Thread by @vjha126

With #COVID19 raging in India - there are discussions galore on what should we do. Here is my take, rather than going back into what went wrong, these are the steps we need to take 1/16 @MenonBioPhysics @AnantBhan @PriyankaPulla @AnooBhu @ScienceTales @dineshcsharma

- Distribute masks to every household, replace as needed, through neighbourhood groups
- Wear masks properly and all the time when not with immediate family
- Educate/co-opt resident welfare associations 2/16

- Influencers : political, religious, social groups have a big role. Educate and make them allies
- Disseminate public health messages from temples, mosques, gurdwaras and churches 3/16

- Restrictions (?lockdowns)  will be needed
- Length, manner and duration should be decided on the basis of overall local risk-benefit calculus, in consultation with communities 4/16

- Important that we be quick and get numbers under control soon
- As summer worsens people will stay indoors more and more which will increase transmission risk 5/16

- Curtail all non-essential outdoor activities, travel.
- Whoever can should work from home.
- If you need to meet, do so outdoors
- If you can, take your business/trade outdoors 6/16

- Rethink vaccination strategy- protect the vulnerable.
- Prioritise those who cannot protect themselves and must work to survive - such as household help, hawkers, vendors, rickshaw/auto drivers, school teachers etc. 7/16

- Do not succumb to cognitive biases
- TV channels/online portals - please limit expert discussions - they do not help
- Do not obsess with testing and sequencing - do to the extent needed to track the virus, understand biology and behavior and make public policy 8/16

- We now know the clinical features. Manage patients like clinician always do.
- Take history, do physical when needed, do only those investigations that will have a bearing on patient management
- Don't order a battery of tests just for the heck of it 9/16

- Be humble, recognise the uncertainty in our knowledge.
- Do not offer miracle cures. The only interventions that have been shown to help time and again are oxygen and dexamethasone. 10/16

- Improve communication - get someone who is credible and can communicate effectively
- For God's sake, collect data, and report transparently - most hospitals are sadly not doing this
- Do not treat data as state secret, be transparent 11/16

- Permanently upgrade the level of preparedness - we will need it to deal with other types of health threats, such as a future pandemic climate change.
- Get 'health system resilience' out of the realms of cliche 12/16

- Promote and invest in research: clinical, epidemiological or laboratory
- Do clinical trials, increase capacity in institute ethics committees
- Put pressure on CDSCO to get sensible members in its expert committee 13/16

- Develop a strategy to open schools - perhaps in early mornings and late evening
- Call small number of students - conduct classes outdoors as far as possible
- Start neighbourhood classes. 14/16

- If you can, please spend money
- Patronise your neighbourhood grocery shops and vegetable venders
- Amazon will survive, they don't need our help 15/16

- Do not pay too much attention to TV and social media.
- Remember, we have some way to go before we can declare mission accomplished 16/16