Renew focus on communicable diseases, not Covid-19 pandemic: Experts

Public health expert Anish T S says during the pandemic, reported cases of tuberculosis and typhoid were fewer

Public health experts say that instead of devoting resources to Covid-19, India must focus its energies on other communicable diseases like malaria, dengue, tuberculosis, and typhoid, which are likely to see a sharp spike.

Public health expert Anish T S, associate professor of community medicine at Government Medical College, Manjeri in Kerala, says during the pandemic, reported cases of tuberculosis and typhoid were fewer. One, people stayed indoors and masked up. Two, the health system did not pick up all cases as it groaned under the weight of Covid.

“But there is an immunity backlog. Since a certain section of the population was not exposed to these diseases in the past two years, chances are there will be a sharp rise in cases of communicable diseases,” he says. He says India must focus its resources and energies into fighting these diseases. The expenditure on Covid, including vaccination, has to be gradually lowered.

He’s not alone. Gagandeep Kang, microbiologist and professor, Christian Medical College, Vellore, says: “We have reasonable control over this disease and its management. Devoting resources to one disease alone is, in my opinion, a privilege of a rich country or rich people. As a society without unlimited resources, we have to see can children go to schools? Can businesses run as usual? Only when there is a situation when these things are likely to be affected will we need to step in and take prompt action.”

At present, mathematical models, too, do not predict an immediate surge in cases in the foreseeable future. Speaking to Business Standard, Manindra Agarwal, an Indian Institute of Technology Kanpur professor involved in the mathematical modelling to understand the pandemic, says the model is not showing any ‘waves’ in the near term. There is no steep jump in the daily caseload, and models typically pick that trend up fast.

“Models either pick up a steep rise in cases in some location or an extended period of rise in cases,” says Agarwal, adding that the modelling will continue as usual as new mutations of this virus are likely to surface from time to time. Agarwal and his team, however, are not trying to predict too far into the future.

This seems to be the right approach as Kang says the models are most accurate when we we know a lot about the disease and when we are not predicting too far into the future.

“In the case of short-term modelling — say, predicting how many cases are expected in the next two or four weeks — chances are we will get it somewhat accurately,” says Kang.

Experts feel India must consolidate its surveillance systems. At the same time, also work on a pandemic policy for the future. “The next pandemic could be in 25 or 30 years. No one knows when. It could be a bacterial pandemic too, and that could be more difficult to handle as we cannot make vaccines easily for bacteria and many antibiotics don’t work against drug-resistant bacteria,” says Anish T S.

He feels that climate change will play a role in the way viruses and bacteria interact with animal hosts or reservoirs, and there could be more spillovers into humans in the future. With greater global mobility, infections will spread faster. He says that it’s time to formulate a pandemic policy and plan our research and public health response.