The renewed surge of COVID-19 cases in China has begun to worry governments across countries. We are seeing a flurry of activities in the government and a parade of experts on media channels. The knee-jerk reaction confirms that we have not learned the lessons that the earlier phase of the pandemic presented us with. We ignore the fact that the virus continues to infect and mutate. We also ignore the fact that the immunity induced either by natural infection or by current vaccines lasts for a short time. There is no one to market face masks even though they are effective in preventing all respiratory infections and safeguarding against the harm resulting from air pollution. We stop warning our elderly and those with comorbidities about the continued risk they face if they do not adhere to COVID-appropriate behavior and if they do not get booster shots every six to nine months.
Some experts claim that India is not at risk of further waves and some others issue dire warnings against it. It is not clear whether these pronouncements are based on objective scientific evidence or subjective expert opinion. A sample population survey for immunity markers (both humoral and cellular) would have given insights as to the level of protection in people who had the COVID-19 infection previously, who had taken COVID-19 vaccines, and in people who neither had natural infection nor di they receive the vaccine. An analysis linked to the duration after an infection or the last vaccine dose would also have given insights into how long the immunity will last. These insights would have given us an assessment of whether our population is vulnerable to ongoing variants and if so what policy decisions should be taken to protect them.
In addition to assessing the current immune status of the population, we should continue to have surveillance to detect the emergence of new immune-evading strains and study their behavior. We should continue to be well informed of all the data coming from various countries on various issues discussed above. A strong and resilient public health system will perform all these in a planned way, take appropriate preventive measures against any potential threat, and prepare the healthcare system to mount an appropriate response in case we fail to prevent the next wave.
Unless we have a culture of learning across health and social systems, we continue to be where we were and we continue to be vulnerable to the onslaught of health crises. The culture of learning is relevant to individuals, families, communities, policymakers, administrators, researchers, civil society organizations, media channels, industry, etc. Learning health systems have inherent strength and resilience to meet the health needs of people during normal times and during crisis times. Ideally, governments should nurture this culture of learning. When governments don’t do it, non-governments should take up the responsibility. InOrder, the health systems institute, is the convener for the India Chapter of the “Global Learning Collaborative for Health Systems Resilience (GLC4HSR)” which was launched in March 2022 with the purpose to enable building strong and resilient health systems through collaborative learning. It is hoped that it will succeed in nurturing learning health systems across states, cities, districts, and even villages.
Dr Krishna Reddy Nallamalla
Photo Credits: HT