Tackle third Covid-19 wave locally

Covid second wave fatalities could have been greatly reduced with an early, decentralised, hyper-local combat strategy

Spreading at breakneck speed, the Omicron variant might give us all the jitters even if it is milder in its potency. So if the exploding numbers mean we are already in the midst of a third wave, will the decentralised triaging system and fight-back perfected during the second wave save us from big trouble this time?

The signs are similar to the second wave. But it is far less deadly, as healthcare experts point out. “If six out of 10 needed hospitalisation then, this time only two to three would need to be admitted. Going by the data from the first two weeks, it is likely that the peak will be reached sometime by the end of January or the first week of February,” points out Dr Ambanna Gowda, Consultant, Internal Medicine, Sparsh Hospital, who has been actively tracking the combat strategies.

Also read: Maharashtra adds 1 lakh Covid cases in 2 days; Pune tops in Omicron infections

But there is no scope for complacency. Learning from the fatal turn that the second wave took, the government is beefing up oxygen supplies and other critical equipment at hospitals and primary health care centres. “Apartments, local hospitals and other healthcare facilities should be ready too.”

Ward-level data

Decentralisation is clearly the way to go. Simply put, this means ensuring ward-level detection of cases, ward-level data on vaccination, availability of beds, ambulances and a hyper-local response that guarantees speed and efficiency.

Early adoption of this strategy, experts are convinced, could have prevented the frantic search for ICU beds, oxygen cylinders and eventually the high fatalities of the second wave. Without proper triaging, a patient from the city’s South zone, for instance, would panic looking for a bed in the North zone.

This time, as Dr Ambanna points out, proper, ward-level triaging should ensure that beds and other facilities are easily available from the zone to ward to even booth level. “Every ward has a BBMP office. Patients should be made aware about the availability of doctors, nurses, medicines and ambulances. This will reassure people and avoid unnecessary panic.”

Beyond automated calls

Tying up with a Bengaluru-based startup StepOne, the government has activated a sytem where Covid-positive patients get daily automated calls enquiring about fever, sore throat and other symptoms.

But as cases rise, this automated setup will need to be complemented by a system that lets the patients / relatives call and enquire about hospitalisation and other facilities available within the ward. “Reliable, ward-specific numbers should be provided to people so that they can call back to know what to do, where to go and if other family members need to be tested.”

Also read: Symptomatic child Covid cases on the rise in third wave, doctors warn

Second wave anxiety had mounted with patients often forced to await generation of a Bengaluru Urban (BU) number for bed allocation. “This was a big problem during the second wave. A dedicated, ward-level, number will avoid anxiety.”

Private hospitals are required to set aside a proportion of their beds for patients sent by the government. Currently, this stands at 30% but could go up to 50 or 70% if the cases continue to rise. But the availability status will need to be constantly updated ward-wise and communicated to patients in need.

No elected corporators

Tara Krishnaswamy, CoFounder, Citizens for Bengaluru (CfB) agrees that ward-level disaster management is a very good strategy. “But it cannot realise its full potential without elected corporators at the helm. The nodal officers can only do so much, and they often run into bottlenecks. We don’t necessarily institutionalise best practices,” she contends.

Ward-level management, Tara notes, implies you can access oxygen cylinders, PPE kits, ambulances locally; a local list of doctors and nurses are easily accessible and anyone with symptoms are identified quickly. “But without an elected ward corporator, who do you hold accountable?”

Yes, in some wards, the system can work with diligent staff. “But without an elected councillor, where is the accountability of a ward committee coming from? Who can follow up if something goes wrong? If you had a corporator, you would bug him, ensure that things are done,” she points out.

Elections to the Bruhath Bengaluru Mahanagara Palike (BBMP) are unlikely to be held before results of the five State polls come in, and as Tara says, the urgency to conduct them will depend on the verdict. “Until then, the city will have to make do without a third tier of governance.”