Thread by @AnantBhan

Writing in @ThePrintIndia today on #WorldHealthDay @MonJunNot & I argue that the current discourse on COVID-19 response focuses overtly on ventilator availability, ICU care & not enough on the art & science of contact tracing #COVID19 #India #publichealth
theprint.in/india/more-tha…

We highlight how its equally if not more important to invest in developing the art and science of, and human resources, for effective contact tracing.

"Ventilators dominate the public discourse, perhaps driven by what Atul Gawande calls the heroic expectation of how medicine works — the image of doctors saving a person from the clutches of certain death is fascinating.

A contact tracer with a clipboard requesting a list of people with whom the patient spent more than 30 mins within two metres proximity in the last seven days appears mundane by contrast.

But in discounting the lucid and effective strategy of contact tracing, we forget that in responding to extraordinary pandemic situations, simplicity might be the ultimate sophistication."

The British Covid-19 patient who was discharged from Ernakulam was treated by a multidisciplinary team of 8 doctors, his sample collection and maintenance was done by four doctors, nursing care by five nurses including infection control and they were assisted by two dieticians..

Containment and mitigation are not necessarily mutually exclusive but rather a continuum.
It’s important to remember that a contact successfully traced, isolated early and treated if sick, could prevent between two to three further new infections.

Large-scale contact tracing may appear daunting and impractical to a diverse country like India. How can India replicate Singapore or South Korea which are smaller & homogenous countries, especially given asymptomatic transmitters?
The foremost requirement is political will.

In Wuhan, at the peak of local spread, China had 1,800 teams of five people each to trace 6,85,000 contacts. We need to recruit a sufficient pool of people, train them, and deploy them.

This resource will be useful for us in future routine health activities such as communicable and non-communicable disease surveillance, as well as to help us be better prepared for other infectious epidemic onslaughts in the coming years.

For surveillance, tech can be incorporated with appropriate ethical safeguards. This can include smartphone apps to track nearby contacts in public spaces or to observe contacts’ adherence to quarantine. CCTV footage can aid police and transport departments for comprehensiveness.