Potential Measures For Management Of The Covid Pandemic Going Forward

I suggest a toolkit of measures that can ameliorate the ongoing second wave and also guard against an endemic disease or even a third wave that arises dues to viral mutations that evade the vaccines being currently scaled up in India.

Such measures will also become the foundation of a barrier against a future epidemic of another respiratory disease: a novel influenza, or novel Covid or something altogether new. I ignore measures such as emergency acquisition of hospital treatment supplies and acceleration of the vaccination schedule which are already being deployed.

1. Coordinated science-based messaging: I suggest a daily public interaction led by the leading scientists in the government – DG ICMR Dr Balram Bhargava, Secretary Biotechnology, Dr Renu Swarup, member NITI Aayog Dr Vinod Paul and PSA Professor K Vijay Raghavan — on a rotating basis in which they speak authoritatively to the full spectrum of scientific and medical issues.

In a couple of weeks this frequency could be halved and then reduced to once a week. This will greatly reassure the nation. The interaction should be designed to be informative and not as a defense of government policy. This will supplement briefings from the Health Ministry on the epidemiology of the epidemic which I understand are also ongoing.

2. Covid transmission mechanism messaging: It is extremely important to convey the best science based advice on how to avoid transmission. The public must be made to understand the nature of aerosol-based transmission.

As of the moment of writing, the FAQ of the Ministry of Health still states that “studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air” which is simply wrong. People can’t protect themselves if they do not clearly understand how they can catch the disease.

3. Mass distribution of diagnostic tools: The government should rapidly distribute infrared thermometers and pulse oximeters to the poor. Combined with clear messaging it should be possible to greatly reduce panic and resulting over-use of hospitals.

4. De-densification, not lockdowns: Lockdowns are destructive of economic activity. What is really needed is de-densification measures which expand the supply of low density opportunities for daily activities. This must be explained to the administrative apparatus of the country. Measures to this effect include keeping markets and such open much longer hours — say 24 hours — extra buses and trains where possible.

5. Rapid analysis of prophylactic and early treatments: The huge number of cases in India is also an opportunity to quickly gather data on successful early treatments for Covid that can keep people out of hospitals. Such ideas are the focus of the Covid Early Treatment Fund in the US.

I propose that the government works with a private firm like TCS to rapidly create a database where people can anonymously but verifiably enter their experience with various medications and some basic medically-relevant demographic data.

This could be done via the Aarogya Setu app but without transfer of the personally identifying information. In 2-4 weeks I would expect to have gathered enough evidence to see if simple and safe drugs (Ivermectin, Fluvoxamine and so on) are proving effective and can credibly reduce serious illness going forward.

Such an exercise could potentially cut short the second wave, limit a third wave and benefit many countries around the world. But this needs to be done in a way that experts outside the government have immediate access to the data so that all available analytic expertise, from around the world even, can be brought to bear upon the problem.

6. Vastly better masks: The domestic production of highly protective powered air masks for everyday use needs to be stepped up and their value made clear to the general public. These devices will effectively create herd immunity against Covid mutations as well as future respiratory pathogens.

As with ordinary PPEs, private industry in India can easily make hundreds of millions of such devices over the next 6 months to a year at which point India will have an insurance policy for the future. India will also become a world leader in the use of such devices.

The important thing is for government leaders to encourage the use of such devices and to incentivise industry to start producing them.

The author is Professor of Physics at Princeton University.