With an unprecedented focus on healthcare infrastructure and coordination reigned in between the government and private sector during Covid-19, Dr. Naresh Trehan, chairman, and managing director, Medanta Heart Institute, said the pandemic has compressed our plans from five years to three.

In a conversation with Kailashnath Adhikari, MD, Governance Now, Dr. Trehan said we always knew that proportionally our services are weak. Close collaboration between the government and private sector during Covid has shown that if we work together, we can offer better protection to our population than if we work separately.

“We always knew that proportionally our services are weak. Numerically, the numbers of beds, nurses, doctors, paramedics are low down in the curve even when compared to some of our poor neighbours. The positive side was that the government and the private sector worked very closely to fight the battle in the health space. A lot of barriers between the government and private sector came down”.

He was in a webcast as part of the Visionary Talk series held by the public policy and governance analysis platform.

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Dr. Trehan said that even in the case of IT, with sophisticated patient management and diagnosis, video management of disease and remote patient care is coming down the pipe now.

Invoking the adage ‘Let He Do What He Does Best’, the eminent cardiovascular and cardiothoracic surgeon said that the government and private sector should leverage upon and harness each other’s strengths and combine the forces to ring immediate relief in areas where earlier there was no coordination or joint effort between the two. During Covid, the industry came in very quickly and rose to the occasion by repurposing PPE, masks and ventilators.

“We must harness the power and resources of our country in a robust movement forward. New manta should be that combined power of hope can bring quick relief to our country at every level. The urgency with which we need to look at healthcare and its infrastructure and attentive service, i.e., train people, have more nurses, doctors, etc must all work in tandem so we can rise up with a well-integrated system.”

Asked if India might have entered the endemic stage of the pandemic, Dr. Trehan said, “This notion has caused a lot of damage at present to people. I think it is confusing to people including people like us.”

He said that a WHO specialist in Europe has cautioned that he expects nearly half a million people to die if infections continue at this rate in the next few months. “This may sound like an exaggeration, but it is a serious warning,” he said.

“Around the world, unvaccinated children are a concern for people like us, and as soon as the schools reopen children will carry it home and give the virus to the elderly in the family. It’s a double whammy of children and elders’ safety. I think it is the time for caution.”

On vaccine hesitancy Dr. Trehan said, “With no major adverse effect seen post-vaccination since it started, why would vaccine hesitancy brew … that’s the big question. Because the counterargument is that you will endanger yourself, your family, your community, and your own country.”

He said considering April -May 2021 was the peak of the second wave, the next four to six weeks will be very critical for India to see if the pattern is similar to earlier or not. “If by the end of January, we have not seen a third wave, we will need to evaluate,” he said as he cautioned that with weddings, festivals, and the coming holiday season, CAB must be followed and the public needs to be warned to mask up and keep distance.

While speaking on booster shots Dr Trehan said that antibodies of most people at six months from the second dose are diminishing to very low levels and with 20 crore surplus doses lying in India there is elbow room to start booster doses because most developed countries have already done it.

“There is data that if you have been double vaccinated and if you get exposed the chances of getting infected or getting serious are less than normal and severity would be limited. With monoclonal antibody drugs available, the cocktail cuts down the viral load immediately. Besides a lot of developments are happening in the Covid ecosystem,” he said.

Praising the government’s policy of mandatory RTPCR test for all international arrivals at airports across the country and test results being used for genome sequencing, Dr. Trehan said this is a good move and must continue to be done for detecting a possible new variant as all international travel has now been opened.

He however said that the wild card is that no one knows if a new variant coming from another country will create havoc around the world again. “If the virus mutates to a level which is defied to our current immunity if it is overcome we could have devastation. The more the number of people getting infected the more there is a chance for the virus to have the new mutation and if the new mutation is more lethal we don’t know,” he cautioned.

He praised the ‘Bhilwada Model’ in the early days of Covid-19 in India where the district administration closed the entire district to contain the virus and said through such a proactive reaction to early warning systems we can contain any new variant if it comes.

He iterated that the lull period right now with a low number of cases can be used to reinforce our early warning intelligence systems so that appropriate measures can be taken to contain if any new case comes up in real time.

Dr. Trehan also said that at Medanta, they have modeled a post-Covid recovery programme in which they do a full check-up to access the damage caused to the body and make a full programme to return to normal life. He advised a protein and vitamin-rich diet with good doses of anti-oxidants to reduce/maintain inflammation in the body and said that any inflammation of the heart must be communicated to the person.