Srinagar, Aug 28: A two-member Central Team of Experts comprising of NITI Aayog Member (Health), Dr V.K. Paul and National Centre for Disease Control (NCDC) Chief, Dr S.K. Singh, on its visit to Kashmir, to take stock of the overall COVID situation in the Valley, today called on the Lieutenant Governor, Manoj Sinha here at the Raj Bhavan.
The meeting was also attended by Sh. Rajeev Rai Bhatnagar, Advisor to the Lieutenant Governor; Sh. BVR Subrahmanyam Chief Secretary; Sh. Atal Dulloo, Financial Commissioner, Health & Medical Education, and Sh. Bhupinder Kumar, Mission Director, NHM J&K.
The two-member team held a detailed review of the situation emerging in the valley due to COVID Pandemic with all the District teams and Tertiary care Hospitals.
While briefing the Lt Governor about the on-ground assessment of the situation made by them, the members of the team lauded the UT Government’s COVID containment and mitigation measures in place and suggested supplementary measures to further augment the same. They appreciated the J&K Government’s testing strategy, mandatory traveller screening, and Homecare model for positive asymptomatic patients. Testing strategy across the J&K is aggressive and robust and it has helped in containing the spread of the disease in the UT, they added.
In view of the impending winter season and sudden spike of positive cases in some districts of J&K, the team suggested a host of immediate measures including establishing 24×7 COVID Counseling Call Centres at Divisional levels with technical team; strengthening the Contact tracing mechanism with all contacts to be home quarantine until they test negative; Micro containment plan in cities with 100 % testing of all inhabitants with strict perimeter control; to strengthen the Referral system from peripheral hospitals to Tertiary care hospitals; involvement of PRI in rural areas for COVID control efforts; continuing the high testing trend and build on same and increasing High flow nasal cannula ( HFNC) inventory and keeping sufficient stock in stores.
The Lt Governor observed that all the important suggestions and recommendations made by the Central team will play an important role in the comprehensive and effective management of the COVID-19 situation in J&K.
The Lt Governor called for heightened awareness to keep the infection low and immediate capacity augmentation, besides utilization of every available resource to arrest the mortality rate.
He asked the health functionaries to formulate comprehensive future management and containment strategy of COVID-19 pandemic in J&K. He stressed on carrying out intensive surveillance and testing, particularly in Red zones, and inviting renewed participation of PRIs, religious leaders and other distinguished personalities to spread awareness.
He called for sustained efforts from all the stakeholders for effectively combating the spread of COVID-19. Strict compliance of all healthcare protocols and SOPs notified by the Central and the UT Government must be ensured to mitigate the threat of the deadly virus, he maintained.
The Lt Governor laid special emphasis on ensuring 100% coverage of Aarogya Setu app and asked for its integration with ITIHAS system, to improve contact tracing and surveillance of positive cases and its geo-mapping must be done to predict hotspots.
He also directed for putting in place a robust mechanism and taking all requisite measures to ensure the safety of frontline COVID warriors including Doctors, paramedics, medical professionals and Security forces who are also at the high risk of catching the infection.
The team acknowledged that J&K has a vigorous 03 dimensional COVID containment strategy that is primary preventive, containment, and surveillance to arrest spread and management for reducing the mortality rate, which is playing an important role in effectively dealing with the COVID pandemic.
Various valuable suggestions were made during the meeting including setting up 24×7 Tele Medicine / e-Support Centres for providing support of senior Doctors, Clinicians and Community Medicine Professionals to the frontline medical professional working on ground; a similar, e-support system of medical professionals and psychologists for home care patients to avoid any mental and psychological fatigue to overcome the disease; improving the Ambulance response time for its immediate availability in rural and urban areas.
Suggestions were also made for providing continuous support to Districts teams from Medical Professionals such as Medical College Clinicians and Community Medicine Professionals for their handholding and better scientific management of COVID-19 situation in the districts.
The team also suggested for evolving scientific learning community, wherein each Medical College including SKIMS can provide necessary scientific handholding to a minimum of three districts with a constant flow of scientific information that would also prove to be helpful in mortality management.
For rural areas, suggestions were made for devising an institutionalized mechanism like Village Monitoring Committees including PRIs, Anganwadi workers and others for tracking incoming travellers and positives cases. Strengthening of IEC measures and revamping ICUs and utilization of the available resources to their full capacity was also suggested.
Health Shocks versus Health Stimulants in COVID19
Dr Binish Qadri
The overpopulated and underdeveloped economies are characterised by the vicious circle of poverty having very low per capita income. It has been argued in the Critical Minimum Thesis of Harvey Leibenstein that underdeveloped economies are underdeveloped because there is a bad interface between the two forces of development viz shocks and stimulants. Since shocks are more intense in underdeveloped economies than stimulants, these economies are caught under a vicious circle of poverty. We must realize the fact that our health shocks are more than our health stimulants and, therefore, we are not in a position to come out of COVID19. What is required in this pandemic is that the economy should receive a stimulus to growth that is more necessary than a certain critical minimum size. To reduce the magnitude of health shocks and increase the magnitude of health stimulants all those forces which reduce the level of output, income, employment and investment etc. need to be suppressed and all those forces which increase the level of output, income, employment and investment etc. are to be boosted.
Shocks dampen the forces of development while stimulants boost the forces of development. Similarly, health shocks dampen the forces of health development parameters while health stimulants boost the forces of health development parameters. Health stimulants have the capacity to raise health levels in general and per capita income levels in particular above the equilibrium level. In backward and undeveloped countries as the magnitude of stimulants is quite small we can’t imagine long-run economic development. This further discourages the magnitude of health stimulants. Therefore, the efforts to evade economic backwardness (health in particular), impulsive or compulsory, are below the critical minimum effort needed for persistent growth that is all-inclusive. Even in our health departments, the efforts to do away with health disparities and COVID19 are very below the critical minimum effort needed for persistent holistic sustained health development.
According to Leibenstein, the attitudes and motivation of the people and the incentives given to them have a great bearing on the generation of stimulants. Nonetheless, the motivation and incentives have no worth without the key factors of economic development. The main factors that promote economic development are the inventors, the entrepreneurs, the discoverers, the innovators, those who have the capacity to accumulate and utilize wealth, and those who can accumulate skills and spread knowledge. COVID19 has depressed the masses to a great extent and reduced the motivation of the people to improve their immunity. Health authorities must give enough incentives to combat the detrimental impact of this virus, increase immunity, and generate health stimulants. No doubt the activities of health authorities and Frontline Health Workers are unending, but they must lay great thrust upon those activities which are in a position to generate health stimulants and promote economic development. COVID19 demands continuous efforts of various social, economic, and health agencies necessary for economic development. We need efficient human capital to produce other efficient human capital (particularly nurses, teachers, doctors, engineers). That is to say that we need a critical minimum amount of investment in human capital to produce more efficient human capital out of human resources. But, it necessitates an extraordinary type of human response towards motivations, attitudes, and incentives, which are created by a sound social and economic environment.
The author is an Assistant Professor at the Department of Economics, University of Kashmir. You can reach her at [email protected]
Third Wave: Precautions, not panic, please
Jammu and Kashmir is in the middle of what medical experts are calling the ‘third wave’ of Covid19. There has been a sharp increase in the number of Covid19 positive cases in the past one month or so. From 136 positive cases reported on December 19, 2021 to 5992 positive cases reported on January 20, 2022, the jump in the tally has been both significant and concerning. This has led to the imposition of a number of curbs across the Union Territory, including the closure of educational institutions for offline classes as well as the postponement of several examinations by universities.
While this increase in the number of positive cases has been concerning for both people and the authorities, the lethality vis-à-vis hospitalisations and deaths has been relatively very low when compared with the figures of deaths and hospitalisations during the second Covid19 wave when the Delta variant of the virus was at its peak.
Today, according to official versions, the bed occupancy is “very low” which is indicative of low levels of the lethality of the new variant called ‘Omicron’ despite the fact that scientists across the world have opined that its transmissibility is extremely high. Though there is no official data to support that the ongoing rise in Covid19 infections in Jammu and Kashmir is a result of the spread of the Omicron variant, nonetheless the rising levels of transmissibility are indicative of it. Truly, it is not possible for the government to go for mass testing for Omicron due to logistic requirements for genome sequencing, the levels of RTPCR testing for Covid19 have gone up significantly in the past few days, reaching as many as 80,000 tests/day on January 19.
Any complacency on part of people or authorities can have potentially dangerous consequences. The testing has to be ramped up. Furthermore, there has to be a close eye on the economic scenario and people’s daily livelihoods to ensure that the same are not jeopardised in any manner. Any decision on imposing lockdown has to be based on the levels of hospitalisations as against the number of daily cases, as some medical experts in J&K have already suggested.
At the public level too, the response to the fresh outbreak has been sagacious enough. Contrary to social stigma and ostracisation seen during the first and second wave of Covid19, when deaths and panic were at their peak, the situation today is far better. People appear to be handling the fresh outbreak with a fair degree of seriousness and maintaining the social cohesion that was seen in tatters in the first and second wave. That is a lesson that seems to have been learned the hard way at the public level, though it is important for the people to continue to mask up, maintain physical distancing and other Covid Appropriate Behaviour (CAB) to halt the fresh outbreak in its tracks.
There is no clear scientific data to suggest that the Omicron variant is going to behave ‘mildly’ in the near future as it is behaving today. That should serve as an alarming sign for both the people as well as medical experts and health professionals dealing with Covid19. There must be no lowering of guard whatsoever. The hospitals have to be fully equipped with Oxygen supply and ICU beds to keep them ready for any eventuality. Dedicated Covid19 hospitals have to be put in a ‘ready mode’ for next few months till the ongoing wave—believed to go in a couple of months from now—ebbs. Any complacency on part of people or authorities can have potentially dangerous consequences. The testing has to be ramped up. Furthermore, there has to be a close eye on the economic scenario and people’s daily livelihoods to ensure that the same are not jeopardised in any manner. Any decision on imposing lockdown has to be based on the levels of hospitalisations as against the number of daily cases, as some medical experts in J&K have already suggested. A reckless lockdown has the potential to hit the livelihoods of people which they are yet to revive after taking a massive hit during the first and second wave of Covid19. Additionally, it is important to explore ways and means to see to it that the education sector doesn’t get impacted any further. It has already taken a heavy toll on children’s education and their socialising in schools and colleges. All decisions have to be weighed in with ground realities and medical advice for a fine and balanced approach. Both people and government need to work together to realise these objectives.
Covid19 reopening: A close watch needed
Jammu and Kashmir, like other parts of the country, continues to battle the Covid19 pandemic. Though the number of daily positive cases is not as alarming as it would be a few months earlier, yet there are some indications of a slow rise in positive cases in the past few weeks. This situation clearly calls for very careful handling of the situation, especially in view of the apprehensions of a possible third wave hitting the country in the months of October and November.
In a welcome move, the Jammu and Kashmir administration recently ordered phased reopening of educational institutions, including colleges and higher-level schools. It was a long-pending demand of all stakeholders, in the larger interest of the student community, to allow children to return to their on-campus classes after a long hiatus. The move coincided with the phased reopening of businesses in the Union Territory to infuse a fresh lease of life into the otherwise ‘dismal’ economy that was badly hit in the wake of the Covid19 pandemic.
The post-pandemic situation calls for revival of economic activity to enable people associated with various trades to resume their businesses and earn a livelihood following a depressing scenario. There is a large section of the population directly dependent on daily earnings to make both ends meet.
There is no denying the fact that the post-pandemic situation calls for revival of economic activity to enable people associated with various trades to resume their businesses and earn a livelihood following a depressing scenario. There is a large section of the population directly dependent on daily earnings to make both ends meet.
It was therefore imperative upon the administration to take care of the interests of this section of the society. It is equally a fact that the resumption of academic activities across Jammu and Kashmir was the need of the hour to enable students to interact with their teachers and peers, re-socialise on the campuses and heave a sigh of relief. To this extent, the administration took certain welcome decisions. However, the fact that the pandemic is still not over can’t be overlooked in such a scenario. It is therefore important to watch the situation very closely for its better management and minimal disruptions in case of any eventuality like the third Covid19 wave.
The onus to ensure a close watch on the situation certainly lies on the officials concerned, especially the Deputy Commissioners of various districts. In the past two months, the number of daily positive cases largely ranges from 100 to 200. This is not alarming if a comparison of these figures is made with the figures of the previous few months. But the level of unpredictability is too high to be taken casually. On September 22, the UT recorded the highest single-day tally of 204 Covid positive cases—up from 145 cases recorded a day earlier. This is where the situation demands utmost caution. At the official level, it is important to keep a track of these figures to decide on further reopening. If the rate of positivity surges, it would be in the fitness of things to reconsider the further process of reopening and reimpose the curbs, wherever necessary. Alongside, it is imperative to ensure that mass gatherings are disallowed and people adhere to the Covid Appropriate Behavior (CAB) in letter and spirit. The administration also requires to watch the Covid scenario in other states of the country and handle the inflow of tourists and visitors to the UT accordingly in strict adherence to the SOPs. The situation just cannot be allowed to go out of control any longer. Sustained and focused attention on the situation can go a long way in facilitating its better management at all levels.
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