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SHORT COMMUNICATION
Year : 2021  |  Volume : 48  |  Issue : 3  |  Page : 215-216

Health system preparedness for a potential third wave of COVID-19: An Indian perspective


1 Professor & Head, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission06-Aug-2021
Date of Acceptance21-Oct-2021
Date of Web Publication28-Dec-2021

Correspondence Address:
Prateek S Bobhate
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_108_21

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  Abstract 


The second wave of COVID-19 pandemic has overwhelmed the health system across India leading to not only the loss of innumerable human lives but also exposed the various shortcomings of healthcare infrastructure. This emphasizes the need for a better preparedness of the health system across the nation to tackle the potential third wave of COVID-19 pandemic more importantly now as the cases and test positivity rate has started to show a downward trend all over India. The key areas which need to be targeted are augmenting the vaccine production and streamlining delivery mechanism, strengthening the existing pediatric emergency units and sick newborn units, expanding the oxygen production capacity in the country, ensuring the availability of drugs, strengthening of health infrastructure, logistic support and surveillance systems, expanding the free testing and diagnostic facilities, improved access to healthcare facilities, and reinforcement of COVID appropriate behavior in the community.

Keywords: COVID appropriate behavior, COVID-19 pandemic, COVID-19 vaccine, health system


How to cite this article:
Bobhate PS, Shrivastava SR. Health system preparedness for a potential third wave of COVID-19: An Indian perspective. J Sci Soc 2021;48:215-6

How to cite this URL:
Bobhate PS, Shrivastava SR. Health system preparedness for a potential third wave of COVID-19: An Indian perspective. J Sci Soc [serial online] 2021 [cited 2022 Jan 18];48:215-6. Available from: https://www.jscisociety.com/text.asp?2021/48/3/215/333838




  Introduction Top


The second wave of COVID-19 pandemic has overwhelmed the health system across India leading to not only the loss of innumerable human lives but also exposed the various shortcomings of healthcare infrastructure. This emphasizes the need for a better preparedness of the health system across the nation to tackle the potential third wave of COVID-19 pandemic more importantly now as the cases and test positivity rate has started to show a downward trend all over India.[1] As the public health experts globally have warned of a possible third wave, it is high time that we are equipped enough to respond to this challenge and preempt the impact of the pandemic on human lives.[2]

A multi-pronged strategy needs to be in place to equip our health system to deal with these anticipated challenges. Following are the key areas which need to be targeted:

Augmenting the vaccine production and streamlining delivery mechanism

The first and the most important strategy is augmenting the vaccine production and streamlining delivery mechanism. Vaccination against COVID-19 has been shown to reduce the chances of infection with the disease and also more importantly, it minimizes the risk of development of severe disease and death, thereby reducing the rate of hospitalization and burden on the healthcare system. Currently in India, Covishield and Covaxin are the two types of vaccines available for use. Scaling up the production of these vaccines to a significant level along with importing preprepared vaccines from abroad can be a short-term measure to rapidly vaccinate the high risk and economically productive population groups.[1],[3] Vaccine delivery mechanisms across all the states need to be streamlined to avoid vaccine shortage as well as wastage.

Strengthening the pediatric healthcare facilities

Second, we should focus on a possible pediatric wave of COVID-19. As there is the dearth of data about the safety and efficacy of vaccines for population below 18 years of age, they remain unimmunized. As a result, it is anticipated to have upsurge in pediatric cases during the third wave of pandemic and hence additional efforts need to be taken to expand healthcare infrastructure to tackle a possible pediatric wave by strengthening the existing pediatric emergency units and sick newborn units, allocation of pediatric ICU facilities including beds and oxygen support, establishment of separate pediatric isolation wards or facilities, etc.[2]

Expanding the oxygen production capacity

Furthermore, expanding the oxygen production capacity in the country cannot be neglected as shortage of oxygen support was one of the most important challenges observed during the second wave of COVID-19 pandemic. In addition, enhanced availability of oxygen beds, improved oxygen storage capacity, creation and use of oxygen corridors in hospitals, addressing pertinent logistic issues with regards to oxygen transport, etc., assume great importance in the current scenario for better preparedness.[4]

Ensuring availability of drugs

Moreover, ensuring the availability of drugs, namely, (viz. antivirals, immunomodulators, and antifungal agents) by impeding their production and their rational use is necessary to avoid drug shortage.[5] Delivery of the drugs should be streamlined; price capping and periodical audits must be made mandatory to avoid illegal sale and storage of these drugs during the pandemic situation and improve affordability for the general population. Furthermore, novel drugs, namely, antibody cocktail, Defence Research and Development Organization's 2DG, etc., can also be made available at a larger scale.

Strengthening of health infrastructure and surveillance system

Strengthening of health infrastructure, logistic support and surveillance system, expanding the free testing and diagnostic facilities, improved access to healthcare facilities, even in rural and difficult to reach areas, notification of cases, etc., is essential for the effective containment of infection. In addition, expanding the health insurance coverage to include COVID-19-related expenditure can be a boon to reduce out-of-pocket expenditure for the people.[1] Moreover, specific measures in hospital settings should be taken including recruitment of more healthcare personnel including doctors and support staff, vaccination of all cadre of healthcare providers, provision of teleconsultation facilities for asymptomatic and mild patients, screening facilities for patients and their attenders, separate entry and exit points for COVID-19 patients, strict adherence to infection control measures, etc.[2],[4] Furthermore, encouraging research by means of seroprevalence surveys and genome sequencing can be undertaken to identify the pattern of viral mutations to take policy decisions with regard to planning and executing an effective health sector response against COVID-19 infection.

Periodical reinforcement of COVID appropriate behavior in community

Last but not the least, reinforcement of COVID appropriate behavior, namely, use of face mask, social distancing, adhering to respiratory and hand hygienic practices, avoiding crowded places, undertaking only essential travel, etc., in the community setting irrespective of vaccination status with the help of behavior change communication and community mobilization is definitely the most important preventive strategy to contain the spread of infection.[3],[4]


  Conclusion Top


It is the need of the hour that our health care delivery system is well prepared to respond effectively and adequately for the containment of COVID-19 infection in a well-coordinated manner and tackle potential waves of the COVID-19 pandemic. Strengthening the capacity of our health-care delivery system is essential to mitigate the impact of the pandemic or any such public health emergency, in the future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jha A, Sachdev V. How Can India Prepare for the Third Wave? 2021. Available from: https://www.hindustantimes.com/india-news/how-to-prepare-for-the-third-wave-101623710031453.html. [Last accessed on 2021 Jun 17].  Back to cited text no. 1
    
2.
Indian Express. Covid Third Wave: CM says Gujarat Preparing for 'Double the Intensity'; 2021. Available from: https://indianexpress.com/article/cities/ahmedabad/covid-third-wave-cm-says-gujarat-preparing-for-double-the-intensity-7359357/. [Last accessed on 2021 Jun 20].  Back to cited text no. 2
    
3.
Matthew P. How to Prepare for a COVID-19 Third Wave, and Future Health Emergencies; 2021. Available from: https://www.moneycontrol.com/news/opinion/how-to-prepare-for-a-covid-19-third-wave-and-future-health-emergencies-6887351.html. [Last accessed on 2021 Jun 21].  Back to cited text no. 3
    
4.
Babu GR, Khetrapal S, John DA, Deepa R, Narayan KM. Pandemic preparedness and response to COVID-19 in South Asian countries. Int J Infect Dis 2021;104:169-74.  Back to cited text no. 4
    
5.
Bookwalter CM. Drug Shortages Amid the COVID-19 Pandemic. US Pharm 2021;46:25-8.  Back to cited text no. 5
    




 

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