The strictest lockdown in China impacted API imports and India was constrained to become self-reliant in APIs and medical devices like PPE kits.
After over three years into the pandemic orchestrated by the SARS-CoV-2 virus that causes Covid-19 disease, the entire globe had blamed the virus and the place—Wuhan in China—from where it originated. With weekly fewer than 500 Covid infections and fewer than 10 deaths, the pandemic is over for India, though we are feeling shy of declaring it. For India, the country with the best example of how an adversary can be turned into an opportunity, the Covid pandemic turned out to be a “blessing in disguise”.
In no way am I putting my morality at stake by justifying the morbidity and mortality caused by the virus or the lackadaisical attitude, if not blunders at times, in handling the pandemic. I would like to look at the other side—the “blessing”. No one should wait for such blessings that come after a lot of miseries. But when it has come, let us analyse and enjoy the fruits. The positioning of India as one of the leading economies and one of the best handlers of healthcare despite the population burden of 140 crore to look after, could not have been achieved so quickly, had there been no Covid pandemic. And hence this piece is to thank the virus, based on several parameters. There are gains at all the levels—national, community as well as at individual levels.
AT THE NATIONAL LEVEL
Economy and food security: My understanding of economy is rudimentary. What I know from news headlines and discussions is that our GDP is 6.7% and likely to be 7%, much better than the top economies globally. Right from the beginning of the pandemic till today, free ration is being provided to 80 crore people, 57% of our population with orange ration cards. Today none has to die for want of food. I think India has one of the best food securities globally. The famine of the 1960s and the Kalahandi starvation deaths in India are part of black-history, when we were compelled to embrace the fodder-quality American wheat.
For over a decade, India has been the global pharma capital with affordable generic medicines. However, pre-pandemic, the Indian pharma industry was largely China-dependent for active pharmaceutical ingredients (API) or bulk drugs. The strictest lockdown in China in accordance to their Zero-Covid policy, impacted API imports and India was constrained to become self-reliant in APIs and medical devices like PPE kits. The Indian government introduced a Production Linked Incentive (PLI) scheme for the promotion of domestic manufacturing of drug intermediates and APIs. Today India continues to be the global pharma capital but without being China-dependent. Similarly, not only we produce better quality PPE kits at low cost in India, but now we export them to over a hundred countries.
When Pfizer and Moderna launched Covid mRNA vaccines touted to be supreme ones with tall claims, we were surprised at their high costs despite the pandemic time and that they were pre-booked by the utterly self-centred rich nations, by five times than their dose requirements. The current fate of Pfizer is an independent chapter. Conversely, when India approved Covishield and Covaxin, besides local distribution, India had launched its Vaccine Maitri to help poor nations with Covid vaccination. Today India is a Covid-vaccine powerhouse with gigantic production capacity to meet the global requirement, with more efficacious vaccines at the lowest cost. India’s vaccine-power isn’t new. For over two decades, India has been the global vaccine capital, meeting 80% of its requirement of vaccines for childhood immunization and that too at a pittance of cost as compared to multinationals and saving millions of children from childhood infections. Though adult vaccines existed pre-pandemic, the concept became popular now.
The unprecedented Delta-wave tragedy during the April-June 2021 peak, taught us crucial lessons on pandemic preparedness, especially with medical oxygen, beds, ICU and ventilator requirements. With the capacity building we have achieved, today we are adequately prepared to handle any pandemic or catastrophe of the size of the Delta-wave.
AT THE COMMUNITY LEVEL COMMUNITY MOBILIZATION: Largely communities in India are adorable with an ever-helping approach. The pandemic noticed langars going on with huge capacities and for prolonged periods; volunteers ferrying patients to hospitals and quarantine centres; medicine and oxygen banks; distribution of PPEs and sanitisers to needy; funeral volunteers—these are only a few examples of how communities were charged up to confront the pandemic. I was impressed with some of our HIV patients carrying medicines for other patients, driving for hundreds of extra miles and also some sharing their medicines with others. The importance to life and livelihood was at an all-time high. Kindness towards others, understanding their woes, in accordance to our imbibed credo “Vaishnavjan to tenekahiye je peed parayeejane re” was perceptible all over. The most important thing that happened was to learn how to take care of ourselves without domestic help during the lockdown. We were literally grounded and started managing life with minimal requirements.
India has the lowest data and telecommunications costs. The pandemic did result in a communication boom with 24×7 WhatsApp industry with groups/broadcasts and teleconferencing. Health-science communication, the most difficult area in translating scientific research outcomes for common people was superbly handled by both print and electronic media, involving experts. Initially, when the WHO-created fear psychoses of “surface” transmission of the virus, forced closure of newspapers, they innovated to launch online editions and that continues. With the efficiency and ease of virtual platforms, one could do several meetings daily without taking travels, has been a great blessing with lasting ramifications in saving resources for government and private establishments.
Medical tele-consultation, which was termed illegal by the National Medical Council in pre-pandemic time, provided great respite for scores of patients and doctors. Home collection of samples, home-based testing and health monitoring became popular and post-pandemic they still remain part of remote-patient management strategies.
AT THE INDIVIDUAL LEVEL
We admire individuals in India as they cooperated immensely and without much of hesitancy that was evident in many countries. Social distancing or “Do-Gajki Doori”, one of the three commandments to minimise the spread of SARS-CoV-2 was the most difficult but was optimally achieved. Masking was difficult but people did get habituated eventually. Having worked for decades in HIV, I know how difficult it was to expect people to achieve sexual distancing or using condom. Alcohol, tobacco and drugs consumption was impacted due to supply-chain disruption. We see the pandemic making positive impact and a lot of my patients have either given up or curtailed their habits. Work from home, WFH start-ups like food and medicine deliveries, online classes and several other innovations are other benefits. One of the most important gains has been improved interpersonal relationships and value of friendship. A lot of hidden talents and hobbies surfaced. People have become practical and realistic with making them self-reliant and learnt to manage life with low resources. Even top notch people were grounded.
Personally, I gained a lot. I have never studied so much medical literature all my life—even while studying medicine—as I did during the pandemic to enable me to write hundreds of multi-lingual articles and speak to media, akin to “Publish or Perish” that is often told to us to keep abreast with the science. To communicate with my extended family, friends, professional contacts and patients, I started several broadcast groups, with almost daily posts, which I otherwise may not have done in my life. I have been blessed with three of our four grandchildren, from my two daughters, born during the pandemic as lock-down babies. It has been such a wonderful experience baby-sitting during free time that holidaying with the grandchildren without their parents is our bucket-list.
Can we collectively thank the virus now?
Dr Ishwar Gilada, is Consultant in HIV and Infectious Diseases, www.UnisonMedicare.com; Secretary General, Organised Medicine Academic Guild-OMAG, President, AIDS Society of India (ASI) & Governing Council Member, International AIDS Society (IAS) firstname.lastname@example.org