Global Best Practices for India to Mitigate COVID-19

By Sharjeel Yunus

The harsh reality of the coronavirus is a daily truth in India. However in some countries, it is but a painful memory of yesteryear. What practices India can adopt from countries world-over to better manage the growing coronavirus pandemic.

Fatiguing, depleting healthcare resources and personnel caring for an ever-increasing amount infected, people being forced to be at home, driving up the number of cases of mental breakdowns and absolutely no end in sight. The battle against coronavirus has exposed many inherent weaknesses in the systems of India. As parts of the country go into self-imposed lockdowns, street restrictions and nightly curfews, when and where this will end, is a question with many speculative answers.

Maybe we could learn and adapt the practices of nations who have been successful in eradicating coronavirus and “coming back to normal”.

While exclusion, suppression and mitigation are useful in reducing the stress on the healthcare system and “flattening the curve,” none of the strategies are as effective in removing the virus as elimination is. And only a few countries have channeled most of their energies down this route. The most notable of which is New Zealand.

New Zealand - Champions of the elimination route

A model for the rest of the world, New Zealand in fact did not expect the coronavirus threat to subside so quickly. It was by mid-March New Zealand transitioned from basic measures such as closing down its borders and contact tracing to an all out elimination strategy. When asked how this was defined, Professor Michael Baker, Professor of Public Health, University of Otaga, Wellington together with his colleagues said, “Past experience has taught us that there are three factors that are critical to elimination success: 1) high-performing epidemiological and laboratory surveillance systems; 2) an effective and equitable public health system that can ensure uniformly high delivery of interventions to all populations; and 3) the ability to sustain the national programme and update strategies to address emerging issues."

Taking an aggressive four-stage plan which involved shutting businesses, and schools in stage 1 for 5 weeks, the government announced the country was virus-free on 8th June 2020. The five week period was used to strengthen testing and contact tracing capabilities while also actively eliminating transmission chains. As New Zealand emerges in the post-pandemic landscape, patients who delayed seeking treatment for other issues are now re-entering the healthcare ecosystem. Using data modelling, Dr Mike O’Sullivian, Faculty of Engineering, University of Auckland, and his team are predicting the future. “Data modelling has shown to be very useful for helping predict and adapt to what might happen next. There is some potential for increased throughput without causing either surgical sessions to overrun or excessive delays for patients and we are currently refining those models...”

Finland - Reduce restriction and increase testing

Another country which has had tremendous success in combating COVID-19 is Finland. The Finnish Prime Minister said their strategy aims at scaling back the restrictions in place while increasing the scale of testing. In terms of action points, this breaks down into: Test, trace, isolate and treat.
Where Finland does have an advantage is in terms of its population density. And even though the 132 active coronavirus cases are monitored, the government still has not allowed for public events and gatherings which goes a long way in ensuring infected clusters don’t emerge.

South Korea - The global leaders in coronavirus testing

However, population density isn’t the only determining factor in controlling COVID-19. South Korea has a population density of 1,366 people per mi2 compared to India’s 1,202 people per mi2. But this has not resulted in the virus spreading faster in South Korea. What was South Korea’s pathway to success? One of the world’s most expansive, and well-organized testing programs. South Korea has conducted more than 1.2 million COVID-19 tests by the end of June 2020, which amounts to more than 5,200 tests per million. Diagnostic capacity at scale certainly seems to be one of the cornerstones in controlling the growth of the virus.

Taiwan & UAE - Don’t worry about the cost of recovery

Public healthcare and cost management are essential in controlling the virus. Taiwan follows a single-payer healthcare system which incentivizes public health. Meanwhile, the United Arab Emirates government is covering all COVID-19 costs irrespective of insurance status. In addition to this, UAE also added aggressive disinfection cleaning campaigns and banned public prayers during Ramadan, a move which limited total deaths from coronavirus to less than 300. This in spite of the fact the first confirmed case of COVID-19 was on January 29th.

So where does India go from here?

Expecting the insurance system to change overnight may not be feasible and with cases only increasing, we need easy solutions quickly. At a more immediate level, the concept of ‘social bubbles’ must be taken into consideration. ‘Social bubbles’ are a middle-ground between social distancing and quarantining which ensures the virus either never reaches the bubble, or goes out of the bubble.

Just doing this will go a long way in restoring a semblance of normalcy, especially at a society level. Another consideration is contract tracing. Although India does have its own solutions, privacy issues and data leaks have brought Aarogya Setu under severe scrutiny from sources national and international.