Cardiologists highlight importance of improving primary health care and public health management
Cardiologists highlight importance of improving primary health care and public health management
Dr K Srinath Reddy, President, Public Health Foundation of India (PHFI) and eminent cardiologist, who was in the city to inaugurate the new campus of the Indian Institute of Public Health-Hyderabad (IIPH-H), highlighted the importance of This exclusive interview highlights gaps in the health system to improve primary health care and public health management with the COVID pandemic.
What has COVID taught us?
COVID has taught us many lessons. Unless you have an efficient and equitable public health system operating in a stable situation even without a public health emergency, we will not be able to generate a rapid, robust and sustained response. We need a strong public health capacity at all levels, from policy and planning to grassroots infrastructure.
Where did we go wrong?
in contact tracing. You have to train people and we handed it over to the police. We focused solely on tertiary care hospitals in the first few months, although they were also important for saving lives. We failed to detect the initial cases when the virus started spreading. If you have a good symptom-based surveillance system in primary care, teams can do home visits, early detection, carry out appropriate tests, and conduct a test to check whether the person needs home care or Whether hospital care is required. This is essential for vaccination and removal of false beliefs. There was a lot of emphasis and trust on testing, even when asymptomatic and people with pre-symptomatic periods were not being tested at that time. Our facade mandate came before the West but behind Southeast Asia.
Again, we made a big mistake in exaggerating the value of vaccines in preventing transmission, when it was clear that they stimulate systemic immunity. This means that they will fight the virus once it has entered the body and cannot stop the virus from entering the body.
But, couldn’t that have caused hesitation in the vaccine?
No, I think it’s important to tell the truth. If they had said that this particular vaccine would prevent serious infection and death, and, it might not prevent you from getting infected. For that you use mask and ventilation. Otherwise, we’ll give the handle to anti-vaxxers. To reduce transmission, you need mucosal vaccines, which can prevent the virus from getting into the respiratory mucosa of the nose or throat.
Why not try to make mucosal vaccines before intramuscular vaccines?
Mucosal vaccines are difficult to make and not all trials have been successful. But the rationale in the available vaccines is also important because they may cause a mild infection and are likely to release fewer viral particles for a shorter period of time. But, it was described as a magic wand to stop transmission altogether. It gave some sort of pause, but the virus has also evolved into an immune-enhanced character, possibly reducing its virulence. Masks, social distancing and vaccines may have interfered with the virus, making it appear more harmless.
How do we see viruses adapting rapidly?
This is the magic of evolution! If humans are offering resistance through immunity or through COVID appropriate behavior, the virus will have to increase infectivity and, therefore, reduce its virulence because it cannot afford to reduce its host population because This happens at your own risk!
Where do you think we did well?
In building health capabilities and responding rapidly such as testing, masks, personal protective equipment and genomic analysis. There was coordination between the Center and the states but in the second wave it was challenged and we paid the price. We got satisfied and built a superhighway for the delta version to spread in different ways. People also wanted their social life back and it became livelihood versus risk.
When will we start preparing for the next pandemic?
It is of utmost importance to build reliable public health care systems capable of monitoring and early detection. District and sub-district hospitals should be strengthened with infrastructure and personnel – doctors, nurses, paramedical staff as well as PH personnel from medical, social science and management sectors – as we need multiple expertise teams. I am in favor of opening more medical schools attached to these hospitals to meet the demand. We need to monitor zoonotic diseases and control environmental degradation.