Community diagnosis in public health is similar to the role of clinical diagnosis when treating an individual patient. In practice of clinical medicine, one does not get down first to treating a wart on the leg of a patient who has come to the hospital with severe chest pain suggestive of a heart attack.
One surely does not resort to such stupidity while practicing clinical medicine. However, in the present pandemic such blunders are being committed with impunity. The table below shows our major disease burden based on incidence and deaths, the proper community diagnosis.[Table 1].
Compared to the community diagnosis of the Indian population as seen in Table 1 the impact of Covid-19 particularly in young Indians and children is negligible as shown in Table 2.
Basic public health principle demands that resources should be used to control diseases with high death rates and morbidity. For this proper monitoring and surveillance to generate good data is essential, which is lacking for our major killer diseases of childhood.
On the contrary, we are blindly spending resources for RT-PCR and contact tracing for Covid-19, an exercise in an extravagant waste of scarce resources and on a disease, which rarely kills young people. Moreover, once community transmission is established, test, trace and isolate is futile.
The 4th round of serosurvey conducted in June 2021 by the Indian Council for Medical Reseach ICMR found 67% of seropositivity. From this we can estimate that over 90 crores of Indians have encountered the corona virus. At that time only 3 crores cumulative cases were reported, indicating that hardly 3-4% of cases of Covid-19 could be detected by this cost & resource intensive test, test, isolate policy.
The biggest public health blunder is spending Rs 35,000 crores for mass vaccination for a disease which has more than 99% survival across all age groups, the lowest among all our endemic diseases, while only 20,000 crores have been earmarked for hygiene and sanitation/water supply lack of which kills over 2000 children every day in India due to diarrhoeal and other diseases.
The latest serosurvey from Delhi has revealed that over 80% of people below 18 years already have antibodies against Covid-19 Do we need to develop and roll out vaccines for children? Studies from various parts of the world have established that immunity after natural infection, which the bulk of young people in our country seem to have acquired, is 13 to 27 times more robust than vaccine-induced immunity.
Compared to the community diagnosis of the Indian population as seen in Table 1 the impact of Covid-19 particularly in young Indians and children is negligible as shown in Table 2.
Basic public health principle demands that resources should be used to control diseases with high death rates and morbidity. For this proper monitoring and surveillance to generate good data is essential, which is lacking for our major killer diseases of childhood.
On the contrary, we are blindly spending resources for RT-PCR and contact tracing for Covid-19, an exercise in an extravagant waste of scarce resources and on a disease, which rarely kills young people. Moreover, once community transmission is established, test, trace and isolate is futile.
The biggest public health blunder is spending Rs 35,000 crores for mass vaccination for a disease which has more than 99% survival across all age groups, the lowest among all our endemic diseases, while only 20,000 crores have been earmarked for hygiene and sanitation/water supply lack of which kills over 2000 children every day in India due to diarrhoeal and other diseases.
The latest serosurvey from Delhi has revealed that over 80% of people below 18 years already have antibodies against Covid-19 Do we need to develop and roll out vaccines for children? Studies from various parts of the world have established that immunity after natural infection, which the bulk of young people in our country seem to have acquired, is 13 to 27 times more robust than vaccine-induced immunity.
It would be unethical to risk adverse effects of vaccines particularly in children with Natural Immunity, when both the efficacy and long term side-effects are still unknown.Against this background, it is very imprudent to have allocated Rs 35,000 crores for covid-19 vaccination almost equal to half the amount of Rs 71,269 crore allocated to department of Health and Family Welfare (click here).
The developed countries enjoy the luxury of overcoming most of these infections and may afford to invest heavily to control the novel coronavirus in children. In developing countries like India, on the other hand other prevalent diseases including malnutrition takes a far heavier toll of children and young people, many times more than Covid-19.
Public Health practice keeps encountering difficult choices. It challenges us to be fair and also accountable when making rational decisions. We need reliable data about our own endemic diseases to make such choices. The current model of real-time monitoring of cases and deaths of the novel coronavirus can be more efficiently used for our own major killer diseases. These data would enable rational allocation of health resources to improve the health of our population.
Futile chase of the coronavirus which kills a minuscule proportion of our population will divert resources and attention from our major public health challenges and compromise further our population health.
Currently, our strategy of focusing all on Covid-19 is like treating a wart in a patient with disease of the heart.
---
Professor & Head, Community Medicine, Clinical Epidemiologist, Editor in Chief, Medical Journal Dr DY Patil Vidyapeeth, Pune. Website: https://amitavb.wixsite.com/amitav-banerjee
Public Health practice keeps encountering difficult choices. It challenges us to be fair and also accountable when making rational decisions. We need reliable data about our own endemic diseases to make such choices. The current model of real-time monitoring of cases and deaths of the novel coronavirus can be more efficiently used for our own major killer diseases. These data would enable rational allocation of health resources to improve the health of our population.
Futile chase of the coronavirus which kills a minuscule proportion of our population will divert resources and attention from our major public health challenges and compromise further our population health.
Currently, our strategy of focusing all on Covid-19 is like treating a wart in a patient with disease of the heart.
---
Professor & Head, Community Medicine, Clinical Epidemiologist, Editor in Chief, Medical Journal Dr DY Patil Vidyapeeth, Pune. Website: https://amitavb.wixsite.com/amitav-banerjee
Comments
None of the other diseases which he has listed with higher mortality has cost so much damage to mobility and economy of countries across the world. Nowadays it a fashion in India to say that the Govt. policies are wrong. I would say that Indian Govt deserves a praise in managing the situation as best as it could given the developing country resources- and challenges like USA stopping supply of some of the essential components for vaccine to the Indian vaccine manufacture due to pressure from US pharma companies. Covaxin- a fully indigenous Indian made vaccine got WHO approval only in Nov 2021 and Lancet article says that this vaccine provides 70% protection- same technology as Chinese sinopharm vaccine which was approved by WHO many months ago and which has seen to have much lower protection.
UK approved Indian made vaccines only when Indian Govt refused to honour vaccine status of UK citizens when they travelled to India and made them to undergo compulsory quarantine.
I think this is an informative post and it is very useful and knowledgeable. therefore, I would like to thank you for the efforts you have made in writing this article.