Lancet recommendations on handling Covid in India
Lancet has given recommendations to India to tackle the resurgent Covid-19. We should all review and give our comments on this. Then perhaps LC manager can compile and escalate. Govt may not think highly of Lancet but if it comes from LocalCircles chances are it will atleast be considered
1. The organisation of essential health services must be decentralised. A one-size-fits-all approach is untenable since the numbers of Covid-19 cases and health services differ substantially from district to district. District-level working groups that have the autonomy to respond to rapidly changing local situations must be empowered to receive funds and resources to coordinate efforts across all sectors of the health system, from front-line workers to tertiary care.
2. There must be a transparent national pricing policy and caps on the prices of all essential health services — ambulances, oxygen, essential medicines, hospital care, and the like. Hospital care should not require any out-of-pocket expenditure and costs should be covered by existing health insurance schemes for all people, as has been done in some states. All local governments must be allocated their grants as recommended by the Fifteenth Finance Commission.
3. Clear, evidence-based information on the management of Covid-19 must be more widely disseminated and implemented. This includes guidelines for home care and treatment, primary care, and district hospital care in local languages. It should also provide information to help prevent increasingly concerning reports of other impacts of Covid-19, including secondary infections such as mucormycosis. Specific guidance should be offered by the central government on the appropriate use of Indian systems of medicine, especially for prevention and health promotion interventions, such as yoga.
4. All available human resources across all sectors of the health system, including the private sector, must be marshalled for the Covid-19 response and adequately resourced, particularly with sufficient personal protective equipment, guidance on the use of clinical interventions, insurance, and mental health support.
5 . Central systems to procure and distribute Covid-19 vaccines free of cost should be established in a departure from the current policy of decentralised procurement through state governments. State governments must decide on the priority groups for vaccination on the basis of evidence to optimise the use of available vaccine doses, which can be incrementally expanded as supplies improve.
6. Community engagement and public participation must lie at the heart of India's Covid-19 response. Active collaboration must be encouraged between government and civil society organisations to create and disseminate accurate information, enabling home-based care, emphasising prevention, helping navigate access to live-saving treatment, and promoting vaccination.
7. There must be transparency in government data collection and modelling to enable districts to proactively prepare for the likely caseloads in the coming weeks. Health system personnel require data on age and sex disaggregated Covid-19 cases, hospitalisations, and mortality rates; community-level coverage of vaccination; and community-based tracking of the effectiveness of Covid-19 treatment protocols and long-term outcomes.
8. The suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India's vast informal economy who have lost their jobs, as is being done by some state governments. Formal sector employers must be required to retain all workers, irrespective of the status of contracts, through a government commitment to offer compensation to these companies when the economy revives. Lockdowns, if necessary, must be announced in advance. more
1. The organisation of essential health services must be decentralised. A one-size-fits-all approach is untenable since the numbers of Covid-19 cases and health services differ substantially from district to district. District-level working groups that have the autonomy to respond to rapidly changing local situations must be empowered to receive funds and resources to coordinate efforts across all sectors of the health system, from front-line workers to tertiary care.
2. There must be a transparent national pricing policy and caps on the prices of all essential health services — ambulances, oxygen, essential medicines, hospital care, and the like. Hospital care should not require any out-of-pocket expenditure and costs should be covered by existing health insurance schemes for all people, as has been done in some states. All local governments must be allocated their grants as recommended by the Fifteenth Finance Commission.
3. Clear, evidence-based information on the management of Covid-19 must be more widely disseminated and implemented. This includes guidelines for home care and treatment, primary care, and district hospital care in local languages. It should also provide information to help prevent increasingly concerning reports of other impacts of Covid-19, including secondary infections such as mucormycosis. Specific guidance should be offered by the central government on the appropriate use of Indian systems of medicine, especially for prevention and health promotion interventions, such as yoga.
4. All available human resources across all sectors of the health system, including the private sector, must be marshalled for the Covid-19 response and adequately resourced, particularly with sufficient personal protective equipment, guidance on the use of clinical interventions, insurance, and mental health support.
5 . Central systems to procure and distribute Covid-19 vaccines free of cost should be established in a departure from the current policy of decentralised procurement through state governments. State governments must decide on the priority groups for vaccination on the basis of evidence to optimise the use of available vaccine doses, which can be incrementally expanded as supplies improve.
6. Community engagement and public participation must lie at the heart of India's Covid-19 response. Active collaboration must be encouraged between government and civil society organisations to create and disseminate accurate information, enabling home-based care, emphasising prevention, helping navigate access to live-saving treatment, and promoting vaccination.
7. There must be transparency in government data collection and modelling to enable districts to proactively prepare for the likely caseloads in the coming weeks. Health system personnel require data on age and sex disaggregated Covid-19 cases, hospitalisations, and mortality rates; community-level coverage of vaccination; and community-based tracking of the effectiveness of Covid-19 treatment protocols and long-term outcomes.
8. The suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India's vast informal economy who have lost their jobs, as is being done by some state governments. Formal sector employers must be required to retain all workers, irrespective of the status of contracts, through a government commitment to offer compensation to these companies when the economy revives. Lockdowns, if necessary, must be announced in advance. more
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Covid has totally disturbed the Economy of Govt as well as Citizens. To return it to Normalacy may take few years. more
Jun 24
Government was doing everything in mutually supportive reforms, starting with notebandi to flush out money from the parallel economy, through goods and services tax, and right upto Jan dhan scheme, along with several flagship programs such as Ujwala Yojana, undoubtedly. However, now there seems that convenience has been the guiding mantra. Lockdown was necessary, for building infrastructure until government got better handle on the situation, but prolonging the measure became convenient when they congratulated themselves on how prime minister handled the pandemic, when building infrastructure anticipating a fresh wave, should continue. Then came the second wave, where deaths now we know are hugely underreported. Government must be transparent with legacy systems running, case in point being the income tax site that was running perfectly, has been changed and now become totally opaque. Why! Less government, more governance, remember? more
Jun 20
Even Lancet is not telling Govt. to release ICMR guidelines for Covid treatment on newspapers for public awareness because the initial 12 medicine protocol was not effective to the best of my knowledge....Hope the Ayush ministry can integrate all the guidelines from various sectors as good Homeopath always advises to take paracetamol for high temperature without getting influenced from business angle.... more
Jun 19
The government should stop looting by all, taxis, manufacturers of all edible items, and essential items. The way the prices have increased, I think it is better off being dead than living in this inflation world. more
Jun 19
What if increments to employees are stopped? People want everything free. Free medicines and food to poor are already being distributed, where is the government going to get the money. States are writing off farmers loans, giving free electricity etc and force the center to give extra money. Due to reduction in consumption government is getting less taxes. Government has already put caps on vax prices and other medicines, some so low that it is difficult to sustain. Should the fees of good doctors be reduced? more
Jun 19
We would like to understand what has China done differently to contain the Pandemic - considering it reports less that 100000 cases of infections over the last 18 months!! If they have something that has worked, we must know what that is and should be happy to learn. more
Jun 19
