In Episode 12: A Message From India, our host Josh Farden speaks with Dr. Sunil Raina, professor and head of the Department of Community Medicine at Dr. RP Government Medical College in Tanda, India. During this interview, Dr. Raina speaks directly to the audience about what needs to happen to help India during the COVID crisis. 

India’s success in managing this pandemic is critical to the success of all of our futures. With a complex, diverse population, various institutions, and infrastructure, if India wins - all of us win. The success of India is important for the entire world. 

Dr. Raina points out India’s biggest downfall; passing the responsibility of pandemic management from the central government to the state governments. The health of the citizens is now in control of the states, and each state has different or limited access to current data to make informed decisions. It’s further complicated by each state’s political party. When COVID-related orders were transitioned to the states, the numbers of cases started to increase.

Alongside the state government's role, there were other factors that led to the pandemic raging out of control, Dr. Raina states. Between premature celebrations with gatherings of hundreds of people, the economy opening up again, and large weddings, along with the virus mutating to be contracted easier, it was a recipe for disaster. 

The thing that further compounded this crisis is the state's lack of scientific infrastructure. There was no scientific intervention to help individual states, many of which don’t have access to resources needed to combat the virus.

So what do we do? Dr. Raina suggests that India builds a national command center that provides guidelines for each state and have direct contact with the central government for key information. Each district should have its own set of different guidelines and restrictions depending on the population and infrastructure. This includes building war rooms or using the ones some districts already have differently to include nearby places that don’t have such infrastructure. 

The message for the world is clear: Actions have to be global. Even if a country currently has zero cases, it may flare up again and again if not totally globally eradicated. We must have a global response, effort, and resilience.

Key Takeaways:

• India has one large central government that works similarly to a federal government, and they have 28 states. Each state has its own political party system which can influence how to handle the pandemic. Within the states are districts that run many functions of each community.

• In 2020, the Covid case numbers were exceptionally good in India. The central government had a nationwide lockdown, and India didn’t have large numbers of cases. It was deemed a success. 

• Prior to the surge, India was in celebration mode. There were large religious gatherings, weddings, and the economy started opening up again, including schools and workplaces. 

• Early this year, the numbers were not falling like last year but were stabilizing. Many political officials didn’t see this as a cause for concern. 

• Two things are concerning many health experts in India: One is that there is a shortage of supplies like ventilators and medications, and two, much like what was witnessed in the US, there's a moral panic of buying things in a bulk way in advance which means much of the general public is left without enough self-protective gear or supplies.

• There are over 700 districts and over 600 medical colleges in India. Dr. Raina suggests that every medical school could be a part of the “war room” efforts. 

• There are some parts of India that are doing very well. Out of the 718 districts, 180 haven’t reported new cases in a long period of time. 

• The goal is to get to zero cases. Iit must involve heavy campaigning for everyone to understand that restrictions need to happen again, and give a definitive timeline, and provide funds so people don’t worry about losing their livelihood.