Retain infrastructure built against COVID till vaccination of majority: Expert

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(EDS: Recast) Bengaluru, May 26 (PTI): The country should retain the medical infrastructure built to combat the COVID-19 pandemic till the large majority of the population is vaccinated, a medical expert said on Wednesday.

Vice-President (Research and Policy)Public Health Foundation of India Prof D Prabhakaran stressed this need for the country to be prepared for the third wave.

Prabhakaran, an epidemiologist, a cardiologist and a public heath expert, said the second wave is already ebbing in urban areas but rural ones may have some way to go.

He said creating a simple home-based care with telemedicine assistance for those with mild and moderate COVID may be an approach that can be thought of, adding, volunteers from the local communities can be trained in terms of 'these management principles'.

'While catering to the rural population, we should also prepare for the third wave. Some of the infrastructure that has been built should be retained at least till the large majority of the population is vaccinated,' Prof Prabhakaran told PTI.

'We also tend to forget the health care providers, and their health, both physical and mental health, should be preserved,' he said.

On his take on the third wave, Prof Prabhakaran said,'One thing to acknowledge about this virus is that we are constantly learning and sometimes it is better to say that we dont know everything. It is hard to predict the timing of the third wave given that the country is in various stages of lockdown.' 'Rather than the date of prediction, the early identification is important so that we can intervene at the earliest with localised and decentralised measures which should include effective contact-tracing,' he said.

Continued surveillance on new variants would be needed, he said.

'As I said earlier, the infrastructure put in place during the second wave should be retained and adequate buffer stocks of essential drugs should be maintained while continuing with the vaccination programme with rigour and vigour,' he said.

On the vaccination strategy, Prof. Prabhakaran said one should ensure adequate supply of vaccines by using all means.

'If we manage to get the daily rate (vaccination) to one million-plus (people), we will be able to contain the pandemic even though there may be some immune escape and breakthrough infections. On the demand side we should continue with vigorous vaccine advocacy,' he said.

On mucormycosis or 'black fungus', Prof.Prabhakaran said there are several potential reasons for it.

'A formal registry should be constituted and we should rapidly assess the reasons. These should include inappropriate use of high dose steroids (some times much higher than the recommended protocols), the role of zinc, mucosal health (for example excessive steaming may destroy the protective elements in the nasal passage) and, of course, uncontrolled diabetes and its complications,' he said.

'Given that a third or more of the adult population depending on the location has diabetes or pre-diabetes, the risk of mucormycosis and other fungal infections will be higher amongst Indians. Early diagnosis is also crucial and education with regard to early warning signs will be helpful,' he said.

Ensuring adequate stocks of lysosomal amphotericin B and making it affordable will also help', Prof. Prabhakaran added. PTI RS NVG NVG

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