Context:

• Innovations in managing the COVID-19 pandemic can help India revolutionise care delivery and related outcomes.

Dharavi’s success strategy:

• Mumbai, Delhi, Chennai, Ahmedabad and Bengaluru are among India’s major metropolitan agglomerations and are also the current foci of the pandemic within the country which points to the speed and the scale of the epidemic moving within densely populated areas.
• However, sustained municipal efforts and community participation can together blunt the spread of the virus for which the case of Dharavi, Mumbai’s densely populated area is an example.

Current scenario

• 49 districts out of the 733 in India accounted for 80% of the nearly eight lakh cases, with eight States accounting for 90% of all the incident cases. 
• India is now third in global case standings. 

Opportunity to act

• Taking the given numbers there are on average 250 cases per district in about 700 districts.
• Many of these districts may be closer to having no cases, while others may be at a significantly higher incidence. 
• The low numbers in a large number of districts present officials the opportunity of stemming the epidemic and preventing morbidity, mortality and economic distress in a significant way.

Key steps at ground level

1. Ensure district level tracking

• Instead of the COVID-19 tracking mechanisms and the national level tables and graphs, there should be 733 district-level versions, where each one is updated and reported on a daily basis, at the district level. 
• State and national summaries are important but are not as critical as ensuring the accuracy and timeliness of district-level tracking.

2. Encourage district magistrate to exercise power

• Encouraging District Magistrates to use the full range of social support schemes available in support of the District Health Officer helps prevent anyone from facing situations of hunger or economic distress by providing better household nutrition and income outcomes.

3. Scale up testing capacity

• The testing capacity in the district can be scaled up dramatically by co-opting the science departments of every college and university. 
• Thus, chemistry and zoology-allied departments such as microbiology and biochemistry can lend their laboratory services to carry out basic polymerase chain reaction (PCR)-based tests.

4. Look out for innovations

• Complexity of current testing protocols, and difficulty in co opting college-level infrastructure and staff, can be overcome by rapid innovations in testing.
• For example, using saliva as the start point for testing rather than using a nasopharyngeal swab for sampling.

5. Chance for biotech

• Besides providing opportunities in the health-care and biotechnological spheres for young minds, the emphasis should also be to encourage innovators and entrepreneurs to bring out and scale up their products without making compromises on the standards.

6. Administrative leaps

• Ensure every positive diagnosis report is delivered along with a pulse oximeter and phone number to call and report status on and there should be enough oxygen-equipped beds in every nook and corner of the country. 

7. Support healthcare workers

• There is a need to ensure that our doctors, nurses, laboratory personnel and floor workers in hospitals are protected with everything they deserve-personal protective equipment to safety at home, and salaries on time. 

8. Critical engagement

• Critical engagement from Indian biopharmaceutical and biotech companies should be encouraged to produce validated and affordable antiviral drugs and monoclonal antibodies.

Conclusion

• COVID-19 is both a crisis and an opportunity for health-care reform as well as understanding the interplay of health outcomes with social and economic support interventions.

Reference:

1. https://www.thehindu.com/opinion/lead/more-than-a-crisis-a-chance-to-rebuild-health-care/article32142683.ece