{"id":7658,"date":"2020-03-29T13:21:47","date_gmt":"2020-03-29T13:21:47","guid":{"rendered":"http:\/\/calamur.org\/gargi\/?p=7658"},"modified":"2020-03-30T01:58:53","modified_gmt":"2020-03-30T01:58:53","slug":"covid-19-after-the-virus-a-wake-up-call-to-invest-in-primary-health-care","status":"publish","type":"post","link":"https:\/\/calamur.org\/gargi\/2020\/03\/29\/covid-19-after-the-virus-a-wake-up-call-to-invest-in-primary-health-care\/","title":{"rendered":"COVID 19: After the virus, a wake up call  to invest in Primary Health Care"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">This was written on the 8th of March. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After the death of <a href=\"https:\/\/gisanddata.maps.arcgis.com\/apps\/opsdashboard\/index.html#\/bda7594740fd40299423467b48e9ec\"><strong>463\npatients<\/strong><\/a>, the Government of Italy has announced <a href=\"https:\/\/www.theverge.com\/2020\/3\/9\/21172390\/italy-lockdown-coronavirus-expansion-lombardy\"><strong>a\nlockdown<\/strong><\/a> for the country, hoping it would stem the rise of coronavirus\ncases. There are cancelled weddings, funerals, and public gatherings. Theatres,\nmovie halls, restaurants will be shut, as will be schools and universities.\nJust one day earlier Italy had put the region of Lombardy under lockdown. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As COVID-19 inches its way around\nthe globe \u2013 <a href=\"https:\/\/gisanddata.maps.arcgis.com\/apps\/opsdashboard\/index.html#\/bda7594740fd40299423467b48e9ecf6\"><strong>115\ncountries<\/strong><\/a> have reported cases &#8211; it is leaving behind panicked\npopulations. &nbsp;Between the breathless TV\ncoverage of the death rate, the science coverage on digital media that is often\ncontradictory, well intentioned WhatsApp forwards, and lockdowns of entire\nregions \u2013 people have gone into <a href=\"https:\/\/fortune.com\/2020\/03\/06\/fear-of-coronavirus-sends-consumers-into-a-grocery-hoarding-frenzy\/\"><strong>panic\nbuying and hoarding<\/strong><\/a> of food, toilet paper, OTC medicines, hand\nsanitisers and bathroom cleaners. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While products like <a href=\"https:\/\/www.bbc.com\/news\/business-51658361\"><strong>Dettol<\/strong><\/a> and <a href=\"https:\/\/www.bloomberg.com\/news\/articles\/2020-02-28\/clorox-ceo-sees-higher-sales-of-cleaning-wipes-as-virus-spreads\"><strong>Clorox<\/strong><\/a>\n, anti-flu tablets, and paracetamol are seeing a spike in sales, and services\nlike Zoom (teleconferencing) are being more used \u2013 there is a negative impact\non the rest of the economy. The starting point of this economic crisis is the\nquarantine that China had to impose in various parts of the country to prevent\nthe spread of the virus. While this could mean work from home options for the\nservice sector, it meant a shut down of factories in much of China. A recent\nsatellite image released by NASA, shows the collateral benefit of the shut down\ndue to the Coronavirus \u2013 a dissipation of the pollution &#8211; but it also gives you\nan indication of the kind of slowdown that is to come, if the spread of the\nvirus is not stemmed. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">.                                                <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"453\" height=\"343\" data-attachment-id=\"7659\" data-permalink=\"https:\/\/calamur.org\/gargi\/2020\/03\/29\/covid-19-after-the-virus-a-wake-up-call-to-invest-in-primary-health-care\/image-4\/\" data-orig-file=\"https:\/\/i0.wp.com\/calamur.org\/gargi\/wp-content\/uploads\/2020\/03\/image-4.png?fit=453%2C343&amp;ssl=1\" data-orig-size=\"453,343\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"image-4\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/calamur.org\/gargi\/wp-content\/uploads\/2020\/03\/image-4.png?fit=453%2C343&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/calamur.org\/gargi\/wp-content\/uploads\/2020\/03\/image-4.png?resize=453%2C343\" alt=\"\" class=\"wp-image-7659\" srcset=\"https:\/\/i0.wp.com\/calamur.org\/gargi\/wp-content\/uploads\/2020\/03\/image-4.png?w=453&amp;ssl=1 453w, https:\/\/i0.wp.com\/calamur.org\/gargi\/wp-content\/uploads\/2020\/03\/image-4.png?resize=300%2C227&amp;ssl=1 300w\" sizes=\"(max-width: 453px) 100vw, 453px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Source : <a href=\"https:\/\/earthobservatory.nasa.gov\/images\/146362\/airborne-nitrogen-dioxide-plummets-over-china\">NASA<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While China with its one party\nsystem, and a disciplined population used to following orders, is more or less\nsuccessful in imposing a lockdown and isolating those with the virus, the\nquestion is how do nations that are chaotic democracies do the same thing? How\ndo you force people to stay isolated? How do you provide care for them? What\nabout those who are daily wage workers? &nbsp;Who\ncompensates for these? And what does a democratically elected government do to\nits citizens who want to step out for a walk? &nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you look at India, it has been\nmiraculously spared the kind of outbreak and spread that is being seen in\nChina, Iran, and Italy. As a nation we need to understand that for miracles to\nwork best, they need help. And, the system in India is woefully underprepared\nto help. From a point of view of spending \u2013 the most vulnerable states \u2013 those\nwith the highest levels of poverty and malnutrition \u2013 have cut spending on\nhealth. Bihar\u2019s cut its health spend by 15% in 2017-18, spending just a shade <a href=\"https:\/\/data.gov.in\/node\/6570341\/datastore\/export\/xls\"><strong>over Rs. 6600\ncrores compared to the previous year\u2019s Rs.7800<\/strong><\/a> crores. Uttar Pradesh\u2019s\nhealth spending went down by 2% in the same period. In contrast the North\nEastern States, and the developed states like Kerala, Tamil Nadu and\nMaharashtra have boosted their spending on health. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There are 50+ cases in India spread\nacross the states. Kerala has the most detected infections, &nbsp;over a <a href=\"https:\/\/www.livemint.com\/news\/india\/coronavirus-kerala-puts-over-1-000-people-under-observation-11583812434140.html\"><strong>1000\npeople<\/strong><\/a> have been put under observation &#8211; and it is contemplating a\nlockdown. The CM of the state has announced a <a href=\"https:\/\/twitter.com\/CMOKerala\/status\/1237292537414447105?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1237292537414447105&amp;ref_url=https%3A%2F%2Fwww.easterneye.biz%2Fkerala-becomes-first-indian-state-to-head-for-complete-lockdown-over-coronavirus%2F\"><strong>state\nof&nbsp; high alert,<\/strong><\/a> with all public\nprogrammes suspended till the end of March. Schools have been shut, and the\ngovernment is undertaking a mass information campaign. Of all the states in\nIndia, Kerala probably has the best primary health care system, with secondary\nand tertiary care built atop a strong foundation of community health and\ntreatment. It coped effectively with the Nipa virus and brought it under\ncontrol, and it is likely to do the same this time around. It can do so because\nof its health infrastructure, and a highly educated people who understand the\nneed for caution. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you turn to states like Uttar\nPradesh or Bihar, this model may just about break down. Their health systems\nare creaking \u2013 in many cases they don\u2019t even exist. &nbsp;And compounding this, is a general state of\nnot following the law and\/or government instructions. How would the system\nfight a virus, for which no cure has been found yet, in states that exist\nslightly above anarchy?&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In most democracies, public health\nsystems are already overburdened and creaking under the weight of increased\nhealth care demand, and consistent funding cuts since the last economic\ndownturn of 2008. Most are woefully unprepared for a pandemic like this. At a\ntime when fiscal discipline is at a premium, nations need to revaluate their\npriorities. At the top of these priorities needs to be robust public healthcare,\nat the core of which is an integrated primary health care system that\nfunctions. With <a href=\"https:\/\/www.who.int\/zoonoses\/en\/\"><strong>zoonotic\ntransmissions<\/strong><\/a> on the rise, we are going to be confronted with many new\nviruses for which there is no cure yet. And, to combat these we need to be\nprepared. This enemy is not going to be fought with supersonic jets, and high\nprecision rockets. It is going to be fought with highly trained medical and\npara medical teams who are able to identify, isolate, and fix the problem. And,\nput in place protocols that train the general population on what to do at times\nlike this. &nbsp;And a larger part of our tax\nmoney ought to go in improving this system. The alternative is too scary to\ncontemplate.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This was written on the 8th of March. After the death of 463 patients, the Government of Italy has announced a lockdown for the country, hoping it would stem the rise of coronavirus cases. There are cancelled weddings, funerals, and public gatherings&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":7660,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[23,42],"tags":[1784,1792,1791,1794],"class_list":["post-7658","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-india","category-society","tag-coronavirus","tag-covid19","tag-primary-health-care","tag-public-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID 19: After the virus, a wake up call to invest in Primary Health Care - A PoV<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/calamur.org\/gargi\/2020\/03\/29\/covid-19-after-the-virus-a-wake-up-call-to-invest-in-primary-health-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID 19: After the virus, a wake up call to invest in Primary Health Care - A PoV\" \/>\n<meta property=\"og:description\" content=\"This was written on the 8th of March. 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After the death of 463 patients, the Government of Italy has announced a lockdown for the country, hoping it would stem the rise of coronavirus cases. 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