Polio anywhere could be a threat to countries that had eradicated it. It took decades to eradicate polio in most parts while some are yet to eradicate. Not just this necessity, it was possible mostly due to a collaborative approach & strong leadership at the global level. 1/N
Lessons from Polio Eradiation, Cochi S et al
-Strong political & social support in each country
-Strategic planning & policy development
-Partnership management & donor coordination
-Program operations & tactics
-Oversight and independent monitoring.
If there was high polio circulation in one region, other countries could prevent the possibilities of its import by vaccinating the children in their countreis. Therefore, all countries are continuing polio vaccination till other regions accomplish eradication.
3/N
High circulation of #COVID19 anywhere is a serious threat to every country. Yet, there is no collaborative approach & strong leadership at the global level. Most developed nations are following a similar approach of polio eradication; vaccinating their citizens. It won't work
4/N
Genesis of the newer variants of concern is from the areas of high transmission. Countries with high coverage will have to keep updating vaccines based on each newer variant and have an illusory protection cover to their citizens and yet fear newer variants. A vicious cycle
5/N
There is a way out. Follow the lessons from polio eradication of global collaborative effort with two objectives.
- Ensure every country vaccinates every eligible person
- Lower the transmission levels in every part of the country to minimize the chances of newer VoCs
6/N
Despite the repeated calls by @DrTedros & leaders at @WHO, many developed countries are yet to make a transformational positional change from conservative, illusory, self-preserving pseudo covers towards meaningful, comprehensive vaccine coverage and surveillance programs.
7/N
This is not an option, this is the inevitable necessity. The sooner the world realizes this, the higher is the success of breaking the vicious cycle of high transmission and associated fatalities. Self-preservation can precede compassion elsewhere, not against #COVID19.
8/N
I had written earlier that isolated efforts of excellence in few countries incl zero covid strategy are illusory goals. The world needs a global program of #covid19 control, integrating priorities of every region to save lives while fighting virus. thehindu.com/opinion/op-ed/…
9/N
It is futile to wage battles in each country locally without collaboratively fighting against the virus in every part of the world.
How long can we continue wage such battles?
-Until we get tired of the illusory targets at the terrible costs of losing many human lives.
One and half years without school is a great toll on the children. The difficult part is to answer how to reopen schools with strict enforcement of #COVID appropriate behaviours. How can schools be made safe and protected bubbles for children?
School transmission varies according to student age and incidence in the local areas. The outbreaks in the school settings are substantially reduced with mitigation measures. Regular testing, teacher and staff vaccination can help reduce transmission. acpjournals.org/doi/full/10.73…
As per the ECDC, there is very little possibility that schools are not associated with accelerating community transmission. ecdc.europa.eu/en/publication…
Case Fatality Rate (CFR) is increasing.
Why?
CFR= # Deaths / # Positive cases
- ↑ in numerator: Poor detection and treatment --> higher deaths
- Low Denominator ↓: Under-reporting of COVID Cases due to poor testing.
Higher the CFR in the city, poorer the TTT strategy.
2ofN
The review of positive Cases, active Cases, and death moving growth rate in juxtaposition will give wholistic view on the situation. #Bengaluru & #Delhi have some work to do.
Not just that the technology is a barrier, this is the first time that India uses anything as a mandatory requirement for getting vaccinated. #CowinApp
Nothing can be a prerequisite for getting vaccinated or getting tested. #VaccineForAll
"It is easier to get married in India than to get vaccinated"
- @Dr_Aqsa_Shaikh , MBBS, MD Community Medicine is an Associate Professor of Community Medicine at Hamdard Institute of Medical Science and Research, Jamia Hamdard, Delhi.
This is a great question. Here are my observations regarding this.
1 of N
Dr Anthony Fauci represents a systems which have complete autonomy & are highly accountable. These are built over a long period of investment in science, public health research, evidence based priorities and goal settings. Such systems will have thousands of Fauci not seen by us.
In this article, the defiance of Dr Fauci to the attempts of the President Trump are depicted, rightly so as heroism.
Such heroes are turned out of favor when science is used as a criteria for decision making in systems that don’t have autonomy and freedom.
The key to curbing transmission is to transform the culture of data collection & review by encouraging accuracy & transparency. This can be done by incentivizing detection & not penalizing those who report.
Testing per million has remained poor in some states. This needs to be reviewed. Specifically, identify the areas with poor surveillance’s and testing and strengthen case detection in these areas. The states with better detection will isolate more cases, and will save more lives.
This is how it was done for polio eradication, in which India is a global leader. Using a syndromic approach, districts were expected to detect at least 1 non-polio AFP annually per 100 000 population in children <15 years. In endemic regions, this rate could be 2 per 100 000.