#TakeAStand

The current COVID19 pandemic in India has exposed the fact that medical and public health experts within the system do not #TakeAStand.

1/4
I am talking about basic stuff like
- Data transparency - eg interpreting low deaths in India based on low reported COVID19 deaths. Govt continue to boast about this.

2/4
I am talking about basic stuff like
- Wrong COVID Vaccination Strategy - we did not plan, stock and use the correct strategy for vaccination. We continue to use CoWin and have opened to all despite no vaccines

3/4
As a country, we have long way to go before we can realistically expect anything from the medical and public health ‘system’

4/4

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More from @HShewade

1 May
Rant

“Don’t criticze. Spread positivity. See how you can help others”

This statement is made with the assumption that people who criticise Governments are not helping others and people who post messages like “spread positivity” are helping others.

..
Let us learn to call a spade a spade and not get stuck in this propaganda of “spreading positivity”.

The central Govt has bungled up COVID19 vaccination despite us having the vaccines (large chunk exported) and technical expertise of running vaccination campaigns.

..
If we had planned and stocked only 44 crore doses, we would have by Feb-Mar fully vaccinated >45y with two doses through our decentralised public health vaccination system. It would have prevented a catastrophe.

..
Read 10 tweets
23 Apr
1/n

Thread 🧵
India COVID19 vaccination, what we did and what we should have done?

Now that we have seen this post👇, do not how LOW is our coverage(%) of 2nd dose(fully vaccinated) among elderly / >45y
2/n
Therefore with these levels of LOW coverage, we cannot expect any dent in the hospitalisations and deaths

We missed a window of opportunity during Feb/Mar
3/n
Had we at least achieved 89-90% of 1st dose coverage along >45, we could have expected significant impact on hospitalisations and deaths. We could have done this through campaign mode vaccination using our public health vaccination system through apriori microplanning.
Read 6 tweets
21 Apr
1/5
#WrongCOVIDVaccinationStrategy

All India had to do in Feb/Mar 2021 was complete both doses for >45 y in campaign mode (at least in elderly, at least in high burden districts)
That required planning in advance, procuring 40 crore doses and distributing to the states
2/5
#WrongCOVIDVaccinationStrategy

The states distribute it to districts and PHCs based on the estimated requirement in microplans.
Vaccination should have been done using our pubic health vacc system that is decentralised upto the Anganwadi through bottom up micro-planning
3/5
#WrongCOVIDVaccinationStrategy
We missed this window of opportunity and here were are.

We are spreading out thin without adequate coverage in vulnerable. This will not dent cases and hospitalisation. the limited coverage also appears inequitable

Two threads for details👇
Read 5 tweets
14 Apr
One tip

If a covid patient at home has a dip in oxygen levels (<94%) despite a 6 min walk test that means they need to get admitted in a covid bed with at least oxygen.

If a bed is available, public or private, get them admitted without DELAY

No If No But
.....
After reaching hospital, hospital says only bed with O2 available, no ventilator

Mistake that people do this travel around looking for bed with ventilator (just in case)

My suggestion would be to get admitted if a bed with O2 is available esp in these times.
...
At home, monitor O2 every two-four hours using a pulse oximeter. DO NOT take this lightly.
Read 10 tweets
13 Apr
#India #WrongCOVIDVaccinationStrategy

We as Indian public, media as well as the Govt lose the plot when we start talking about absolute numbers and vaccinating entire population, at least for now

1/n
For immediate reduction in hospitalisation and deaths (within 4-6 wks), we should ensure a rapid and wide coverage of COVID-19 vaccines in >45y population.

So
Ask data for coverage among these vulnerable pop.
Ask, is the current CoWin dependent strategy appropriate?

2/n
>45 are roughly one-fifth of the population. We should cover these using our public health vacc system thru decentralised approach (no need for CoWin). If vacc supply is the issue use sectoral approach. By spreading out thin we are not denting admissions and deaths.

3/n
Read 5 tweets
4 Apr
Thread 🧵
India should urgently change its COVID-19 vaccination strategy - why and how?
@MoHFW_INDIA @NITIAayog

(1/25)
Change in strategy is not as simple as making vaccination open to all (vacc criteria).
Still after 35 days of phase II, the numbers suggest that the coverage among elderly is abysmal and this needs immediate correction

(2/25)
Opening the vaccination to all will spread thin the already available doses. And it will also be an implementation nightmare.
This sounds fine at individual level but impractical and not correct at population level.
Again context specific exceptions could be made

(3/25)
Read 26 tweets

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