, justifies the have to have for centralized handle of scarce sources. There is a have to have to declare it as ‘National Health Emergency’ and activate the current program and infrastructure of National Disaster Management Authority (NDMA) below Prime Minister, suitably modified for handling coronavirus pandemic, with minimum turbulence in ongoing work.
It is essential to have this central agency activated with state representatives for collective strategic selection producing at two levels firstly, at strategic level with CCS (Health Minister incorporated) to coordinate work of many ministries to boost capacity creating, healthcare resource generation and policy suggestions secondly at operational level National Crisis Management Committee below Cabinet Secretary with senior representative of all stakeholders like Centre (Health, Home, Defence Ministries and Intelligence agencies) and States (Nominated secretaries), professional specialists from many fields, physicians, public and private players, producers and Defence Services, involved in COVID-19 management to challenge implementable directions for related set up at state levels. It wants to be understood that pandemic management, apart from healthcare care, calls for sound logistics management and details management.
There is a have to have to activate NDMA Resource Centre (suitably modified for pandemic) in New Delhi, with each and every probable details on smartboards concerning patient load, availability of hospital facilities, progress of vaccination, production of vaccines, overall health appliances, purchases, aids and each and every details to make a viable strategic and operational, implementable plans, by way of a method of collective selection producing, nominating the agency to execute, which must be held accountable. It should have a media outlet to hold the nation informed of policy suggestions and allocations, as inadequate details leads to rumors, panic and connected actions like hoarding. If allotments are carried out by way of digitized models making use of most up-to-date management methods (like transportation model) by participative selection producing, then the centre-state blame game can be decreased to a level that it does not obstruct response mechanism and tends to make last man delivery quicker. All purchases and delivery should be on digital transaction mode to decrease leakages.
How can Defence Forces Help?
Currently Defence Forces are assisting the national work in the fight against COVID-19 pandemic. The Air Force and Navy is extensively involved in transportation of overall health-connected gear from abroad and inside the nation. Indian Army has opened quite a few more make shift covid hospitals, apart from opening the current ones to civil patients. Efforts are also underway to recall some of the retired healthcare personnel to join in and add on to the work. There is also a scope to incorporate logistics experience of services throughout crisis management in enhancing the provide chain management throughout such criticalities. The engineering sources of Railways and Defence Forces can be utilized for diverting manufacturing assembly lines of other gases to Oxygen in the nation to tide more than shortages. For greater synergy of efforts with civil authorities, it is essential to hold defence services in the details and selection-producing loop. Currently out of 11 empowered groups, none had any representative from the military, in spite of some states wanting the Army to step in. Defence forces should assistance national work, but in contrast to some other disasters, it is not suggested that a state or district be handed more than to the military for covid management.
The second wave of coronavirus has established that overall health safety is an inseparable portion of national safety and the pandemic will have to be fought like a war, on a mission mode, with every single agency playing its portion in a coordinated manner to economise on efforts and sources. Health workers and most agencies are contributing to the finest of their capabilities, but there is a have to have for greater coordination to decrease shortages, leakages, and boost general efficiency to decrease wastages, as lot of reserve sources will be essential for third wave as nicely. Centralised organizing, coordination, digitized allocation of meagre sources and decentalised execution at State level, is the have to have of the hour. The safety agencies and courts have to be ruthless in punishing hoarders/black marketers with quickly-track trials. Foreign assistance is welcomed, but the future case load demands self-reliance in capacity creating to defeat the pandemic, at an unprecedented speed.
(The views expressed are private views of the author. He can be reached at Facebook, LinkedIn, and Google+ as Shashi Asthana, @asthana_shashi on twitter, e mail : [email protected] Views expressed are private and do not reflect the official position or policy of TheSpuzz Online.)