Covid concerns - again

Govt must gear up to treat the disease as endemic

The case for complacency over Covid-19 is clearly narrowing with India recording over 25,000 cases in the week ended Sunday, the highest weekly jump in three months. Though the bulk of the cases are concentrated in Kerala and Maharashtra and the death rate is low, the trajectory of the disease over the past two years suggests that the Centre and the state governments would do well to take preventive action earlier rather than later. The experience of China and Hong Kong points to the dangers of reacting late to the continuing threat of the virus, no matter how relatively non-lethal it has become. Instead of Beijing’s extreme “zero-Covid” strategy, the more sensible approach would be to treat the disease as endemic and mutative and respond accordingly. The good news is that India now has before it a template, admittedly put in place by much trial and error, to contain the spread of the disease. The easiest and lowest-cost solution, of course, lies in declaring and enforcing mask mandates in public places. Maharashtra has done so already but, as always, serious enforcement remains the issue. The need for constant public education and advocacy for mask wearing remains a vital but neglected element of the Covid-19 intervention programme.

If masks work as the first line of defence, vaccines are unambiguously the critical second line. There is no doubt that the superfast development of vaccines and their roll-out brought the disease under control in less than two years. In that respect, despite a slow start, India has done well and about 90 per cent of the adult population is now fully vaccinated. However, the slow uptake of the booster dose should be cause for concern. Now that the vaccine is easily available, the long, artificially imposed interval between the first, second, and third doses must be reduced. Opening the booster or “precautionary” dose to all adults in April was a wise move but limiting the free dose to only frontline workers and those over 60 years seems to have slowed the momentum. The Delhi government’s programme to dispense the booster dose to its population is an example worth emulating by other states. In fact, there is a strong case for the central government to make the third dose available to the states like the first two.

At the same time, the possibility of the virus mutating into a more lethal form remains a constant danger that precludes the hopes of “herd immunity”. Tracking these changes ahead of the curve demands a far more robust genome-sequencing infrastructure. India’s genome sequencing is among the lowest in the world, which in turn determines the slow speed of the country’s public health responses. India has a consortium of just 28 genome-sequencing labs in the public sector and five private labs were approved earlier this year. These numbers are clearly inadequate and their location excludes large parts of the east and Northeast, both sources of highly mobile migrant labour. The experience of the past two years has taught Indians that prevention against Covid-19 is better when a viable medical cure remains elusive still. The Centre and the states would do well to respond with proactive urgency.