As hyped by the media, Covid-19 cases continue to rise in the country, and the Union Health Ministry has asked several states and union territories, including Delhi, to put preventive measures in place.
As of 28 May 2025, India recorded 1,621 active cases, with Kerala, Maharashtra, Delhi, Gujarat, Tamil Nadu, and Karnataka accounting for over 90 percent of total active infections.
In a letter dated 29 May 2025 to state chief secretaries and UT administrators, instructions have been passed to assess readiness at district and sub-district levels, including medical colleges, tertiary care centres, and other inpatient healthcare facilities. This includes ensuring the availability of diagnostics, essential drugs, personal protective equipment (PPE), isolation facilities, oxygen supply, critical care beds, and ventilator-supported beds.
Facilities must conduct mock drills to verify oxygen preparedness. An action taken report has to be shared by June 2. The Health Ministry emphasized following testing protocols as per operational guidelines: testing all severe acute respiratory illness (SARI) cases and 5% of influenza-like illness (ILI) cases. SARI-positive samples have to be forwarded to regional centres for whole genomic sequencing.
District Surveillance Units must monitor ILI/SARI trends, track SARI proportions among cases, and maintain regular data entry on the concerned portal. Vulnerable groups, including the elderly and immunocompromised individuals, should avoid crowds and poorly ventilated spaces or wear face masks. Individuals experiencing respiratory symptoms should monitor their health and seek medical attention if they develop serious symptoms such as breathing difficulties or chest pain.
The Health Ministry’s quixotic guidelines give an illusion of control. Mock drills may divert attention from real public health issues.
People primed by media hype and propaganda about rising daily case numbers—which are mild and self-limiting—and deaths among those with co-morbidities, will credit the Health Ministry for taking proactive measures to ward off the fresh corona crisis largely created by the media. But going by hard data and science, these measures are quixotic and will divert attention and resources from our real public health issues. It is like VIP movement when all roads are blocked for the commoner. Focusing only on Covid-19, which currently has zero mortality in the healthy population, and conducting mock drills around it, will divert attention and resources from serious underlying diseases, including co-morbidities, which make one vulnerable to any viral infection—not just the coronavirus.
We should count the co-morbidities which go inadequately treated in our country due to poor public health systems. Any public health expert worth his/her salt—and we are sure there are some in the Ministry of Health—would know that there is no present or impending threat from Covid-19, given the nature of the virus, which is now much attenuated due to multiple mutations. Repeated mutations lead to milder and milder strains, not monsters, as the media tries to project.
But such mildest of mild viruses are ideal for giving an illusion of control by the authorities. While the media creates an illusion of impending disaster, public health authorities, through such detailed recommendations and guidelines, create an illusion of control—brushing real public health problems under the carpet.
Mock drills around a relatively harmless virus will take attention and resources away from real pathogens and diseases that are major public health problems in India. For instance, whole genome sequencing is being recommended for the SARS-CoV-2 coronavirus, which hardly kills anyone without co-morbidities, while the same is not easily available for detecting drug resistance in Tuberculosis, which kills 1,400 people daily in India.
According to WHO estimates, rabies—a disease with 100% case fatality—kills 20,000 people in India every year, i.e., 54 deaths occur daily in India from this painful and horrible disease. Why does the media not cover these 50-odd daily deaths from rabies? And tragically, around 50% of these deaths are among children. Why do public health authorities not ensure the control of rabies through 100% vaccination of dogs and elimination of stray dogs? And regrettably, these are only estimates, as we are not counting this deadly disease as meticulously as we are counting the very mild Covid-19 cases and deaths—deaths due primarily to co-morbidities.
These are just two examples among many of our serious public health burdens. Brushing all these under the carpet, we are preparing for a pandemic of Disease X, or of Nipah virus, Bird Flu, and so on.
Knee-jerk measures like mock drills for the anticipated corona crisis or preparing for future pandemics of unknown Disease X, to the extent of signing the proposed WHO Pandemic Treaty, are band-aids over our deeply wounded public health infrastructure. Band-aids will not heal compound fractures in our health system.
For an effective public health system that truly protects us from future pandemics (real or imaginary), facilities and human resources must be positioned to ensure accessibility and affordability for the common citizen. You cannot win a football game by neglecting the goalkeeper and deep defenders while focusing only on the forwards to score goals and impress the selectors and their sponsors. To combat illness and promote health, the same strategies that work on the playing field are applicable. It is common sense rather than rocket science. A look at our healthcare playing field will make one realize that we are not fit to fight any real pandemics—or even the silent ongoing pandemics for which there is no media hype.
Uneven Public Health Playing Field – skewed towards centre-forwards (glamorous urban healthcare) and lacking deep defenders and goalkeepers (poor infrastructure in rural and low-income regions)
More than the inadequate availability of basic healthcare infrastructure, it is the grossly uneven accessibility, especially due to the urban-rural and rich-poor divide, which poses a greater challenge. For example, the state of Karnataka has 4.2 beds per 1,000 population, whereas Bihar has only 0.29 beds per 1,000 population. Even within states, there is a major imbalance from district to district, and only a handful of districts have tertiary/quaternary care facilities. This forces people to travel long distances within or even outside their state, thereby depriving them of timely care. In a real pandemic, this movement toward urban health centres will facilitate the spread of infections along the route.
Health Professionals Missing – You Cannot Win a Match with Less Than 11 Players
A lack of adequate healthcare professionals means we are playing without a full team. A recent report by the Comptroller and Auditor General of India (CAG) commented on the failure to fill vacancies across various categories of health professionals, including doctors, nurses, and technicians. Most peripheral health centres at village and district levels had insufficient staff and equipment.
More surprisingly, the National Medical Council of India recently issued notices to government medical colleges across the country for deficiencies in medical faculty and staff and insufficient infrastructure. Shockingly, a few government medical colleges have less than 50% of the authorised staff. If this is the state of affairs in tertiary care centres, one can imagine the condition of primary and secondary healthcare, where the majority of Indians seek care.
Poor Overall Health Makes Us Vulnerable—Not Necessarily Viruses
The Covid-19 pandemic—both in its initial phase and now in its much milder form—drives home the message that it is co-morbidities like obesity, diabetes, hypertension, and a host of other conditions that kill, not the virus itself.
The way forward lies in ensuring balanced healthcare services distributed equitably between urban and rural areas and across socio-economic divides.
Unfortunately, the focus remains on chaotic, knee-jerk reactions during a pandemic—or even just the apprehension of one—rather than a day-to-day focus on strengthening public health infrastructure.
Since co-morbidities are the real killers, we should focus first on preventing them through lifestyle changes in the population and second on ensuring accessible healthcare services for early diagnosis and treatment.
If we have a robust public health infrastructure, we can cope with any pandemic—without having to resort to mock drills and reactive responses.
“The art of war teaches us to rely not on the likelihood of the enemy's not coming, but on our own readiness to receive him; not on the chance of his not attacking, but rather on the fact that we have made our position unassailable.”
― Sun Tzu, The Art of War
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Dr Amitav Banerjee is a renowned epidemiologist and currently Professor Emeritus at Dr DY Patil Medical College in Pune, India. Having served as an epidemiologist in the armed forces for over two decades, he ranked in Stanford University’s list of the world’s top 2% scientists for two consecutive years, 2023 and 2024. He has authored the book Covid-19 Pandemic: A Third Eye. Dr Banerjee is also a founding member of the Universal Health Organization (UHO), an independent registered organization. Details of UHO can be accessed at https://uho.org.in/. This commentary is based on inputs from the core members of the UHO
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