New epidemiology units must be established at the district and block levels in Rajasthan, with a focus on surveillance and control along with logistic plans for the storage and distribution of the COVID-19 vaccine, an eminent public health expert said here on Wednesday, adding that the State should also revive health communication structures for alerting people about risks to their well-being.
Daya Krishan Mangal, who served in the Directorate of Health Services and worked with UNFPA’s Indian Country Office, told The Hindu that the experience of the pandemic had highlighted the need for having trained health workers and epidemiologists at all levels, who would have managed the crisis in a “much better way”.
Dr. Mangal called for a renewed focus on public health measures at the present juncture, when cases of new infections were falling and the containment stage was likely to be reached in three to four months. “Consistent and sincere public health efforts are vital to ensure that the cases, which reach zero levels, do not flare up again,” he said.
Dr. Mangal is at present Dean (Research) at the Indian Institute of Health Management Research (IIHMR) in Jaipur. He said the State epidemiology unit should have capacities for data analysis and modelling to predict epidemics, as the government could not sustain the control measures when the cases increased exponentially.
“If implemented well, we must realise that public health measures halt the transmission of any infectious disease, while accessible and affordable treatment reduces mortality,” said the expert, who has authored 25 scientific articles published in the peer-reviewed national and international journals. Rajasthan kept the mortality rate below the national average because of decline in COVID-19 cases, he said.
In a word of caution about the vaccination likely to start soon, Dr. Mangal said the COVID-19 vaccine would demonstrate its advantage only when at least 60% to 70% of the population received it. “Despite all preparatory activities and sound planning, it will take six to nine months to reach this coverage level,” he said.
Dr. Mangal pointed out that a vaccine by itself could not control the epidemic or save lives, and added that the vaccination programme would control the spread of infection through personal protection and contribute to herd immunity. This would effectively save lives by reducing infection among highly vulnerable sections of the population.
“We have to wait to assess the implications of the new mutant strain of virus detected in Britain,” Dr. Mangal said. He said pregnant women and children below 15 years of age would be excluded from the initial round of vaccination, as the vaccine's safety had not been tested in these groups. It would require Phase-3 trials in these age and population groups, he added.
