Expert view: Preparing for a possible third wave of COVID-19 in India

By Dr Edmond Fernandes, Founder & CEO, CHD Group

Amid warnings of an impending third COVID-19 wave in India, we must draw up a strategic roadmap to counter this looming threat. Regardless of its severity, we need to take an evidence-based approach to control and mitigate the impact of the third wave.

This calls for a collective effort to implement critical preventive measures, including reinforcing COVID-19-appropriate behaviour and ramping up pace of vaccination. What India needs now is a strong public health response led by a core group equipped to lead the nation at every level of governance. This community-led plan should put public health professionals at the forefront, with other healthcare workers supporting their efforts. 

As we take lessons from the second wave, let us remain open to learning, unlearning and relearning in the fight against COVID-19. India’s economy is at a critical juncture today. It is time we reject easy solutions – like repeated lockdowns – and explore more sustainable solutions to combat the Coronavirus challenge.

Here are eight measures that India must urgently pursue in preparation of COVID-19 third wave:

Vaccinate Tier 1 and Tier 2 cities as soon as possible 

Complete vaccination drives for India’s adult population (those above the age of 18 years) across Tier 1 and Tier 2 cities as soon as possible. Our efforts to increase vaccination rates and coverage will greatly help in containing the spread of the virus.

Run mobile healthcare vehicles for mild and moderate cases

Mobile healthcare vehicles should be tasked with treating mild and moderate COVID-19 cases. Patients can be taken care of by nurses and medical students, remotely supported and guided by doctors using teleconsultations. These vehicles should be in every taluk of India, especially those with high COVID-19 positivity rates. This will reduce hospital caseloads, and ensure optimal monitoring. 

Empower district hospitals in Tier 2 and Tier 3 cities with more ICU beds 

District and taluk hospitals in Tier 2 and Tier 3 cities should have better ICU set-ups. This includes more beds to handle expected surge in COVID-19 cases during the third wave. This will increase capacity to a great extent. 

Courts in India must step in when necessary

Indian courts must monitor public health approaches to COVID-19, and must step in when necessary. The distress the country is facing today is a direct outcome of an unscientific and emotionally-driven approach to public health, and must be appropriately dealt with.

Plug bottlenecks and communicate effectively

Too many orders, but too little implementation marks the story of India’s bureaucracy. This can be turned around by improving communication channels, looking beyond national and state capitals, and focusing on on-ground implementation. 

Put a stop to unnecessary lockdown measures

Refrain from imposing unnecessary lockdown measures – both lives as well as livelihoods are important. Instead, we must reinforce COVID-19-appropriate behavior, like wearing masks, maintaining hand hygiene and avoiding huge gatherings.

Convert cricket and football stadiums into makeshift hospitals 

Identify cricket and football stadiums in every district in the country, and convert them into makeshift hospitals to deal with COVID-19 cases. This will keep panic at bay, with surplus beds made available outside of traditional medical establishments.

Support economic revival by not mandating RT-PCR tests

Thousands of people refrain or are discouraged from travelling due to mandated RT-PCR tests when crossing certain state borders. Instead of this approach, we must improve our efforts to vaccinate as many people as possible to enable safe and open movement of people.

If implemented well, these broad preventive measures will help India mitigate some of the impact of a possible third COVID-19 wave. Infectious variants of the Coronavirus may continue to emerge and spread, so we must not lower our guard and continue to follow COVID-19 appropriate behaviour until the pandemic subsides.


(Dr Edmond Fernandes is Founder of CHD Group – a public health organization headquartered at Mangalore, and Senior Fellow, Atlantic Council, Washington DC)


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