COVID-19: Beyond Biological Dynamics

In the absence of specific drugs and vaccines, precautions at the personal level (hygiene, maintaining physical distancing and so on), people’s participation in population-level interventions (such as sharing scientific information, case-tracking and strategic area-specific lockdowns) and health service system preparedness are the three key available measures against the COVID-19 pandemic. However, the necessary ingredients for these three measures are missing— induced by poverty and structural inequality; a lack of people’s trust and a crippled public sector in health with a low resource base; shrinking, fragmented and weakened infrastructure that has lost on inter-institutional referral links and monitoring and surveillance systems. Not only has an ill-planned lockdown crippled an already struggling economy and depleted health systems and overshadowed containment efforts but the time has not been utilised to strengthen primary healthcare (PHC) services and secondary and tertiary public sector healthcare infrastructure. A phased relaxation of the lockdown with a comprehensive fiscal stimulus to jump-start the economy, coupled with the strengthening of health systems that put the needs of the poor at the forefront, is suggested.